Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
Yulius Mental Health, Dordrecht, The Netherlands.
J Child Psychol Psychiatry. 2018 Mar;59(3):277-284. doi: 10.1111/jcpp.12829. Epub 2017 Oct 27.
Although a bidirectional relationship between autism spectrum disorder (ASD) and anxiety symptoms is assumed, few studies have investigated this. Moreover, little is known about potential differential relationships of the two core symptom domains of ASD - social communication impairment and restricted, repetitive behavior - with anxiety over time.
Participants were 130 children with an ASD (M age 6.7 years, 81.5% boys) of whom 79 participated in a follow-up assessment 2 years later. We used cross-lagged models to test whether social communication impairment and restricted, repetitive behavior at T0 predicted anxiety at T2 and vice versa.
Crossed-lagged models showed that anxiety symptoms predicted social communication impairment over time (β = .22, p = .008), but not vice versa (β = -.07, p = .49). There were no significant paths from anxiety symptoms to later restricted, repetitive behavior (β = .11, p = .34) or vice versa (β = -.11, p = .27).
Our results do not support a bidirectional relationship between the ASD core symptom domains and anxiety, but suggest that higher levels of anxiety symptoms increase the risk of more social communication impairment over time in children with ASD. This underlines the importance of treating anxiety symptoms to improve both social and emotional functioning.
尽管自闭症谱系障碍（ASD）和焦虑症状之间存在双向关系，但很少有研究对此进行调查。此外，对于 ASD 的两个核心症状领域——社交沟通障碍和受限、重复行为——与焦虑随时间的潜在差异关系，人们知之甚少。
参与者为 130 名患有 ASD 的儿童（M 年龄 6.7 岁，81.5%为男孩），其中 79 名儿童在 2 年后参加了随访评估。我们使用交叉滞后模型来测试 T0 时的社交沟通障碍和受限、重复行为是否预测 T2 时的焦虑，反之亦然。
交叉滞后模型显示，焦虑症状随时间预测社交沟通障碍（β=.22，p=.008），反之则不然（β=-.07，p=.49）。焦虑症状与后来的受限、重复行为之间没有显著的路径（β=.11，p=.34），反之亦然（β=-.11，p=.27）。
我们的结果不支持 ASD 核心症状领域和焦虑之间的双向关系，但表明更高水平的焦虑症状会增加 ASD 儿童随时间推移出现更多社交沟通障碍的风险。这强调了治疗焦虑症状以改善社交和情感功能的重要性。
