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Parent-Rated Anxiety Symptoms in Children with Pervasive Developmental Disorders: Frequency and Association with Core Autism Symptoms and Cognitive Functioning

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Abstract

Background

In addition to the core symptoms, children with Pervasive Developmental Disorders (PDD) often exhibit other problem behaviors such as aggression, hyperactivity, and anxiety, which can contribute to overall impairment and, therefore, become the focus of clinical attention. Limited data are available on the prevalence of anxiety in these children. We examined frequency and correlates of parent-rated anxiety symptoms in a large sample of children with PDD.

Methods

The goals of this study were to examine the frequency and correlates of parent-rated anxiety symptoms in a sample of 171 medication-free children with PDD who participated in two NIH-funded medication trials. Twenty items of the Child and Adolescent Symptom Inventory (CASI) were used to measure anxiety.

Results

Forty three percent of the total sample met screening cut-off criteria for at least one anxiety disorder. Higher levels of anxiety on the 20-item CASI scale were associated with higher IQ, the presence of functional language use, and with higher levels of stereotyped behaviors. In children with higher IQ, anxiety was also associated with greater impairment in social reciprocity.

Conclusion

Anxiety is common in PDD and warrants consideration in clinical evaluation and treatment planning. This study suggests that parent ratings could be a useful source of information about anxiety symptoms in this population. Some anxiety symptoms such as phobic and social anxiety may be closer to core symptoms of PDD. Further efforts to validate tools to ascertain anxiety are needed, as are studies to empirically test approaches to treat anxiety in PDD.

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Abbreviations

ABC:

Aberrant Behavior Checklist

ADI-R:

Autism Diagnostic Interview-Revised

CASI:

Child and Adolescent Symptom Inventory

PDD:

Pervasive Developmental Disorders

RUPP:

Research Units on Pediatric Psychopharmacology

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Acknowledgements

From the Research Units on Pediatric Psychopharmacology Autism Network. Supported by contracts from the National Institute of Mental Health (N01MH70001, to Dr. McDougle; N01MH70009, to Dr. Scahill; N01MH80011, to Dr. Aman; and N01MH70010 and 1K24 MH01805 to Dr McCracken), General Clinical Research Center grants from the National Institutes of Health (M01 RR00750, to Indiana University; M01 RR06022, to Yale University; M01 RR00034, to Ohio State University; and M01 RR00052, to Johns Hopkins University), and the Korczak Foundation, Dr. Scahill.

The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the National Institute of Mental Health, the National Institutes of Health, or the Department of Health and Human Services.

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Authors and Affiliations

  1. The Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT, 06520, USA

    Denis G. Sukhodolsky & Lawrence Scahill

  2. The Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, NY, USA

    Kenneth D. Gadow

  3. The Nisonger Center, Ohio State University, Columbus, OH, USA

    L. Eugene Arnold, Michael G. Aman & Luc Lecavalier

  4. The Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA

    Christopher J. McDougle

  5. The Neuropsychiatric Institute, University of California, Los Angeles, CA, USA

    James T. McCracken

  6. The Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA

    Elaine Tierney

  7. The Virginia Treatment Center for Children, Virginia Commonwealth University, Richmond, VA, USA

    Susan Williams White

  8. The National Institute of Mental Health, Bethesda, MD, USA

    Benedetto Vitiello

Authors
  1. Denis G. Sukhodolsky
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  2. Lawrence Scahill
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  3. Kenneth D. Gadow
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  4. L. Eugene Arnold
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  5. Michael G. Aman
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  6. Christopher J. McDougle
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  7. James T. McCracken
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  8. Elaine Tierney
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  9. Susan Williams White
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  10. Luc Lecavalier
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  11. Benedetto Vitiello
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Correspondence to Denis G. Sukhodolsky.

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Sukhodolsky, D.G., Scahill, L., Gadow, K.D. et al. Parent-Rated Anxiety Symptoms in Children with Pervasive Developmental Disorders: Frequency and Association with Core Autism Symptoms and Cognitive Functioning. J Abnorm Child Psychol 36, 117–128 (2008). https://doi.org/10.1007/s10802-007-9165-9

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