Identifying Mechanisms That Contribute Towards the Development of Social Anxiety in Autistic and Neurotypical Young People.

Background: Social anxiety is one of the most common and disabling mental health problems for autistic young people, which has a significant impact on school performance and opportunities to form important peer relationships. Despite the high prevalence rates seen in this population, very little is known about the cognitive, emotional and perceptual mechanisms underpinning the development of social anxiety in autistic adolescents. Further research focusing on understanding the profile of mechanisms that contribute towards social anxiety in autistic adolescents and how this may differ from neurotypical adolescents is imperative for understanding aetiology and informing effective disorder-specific interventions.

Objectives: Our project aims to explore the inter-relationships between mechanisms that may contribute towards feelings of social anxiety in autistic and neurotypical young people. The cognitive mechanisms that were explored include Theory of Mind, social insight and intolerance of uncertainty. Additional difficulties often experienced by autistic individuals, such as alexithymia, interoceptive processing, emotion regulation processes and sensory processing, were also explored. This project aims to answer two key research questions. Firstly, are the mechanisms underpinning social anxiety the same in young people with and without a diagnosis of autism? Secondly, are there some mechanisms related to social anxiety in autistic young people that are specific to these individuals?

Methods: We employed a mixed experimental design, with young people completing both cognitive tasks (e.g. IQ, Theory of Mind, interoceptive processing) and questionnaires (e.g. social anxiety, intolerance of uncertainty, social insight, alexithymia, emotion regulation, sensory processing). Parent-reported questionnaires were also completed (e.g. autistic traits, intolerance of uncertainty, emotional difficulties). In total, 61 autistic (42 boys, mean_age = 13.46) and 62 IQ-matched neurotypical (26 boys, mean_age = 13.52) young people took part in our research project. Questionnaire data from 119 parents was also collected.

Results: We have recently completed data collection for this project. Firstly, we observed no significant difference in social anxiety symptoms for autistic and neurotypical young people. Significant associations were observed between several mechanisms (e.g. intolerance of uncertainty, emotion regulation, sensory processing sensitivities, alexithymia) and social anxiety symptoms across the whole sample. As such, we plan to conduct further group-level analyses to investigate specific mechanisms associated with social anxiety symptoms for autistic and neurotypical young people. Analyses investigating group differences (e.g. ANOVA), in addition to correlational analyses and multiple linear regressions will be reported.

Conclusions: The present research will have important implications for understanding the mechanisms that contribute towards the development of social anxiety in autistic and neurotypical young people. Furthermore, this research has important clinical implications for prevention, early identification and subsequently informing the development and adaptation of interventions to improve the efficacy of treatments designed to target social anxiety in autistic young people.