Brief Report: Social Anxiety in Autism Spectrum Disorder is Based on Deficits in Social Competence

J Espelöer,K Vogeley,M Hellmich,C M Falter-Wagner

doi:10.1007/s10803-020-04529-w

J Espelöer, K Vogeley + Show 2 more

Open Access

https://doi.org/10.1007/s10803-020-04529-w

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Abstract

This study differentially examined the relation between two clinical constructs: “social anxiety” and “social competence” in autism spectrum disorder (ASD). Employing two questionnaires (SASKO; IU), individuals with ASD (n = 23) showed increased scores of SOCIAL ANXIETY (SASKO) and of INTOLERANCE OF UNCERTAINTY (IU), compared to a non-clinical comparison group (NC; n = 25). SOCIAL ANXIETY scores were equally increased for ASD and a reference population of individuals with social anxiety disorder (SAD; n = 68). However, results showed increased SOCIAL COMPETENCE DEFICITS in ASD compared to SAD and NC groups. This study allows drawing the conclusion that social anxiety symptoms in ASD can be traced back to autism-specific deficits in social skills and are therefore putatively based on different, substantially “deeper” implemented cognitive mechanisms.

Highlights

Deficits in social interactional skills represent core diagnostic impairments of autism spectrum disorder (ASD)
Some symptoms of ASD might be misinterpreted as social anxiety symptoms, which represents a challenge for differential diagnostics so that individuals with ASD diagnosed late in life might be prone to a misdiagnosis of social anxiety disorder (SAD) (Tebartz van Elst et al 2013)
The aim of the current study was to examine the characterization of social anxiety symptoms in ASD, that can be addressed by the appropriate subscales of SASKO anxiety of speaking and being in focus of attention (SPEAKING) and anxiety of being rejected by others (REJECTION), under special consideration of social competence deficits, including the SASKO subscales interaction deficits (INTERACTION) and deficits in processing social information (INFORMATION), in a group of high-functioning adults with ASD, adults with SAD, and a non-clinical (NC) comparison group

Summary

Introduction

Deficits in social interactional skills represent core diagnostic impairments of autism spectrum disorder (ASD). Some symptoms of ASD might be misinterpreted as social anxiety symptoms, which represents a challenge for differential diagnostics so that individuals with ASD diagnosed late in life might be prone to a misdiagnosis of SAD (Tebartz van Elst et al 2013). The reason for this misinterpretation might be that individuals with ASD diagnosed late in life often possess high cognitive skills and have had years of developing and refining cognitive learning processes to compensate for their fundamental deficits in social communication and interaction (Lehnhardt et al 2011, 2013). The high effort though that has to be invested for the compensation strategies can result in exhaustion, depression and social retreat, which in turn could resemble SAD (Cath et al 2008; Davis et al. Vol.:(0123456789)

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