Connor Kerns

Social impairment, including deficits in social ability and poorer quality peer relationships, is elevated among children with ASD and anxiety disorders, and may influence the presentation of anxiety symptoms experienced by these children, particularly social anxiety. Most research to date has investigated this topic using only single-informant, broad measures of social functioning, limiting our understanding of how different aspects of social functioning relate to one another and to anxiety in this population. The current study sought to extend prior work by using a novel network analytic approach to examine how different facets of social ability (e.g., social communication, social motivation) and peer relationships (e.g., friendships, bullying) relate to one another and to anxiety severity and comorbidity in a large treatment-seeking sample of children with ASD and anxiety disorders. Additionally, this study sought to clarify the role of social functioning in the presentation of social and non-social anxiety symptoms in children with ASD. A sample of 200 children with ASD and anxiety disorders and their caregivers completed a clinical interview and a multi-informant battery of standard and clinically-informed measures of social functioning. The network analysis demonstrated strong connections among the core social deficits of ASD (i.e., social motivation, social communication), and among measures of social integration (i.e., conflict with peers, bullying), though there was little overlap between these two communities. Theory of Mind (ToM), or the ability to understand the thoughts and feelings of others, was positively associated with nearly every measure of social ability and peer relationships in the network, suggesting that this social-cognitive skill may play a central role in the social well-being of children with ASD and comorbid anxiety. ToM also appeared to play a role in the presentation of anxiety symptoms, whereby greater ToM impairment was associated with a distinct presentation of social anxiety (i.e., social fears without fear of negative evaluation). Findings suggest that difficulties in one area of social ability or peer relationships may be associated with difficulties in other, related areas of social functioning—particularly ToM, which may represent an optimal target for psychosocial treatments for children with ASD and anxiety disorders.

View record