Briot Kellen, Jean François, Jouni Ali, Geoffray Marie-Maude, Ly-Le Moal Myriam, Umbricht Daniel, Chatham Christopher, Murtagh Lorraine, Delorme Richard, Bouvard Manuel, Leboyer Marion, Amestoy Anouck
University of Bordeaux, Medical Sciences Department, Bordeaux, France.
Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France.
Front Psychiatry. 2020 Jul 24;11:710. doi: 10.3389/fpsyt.2020.00710. eCollection 2020.
Recognition of symptoms of Social anxiety (SA) may be difficult among individuals with Autism Spectrum Disorders (ASD) because of overlap between social anxiety and autistic symptomatology. The main aim of our study was thus to explore the association between symptoms of social anxiety and clinical characteristics of ASD in order to identify individuals experiencing concomitant ASD and social anxiety disorder. We also described the prevalence of SA in a sample of children and adolescents with ASD.
79 children and adolescents with ASD (with and without intellectual disability) and 28-matched control participants were recruited in two French Expert Centers for ASD, coordinated by the Fundation FondaMental. Psychiatric comorbidities, anxiety disorders and depression were screened with standard tools (Liebowitz social anxiety scale, Hamilton Depression and Anxiety Rating Scale) and correlated to autistic features and social skills assessed with the social responsiveness scale 2 (SRS-2) and the repetitive behavior scale (RBS-R). We performed bivariate analysis between the social anxiety level and the scores measured with different clinical scales. We then adjusted the observed relationships with the alterations of SRS-2 and RBS-R scores.
After adjustment, the level of social anxiety appeared as significantly associated with alterations in social reciprocity and particularly with the SRS-2 "social communication" and "social motivation" sub-scores, but not with RBS-R score.
We confirm previous reports showing that individuals with ASD are at high risk for specific anxiety disorders. In particular, high levels of impairments in social motivation and social communication (SRS-2) are indicative of comorbid disorders namely, social anxiety and ASD. Our findings clearly inform diagnostic assessment in ASD and stress the need to take comorbid anxiety disorders into consideration to improve treatment of ASD. To further clarify the impact of social anxiety on social competences and socio-adaptive handicap, longitudinal studies and cluster analysis will be needed in the future.
由于社交焦虑与自闭症症状存在重叠，在自闭症谱系障碍（ASD）患者中识别社交焦虑（SA）症状可能较为困难。因此，我们研究的主要目的是探讨社交焦虑症状与ASD临床特征之间的关联，以确定同时患有ASD和社交焦虑障碍的个体。我们还描述了ASD儿童和青少年样本中SA的患病率。
在由FondaMental基金会协调的两个法国ASD专家中心，招募了79名患有ASD的儿童和青少年（有或无智力障碍）以及28名匹配的对照参与者。使用标准工具（利博维茨社交焦虑量表、汉密尔顿抑郁和焦虑评定量表）筛查精神共病、焦虑障碍和抑郁症，并将其与通过社交反应量表2（SRS - 2）和重复行为量表（RBS - R）评估的自闭症特征和社交技能相关联。我们对社交焦虑水平与不同临床量表测得的分数进行了双变量分析。然后，我们根据SRS - 2和RBS - R分数的变化对观察到的关系进行了调整。
调整后，社交焦虑水平与社交互动的改变显著相关，特别是与SRS - 2的“社交沟通”和“社交动机”子分数相关，但与RBS - R分数无关。
我们证实了之前的报告，即ASD患者患特定焦虑障碍的风险很高。特别是，社交动机和社交沟通（SRS - 2）的高水平损害表明存在共病，即社交焦虑和ASD。我们的研究结果为ASD的诊断评估提供了明确信息，并强调需要考虑共病焦虑障碍以改善ASD的治疗。为了进一步阐明社交焦虑对社交能力和社会适应障碍的影响，未来需要进行纵向研究和聚类分析。
