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The Relationship Between Anxiety and Repetitive Behaviours in Autism Spectrum Disorder

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Rodgers, J., Glod, M., Connolly, B., McConachie, H.·2012·Journal of Autism and Developmental Disorders

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Abstract

Children with Autism Spectrum Disorder are vulnerable to anxiety. Repetitive behaviours are a core feature of Autism Spectrum Disorder (ASD) and have been associated anxiety. This study examined repetitive behaviours and anxiety in two groups of children with autism spectrum disorder, those with high anxiety and those with lower levels of anxiety. Children with high anxiety had more repetitive behaviours than those without anxiety. Within the anxiety sample, higher levels of insistence on sameness were associated with more anxiety. No association was found between sensory motor repetitive behaviours and anxiety in this group. In the non-anxious sample, anxiety was associated with sensory motor repetitive behaviours. These findings indicate a differential relationship for repetitive behaviours in relation to anxious and non-anxious children with ASD.

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Dissection of the relationship between anxiety and stereotyped self-grooming using the Shank3B mutant autistic model, acute stress model and chronic pain model
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“Many measures relied on parental recognition of behavioural symptoms of anxiety, which may be qualitatively different in children with ID, and hence not be detected by measures developed for use in neurotypical children (Rodgers et al., 2012).”
Background
Development of restricted and repetitive behaviors from 15 to 77 months: Stability of two distinct subtypes?
Uljarević, M., Arnott, B., Carrington, S. J., Meins, E., Fernyhough, C., McConachie, H., Couteur, A. S. L., & Leekam, S. (2017) · Developmental Psychology · doi:10.1037/dev0000324 · Cited by 62
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Autistic adults’ experience of restricted repetitive behaviours
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An investigation of anxiety in children and adolescents with autism spectrum disorder
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Mast Cells, Stress, Fear and Autism Spectrum Disorder
Theoharides, T. C., Kavalioti, M., & Tsilioni, I. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20153611 · Cited by 60
“ASD patients are prone to stress, and their level of anxiety was strongly correlated with repetitive behaviors [169].”
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Big Data Approach to Characterize Restricted and Repetitive Behaviors in Autism
Uljarević, M., Frazier, T. W., Jo, B., Billingham, W. D., Cooper, M. N., Youngstrom, E. A., Scahill, L., & Hardan, A. Y. (2022) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2021.08.006 · Cited by 53
Towards a Treatment for Intolerance of Uncertainty for Autistic Adults: A Single Case Experimental Design Study.
Rodgers, J., Herrema, R., Honey, E., & Freeston, M. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3550-9 · Cited by 51
“The concept resonates clinically with some of the core characteristics of ASD (Joyce et al. 2017; Rodgers et al. 2012; South and Rodgers 2017).”
BackgroundSelf-citation
Trait Anxiety Attenuates Response Inhibition: Evidence From an ERP Study Using the Go/NoGo Task
Xia, L., Mo, L., Wang, J., Zhang, W., & Zhang, D. (2020) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2020.00028 · Cited by 54
“Moreover, several evidences suggested that repetitive compulsive behaviors and trait anxiety are highly positive related (Black, 2008; Rodgers et al., 2012; Goodwin, 2015).”
Background
Collaborative Research Project: Developing and Testing a Robot-Assisted Intervention for Children With Autism
Kostrubiec, V., & Kruck, J. (2020) · Frontiers in Robotics and AI · doi:10.3389/frobt.2020.00037 · Cited by 53
Exploring the impact of adolescent cognitive inflexibility on emotional and behavioural problems experienced by autistic adults
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“Indeed, our findings show that RRBs were significantly associated with emotional symptoms in the same pattern as the more narrowly defined cognitive inflexibility points to an overlapping relationship, and is consistent with previous work on RRBs (Joyce et al., 2017; Rodgers et al., 2012).”
BackgroundResult
Thriving in Youth with Autism Spectrum Disorder and Intellectual Disability
Weiss, J. A., & Riosa, P. B. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2412-y · Cited by 49
“…with home participation may be related to the higher levels of restricted interests and behaviors (Gabriels et al. 2005; Matson et al. 2008; Rodgers et al. 2012), emotional and behavioral problems (Bodfish et al. 2000; Brereton et al. 2006), and parental stress and mental health problems…”
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Autism spectrum disorders and terrorism: how different features of autism can contextualise vulnerability and resilience
Al‐Attar, Z. (2020) · Journal of Forensic Psychiatry and Psychology · doi:10.1080/14789949.2020.1812695 · Cited by 55
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Sensory Sensitivity and Intolerance of Uncertainty Influence Anxiety in Autistic Adults
Normansell-Mossa, K. M., Top, D. N., Russell, N., Freeston, M., Rodgers, J., & South, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.731753 · Cited by 45
“sameness and reduced cognitive flexibility may likewise be associated with IU (Rodgers et al., 2012; South & Rodgers, 2017; Wigham et al., 2014).”
BackgroundSelf-citation
Prenatal and Early‐Life Exposure to High‐Level Diesel Exhaust Particles Leads to Increased Locomotor Activity and Repetitive Behaviors in Mice
Thirtamara Rajamani, K., Doherty‐Lyons, S., Bolden, C., Willis, D., Hoffman, C., Zelikoff, J., Chen, L., & Gu, H. (2013) · Autism Research · doi:10.1002/aur.1287 · Cited by 42
Putative Brain Networks Underlying Repetitive Negative Thinking and Comorbid Internalizing Problems in Autism
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Insistence on sameness relates to increased covariance of gray matter structure in autism spectrum disorder
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“Alternatively, IS, unlike lower-level repetitive sensory and motor behaviors, has been linked with anxiety in ASD [51].”
Background
The Mediating Effects of Alexithymia, Intolerance of Uncertainty, and Anxiety on the Relationship Between Sensory Processing Differences and Restricted and Repetitive Behaviours in Autistic Adults
Moore, H. L., Brice, S., Powell, L., Ingham, B., Freeston, M., Parr, J. R., & Rodgers, J. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05312-1 · Cited by 42
Self-citation
The coherence of autism
Hobson, R. P. (2013) · Autism · doi:10.1177/1362361313497538 · Cited by 49
“, 2010) arise from the absence of socially derived movements in thought and feeling, together with defensive channelling of motivation and interest according to what the individual can control and manage (also Baron-Cohen, 1989; Rodgers et al., 2012).”
Background
Intolerance of uncertainty and anxiety as explanatory frameworks for extreme demand avoidance in children and adolescents
Stuart, L., Grahame, V., Honey, E. J., & Freeston, M. H. (2019) · Child and Adolescent Mental Health · doi:10.1111/camh.12336 · Cited by 40
Sleep Problems and Trajectories of Restricted and Repetitive Behaviors in Children with Neurodevelopmental Disabilities
MacDuffie, K. E., MUNSON, J. A., Greenson, J., Ward, T. M., Rogers, S. J., Dawson, G., & Estes, A. M. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04438-y · Cited by 41
Assessment of Social Anxiety in Children and Adolescents With Autism Spectrum Disorder
Kreiser, N. L., & White, S. W. (2014) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12057 · Cited by 45
Don't ask me what's the matter, ask me what matters: Acute mental health facility experiences of people living with autism spectrum conditions
Maloret, P., & Scott, T. (2017) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12438 · Cited by 39
“Agitation, aggressive and self- harming responses can also be a marker and an alleviator of anxiety within ASC populations (Lidstone et al., 2014; Rodgers et al., 2012).”
BackgroundInfluential
Parent and professional perspectives on behavioral inflexibility in autism spectrum disorders: A qualitative study
Sethi, C., Harrop, C., Zhang, W., Pritchett, J., Whitten, A., & Boyd, B. A. (2018) · Autism · doi:10.1177/1362361318810217 · Cited by 39
“This finding was not surprising, as several studies have shown a link between insistence on sameness and anxiety (c.f.e. Joyce et al., 2017; Rodgers et al., 2012).”
Result
Factor Structure of Repetitive Behaviors Across Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
Brierley, N. J., McDonnell, C. G., Parks, K. M. A., Schulz, S. E., Dalal, T. C., Kelley, E. A., Anagnostou, E. A., Nicolson, R., Georgiades, S., Crosbie, J., et al. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04800-0 · Cited by 43
“Individuals with RRBs can often become anxious if their routines or rituals are interrupted (Rodgers et al. 2012), and the behaviors can often be socially inappropriate and can interfere with communication and learning (Rimmer et al.”
Background
Relationship between repetitive behaviour and fear across normative development, autism spectrum disorder, and down syndrome
Uljarević, M., & Evans, D. W. (2016) · Autism Research · doi:10.1002/aur.1674 · Cited by 42
“These findings also support previous work on the RIS-anxiety association in ASD [Lidstone, Uljarević, et al., 2014; Rodgers et al., 2012] and in DS [Evans & Gray, 2000; Evans et al., 2014].”
BackgroundResult
People with Autism Spectrum Disorder Could Interact More Easily with a Robot than with a Human: Reasons and Limits
Dubois-Sage, M., Jacquet, B., Jamet, F., & Baratgin, J. (2024) · Behavioral Sciences · doi:10.3390/bs14020131 · Cited by 41
“Given the link between stress and stereotyped behavior [80,81], Social Cognition Theory could explain why interaction with a robot minimizes the occurrence of stereotyped behavior if this result is confirmed by the scientific literature.”
BackgroundResultInfluential
Anxiety in Autism Spectrum Disorder
Uljarević, M., Nuske, H. J., & Vivanti, G. (2016) · Springer eBooks · doi:10.1007/978-3-319-29695-1_2 · Cited by 38
Anxiety in autistic individuals who speak few or no words: A qualitative study of parental experience and anxiety management
Tarver, J., Pearson, E., Edwards, G., Shirazi, A., Potter, L., Malhi, P., & Waite, J. (2020) · Autism · doi:10.1177/1362361320962366 · Cited by 39
“For example, increasing repetitive behaviours could be an indicator of anxiety (Rodgers et al., 2012).”
Background
The Effects of Deep Pressure Therapies and Antecedent Exercise on Stereotypical Behaviors of Students With Autism Spectrum Disorders
Losinski, M. L., Cook, K., Hirsch, S. E., & Sanders, S. (2017) · Behavioral Disorders · doi:10.1177/0198742917715873 · Cited by 41
Effect of Stress on Neuroimmune Processes
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Oxytocin treatment attenuates amygdala activity in autism: a treatment-mechanism study with long-term follow-up
Bernaerts, S., Boets, B., Steyaert, J. G., Wenderoth, N., & Alaerts, K. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-01069-w · Cited by 36
Psychophysiological arousal and auditory sensitivity in a cross-clinical sample of autistic and non-autistic anxious adults
Top Jr., D. N., Luke, S. G., Stephenson, K. G., & South, M. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00783 · Cited by 36
“These anxiety symptoms can cause significant additional distress, and have been linked to increased levels of problematic behavior (11, 12), difficulty with decision making (13), and considerable stress on family systems (14).”
Background
Unraveling the nature of autism: finding order amid change
Hellendoorn, A., Wijnroks, L., & Leseman, P. P. M. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00359 · Cited by 35
“Repetitive manipulation of objects may provide children with ASD with feelings of security and a sense of control of an unpredictable and highly variant environment, hence reduce feelings of anxiety or anger ( Leekam et al., 2011; Rodgers et al., 2012).”
Understanding the prevalence and manifestation of anxiety and other socio-emotional and behavioural difficulties in children with Developmental Language Disorder
Burnley, A., St Clair, M., Bedford, R., Wren, Y., & Dack, C. (2023) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-023-09486-w · Cited by 33
Oxytocin induces long-lasting adaptations within amygdala circuitry in autism: a treatment-mechanism study with randomized placebo-controlled design
Alaerts, K., Bernaerts, S., Prinsen, J., Dillen, C., Steyaert, J. G., & Wenderoth, N. (2020) · Neuropsychopharmacology · doi:10.1038/s41386-020-0653-8 · Cited by 36
Anxiety characteristics in individuals with Williams syndrome
Royston, R., Oliver, C., Howlin, P., & Waite, J. (2021) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12864 · Cited by 33
“This trigger could also be considered socially related, which is a surprising finding considering the low reported rates of social anxiety in Williams syndrome (Royston et al., 2017).”
BackgroundMethodResultInfluential
How is Anxiety Identified and Diagnosed in Individuals with Autism Spectrum Disorder and Intellectual Disability? A Scoping Review
Appleton, H. P., Roberts, J., & Simpson, K. (2019) · Journal of Mental Health Research in Intellectual Disabilities · doi:10.1080/19315864.2019.1679299 · Cited by 32
“This relationship has also been found by Rodgers et al. (2012) and Spiker et al. (2011), with Kerns et al. (2014) suggesting that the presence of a cooccurring disorder is likely to be exhibited through ASD symptom amplification rather than a separate set of behaviors.”
Background
Characterization and Prediction of Anxiety in Adolescents with Autism Spectrum Disorder: A Longitudinal Study
Ben‐Itzchak, E., Koller, J., & Zachor, D. A. (2020) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-020-00673-0 · Cited by 32

Authors: Rodgers, J., Glod, M., Connolly, B., & McConachie, H.
Affiliations: University of Newcastle Australia (AU)
Corresponding author: Rodgers, J.
ORCID: Rodgers, J.
Glod, M.
McConachie, H.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2012-04-17
Volume: 42
Issue: 11
Pages: 2404-2409
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1007/s10803-012-1531-y
OpenAlex: W2141257736
Cited by: 296
References: 35
Citations by year: 2026: 10 · 2025: 15 · 2024: 30 · 2023: 21 · 2022: 25 · 2021: 38 · 2020: 34 · 2019: 29 · 2018: 18 · 2017: 19 · 2016: 16 · 2015: 15 · 2014: 10 · 2013: 15 · 2012: 1
FWCI: 6.72
Type: journal article
Language: en
Open access: green
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Autism and Developmental Disorders (publishedVersion)
PubMed (publishedVersion)
Newcastle University ePrints (Newcastle Univesity)
Funders: National Institute for Health and Care Research (PB-PG-0408-16069)
National Institutes of Health
Research for Patient Benefit Programme
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords: autism spectrum disorder, anxiety, repetitive behavior, insistence on sameness, children, comorbidities
MeSH terms: Adolescent, Anxiety, Child, Child Development Disorders, Pervasive, Female, Humans, Intelligence, Male, Stereotyped Behavior

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The Relationship Between Anxiety and Repetitive Behaviours in Autism Spectrum Disorder

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