The DOI matches its Crossref record; 102 of the 104 references it cites were found in a registry or an index.
Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis
Open accessAbstract
There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic review of the literature identified 31 studies involving 2,121 young people (aged <18 years) with ASD, and where the presence of anxiety disorder was assessed using standardized questionnaires or diagnostic interviews. Across studies, 39.6% of young people with ASD had at least one comorbid DSM-IV anxiety disorder, the most frequent being specific phobia (29.8%) followed by OCD (17.4%) and social anxiety disorder (16.6%). Associations were found between the specific anxiety disorders and ASD subtype, age, IQ, and assessment method (questionnaire versus interview). Implications for the identification and treatment of anxiety in young people with ASD are discussed.
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“Specific phobia (29%), obsessive–compulsive disorder (OCD) (17.4%), and social anxiety disorder (16.6%) were the three most commonly observed anxiety disorders in ASD youth [94].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [94]
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“Approximately 20% of children under 6 years and 40% of children ages 6 to 18 years with ASD have one or more anxiety disorders [45, 47].”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [45]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Although prevalence estimates vary across studies, the current consensus is that 40%–50% of autistic individuals meet formal criteria for a co-occurring anxiety disorder (Buck et al., 2014; Van Steensel et al., 2011)”
From Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools. (2020) · cites this paper as Van Steensel et al., 2011
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Like ADHD, these other diagnoses are now recognized to occur commonly in individuals with ASD, including lifetime estimates for depression as high as 25% (Leyfer et al. 2006) and anxiety as high as 35% (van Steensel et al. 2011).”
From Recent Advances in Autism Research as Reflected in DSM-5 Criteria for Autism Spectrum Disorder (2015) · cites this paper as van Steensel et al. 2011
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“According to a meta-analysis, 39.6% of youth with ASD have at least one co-occurring anxiety disorder based on the DSM-IV criteria [71, 94].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [94]
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Citations
Cites
Tabachnick, B. G., & Fidell, L. S. (1983) · Cited by 79,882
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · cited 2×
“Publication bias is typically assessed via visual inspection of funnel plots (Munafò et al. 2004), tests of funnel plot asymmetry (Egger et al. 1997), or rank correlation methods (Begg and Mazumdar 1994).”
MethodOperating characteristics of a rank correlation test for publication bias
Begg, C. B., & Mazumdar, M. (1994) · Biometrics · doi:10.2307/2533446 · Cited by 16,955 · cited 2×
“Publication bias is typically assessed via visual inspection of funnel plots (Munafò et al. 2004), tests of funnel plot asymmetry (Egger et al. 1997), or rank correlation methods (Begg and Mazumdar 1994).”
Method(2000) · Cited by 9,198
Lord, C., Rutter, M., & Le Couteur, A. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172145 · Cited by 9,065 · cited 1×
“To our knowledge, this is the first meta-analysis of anxiety disorders in young people with ASD and the first to evaluate factors influencing the observed heterogeneity for rates of anxiety reported in the literature.”
BackgroundLord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1005592401947 · Cited by 7,520 · cited 4×
“The interrater reliability, internal consistency, and test–retest reliability as well as diagnostic validity of the ADOS-G were found excellent (Lord et al. 2000).”
BackgroundMethodInfluentialAchenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987) · Psychological Bulletin · doi:10.1037/0033-2909.101.2.213 · Cited by 5,436 · cited 2×
“It is widely known that parents tend to underestimate the frequency of internalizing symptoms in their own children (e.g., Muris et al. 1999; Cosi et al.2010) and that child‐parent agreement for internalizing problems is generally lower compared with the child‐parent agreement of externalizing problems (e.g., Achenbac…”
ResultDiagnostic and Statistical Manual of Mental Disorders ( DSM ‐ IV ‐ TR )
Segal, D. L. (2010) · Wiley eBooks · doi:10.1002/9780470479216.corpsy0271 · Cited by 4,687
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e318179964f · Cited by 3,399 · cited 4×
“2008) or training interviewers to distinguish anxiety from ASD (Simonoff et al. 2008).”
BackgroundInfluentialFixed-and random-effects models in meta-analysis.
Hedges, L. V., & Vevea, J. L. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.4.486 · Cited by 2,977 · cited 1×
“These results should therefore be interpreted with caution as effects found in the fixed effect model only allow for inferences based on the studies included in the meta-analysis and limits the generalizability to other (future) studies (see Hedges and Vevea 1998 for a detailed discussion).”
Result
Research works printed but not linked: 5
- Achenbach, T. M. (1991). Manual for the child behavioral checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.
- Beidel, D. C., Turner, S. M., & Morris, T. L. (1998). Social Phobia and anxiety inventory for children (SPAI-C). User’s manual, North Tonawanda, NY: Multi-Health Systems Inc.
- Matson, J. L., Boisjoli, J., & Wilkins, J. (2007). The Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). Baton Rouge, LA: Disability Consultants, LLC.
- Matson, J. L., & González, M. L. (2007). Autism Spectrum Disorders–Comorbidity–Child Version. Baton Rouge, LA: Disability Consultants, LLC.
- Reynolds, C. R., & Richmond, B. O. (1985). Revised children’s manifest anxiety scale manual. Los Angeles: Western Psychological Services.
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Items 1,001–1,002 of 1,002
Byrne, G., Vickers, L., Ni Longphuirt, E., & Cunningham, R. (2022) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/10883576221121280 · Cited by 2
“Estimates indicate that 40% of children with autism meet diagnostic criteria for at least one anxiety disorder (van Steensel et al., 2011).”
BackgroundZentner, K. E., Dueck, B. S., Le, J., & Lee, H. (2025) · Journal of Mental Health Counseling · doi:10.17744/mehc.47.3.02
Metadata
- Authors
- van Steensel, F. J. A., Bögels, S. M., & Perrin, S.
- Affiliations
- University of Amsterdam (NL)
- King's College London (GB)
- Venue
- Clinical Child and Family Psychology Review
- Published
- 2011-07-07
- Volume
- 14
- Issue
- 3
- Pages
- 302-317
- ISSN
- 1096-4037 (ISSN-L)
- 1573-2827
- PMC
- PMC3162631
- OpenAlex
- W2138006810
- Cited by
- 1,463
- References
- 104
- Citations by year
- 2026: 147 · 2025: 105 · 2024: 94 · 2023: 109 · 2022: 134 · 2021: 137 · 2020: 138 · 2019: 112 · 2018: 107 · 2017: 94 · 2016: 83 · 2015: 70 · 2014: 59 · 2013: 52 · 2012: 21
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Clinical Child and Family Psychology Review (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, anxiety disorders, comorbidities, children and adolescents, specific phobia, obsessive-compulsive disorder, social anxiety disorder, ASD subtypes, IQ
- MeSH terms
- Adolescent, Anxiety Disorders, Child, Child Development Disorders, Pervasive, Child, Preschool, Humans, Intelligence, Obsessive-Compulsive Disorder, Phobic Disorders, Comorbidity, Prevalence, Databases, Bibliographic
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