Parent-rated anxiety in autistic adolescents and young adults: Concurrent links to autism traits and chronic sleep problems

Abstract

BackgroundAnxiety is prevalent among autistic individuals, but less is known about the different anxiety problems autistic adolescents and young adults experience and the main behavioral manifestations of their anxiety. This study investigated these issues and the relation between the overall level of anxiety and a range of factors in autistic adolescents and young adults, including autism traits, challenging behaviors, adaptive behavior, sleep problems, and gastrointestinal issues. Method66 parents of autistic adolescents and young adults completed an interview and responded to questionnaires on their children’s anxiety, autism traits, sensory processing, challenging behaviors, adaptive behavior, and medical issues. ResultsThe most frequently parent-endorsed moderate and severe anxiety problems were related to social situations, new situations, upcoming events, loud noises, and changes in routine. In contrast, parents were least likely to endorse anxiety problems related to being separated from others, being noticed, or being late. Regarding anxiety-related behaviors, parents frequently endorsed avoidance, requiring constant reassurance, performing repetitive behaviors, shutting down, and overreacting to changes. Individuals with more severe social cognition difficulties, restricted and repetitive behaviors (RRBs), and chronic sleep problems demonstrated elevated levels of anxiety. Chronic sleep problems emerged as the primary concurrent predictor of anxiety in autistic adolescents and young adults and mediated the association between RRBs and anxiety. ConclusionsFuture anxiety treatment should consider targeting sleep problems simultaneously for autistic adolescents and young adults.