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Traditional and Atypical Presentations of Anxiety in Youth with Autism Spectrum Disorder
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We assessed anxiety consistent (i.e., "traditional") and inconsistent (i.e., "atypical") with diagnostic and statistical manual (DSM) definitions in autism spectrum disorder (ASD). Differential relationships between traditional anxiety, atypical anxiety, child characteristics, anxiety predictors and ASD-symptomology were explored. Fifty-nine participants (7-17 years, M(age) = 10.48 years; IQ > 60) with ASD and parents completed semi-structured interviews, self- and parent-reports. Seventeen percent of youth presented with traditional anxiety, 15 % with atypical anxiety, and 31 % with both. Language ability, anxious cognitions and hypersensitivity predicted traditional anxiety, whereas traditional anxiety and ASD symptoms predicted atypical anxiety. Findings suggest youth with ASD express anxiety in ways similar and dissimilar to DSM definitions. Similarities support the presence of comorbid anxiety disorders in ASD. Whether dissimilarities are unique to ASD requires further examination.
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“Thus, instruments that are currently widely used in clinical settings to screen for anxiety disorders in the general adult population can probably be considered valid also for autistic adults, with the caveat that autism-specific presentations of anxiety may be missed”
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 Kerns et al., 2014
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“occurring in an estimated 50% of children [17]”
From Autistic Cognition: Charting Routes to Anxiety (2021) · cites this paper as [17]
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“Kerns et al. (2014) in a discussion of the differential diagnosis of anxiety disorders in autism report that fears associated with uncertainty may be an important mechanism in the development and maintenance of anxiety in ASD.”
From Towards a Treatment for Intolerance of Uncertainty in Young People with Autism Spectrum Disorder: Development of the Coping with Uncertainty in Everyday Situations (CUES©) Programme. (2017) · cites this paper as Kerns et al. (2014)
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“which may furthermore not be sensitive to autism-specific expressions of anxiety (Kerns et al., 2014)”
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 Kerns et al., 2014
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Perihan, C., Burke, M. D., Bowman-Perrott, L. J., & Gallup, J. L. (2019) · Springer eBooks · doi:10.1007/978-1-4614-6435-8_102461-1 · Cited by 2
Mood Alternations on the Autistic Spectrum
Sáez‐Suanes, G. P. (2024) · Springer eBooks · doi:10.1007/978-3-031-40858-8_5-1 · Cited by 2
Roberts-Davis, R. J., Happé, F. G., & Lau-Zhu, A. (2026) · Autism · doi:10.1177/13623613261455375 · Cited by 1
“Participants were recruited if they identified as having anxiety problems, rather than requiring a clinical diagnosis, to allow for participants who experience anxiety outside of traditional criteria (Kerns et al., 2014).”
Schwartzman, J. M., Antezana, L., & Conner, C. M. (2024) · Autism Research · doi:10.1002/aur.3208 · Cited by 1
“…based anxiety symptoms (rather than avoidance or other behavioral manifestations) and as anxiety may present differently in autistic adolescents (Kerns et al., 2014), it will be important for future work to examine these relationships with autism-sensitive measures of anxiety (i.e., Scahill et…”
Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa
Sánchez-Cueva, M. S., Alcantud Marín, F., & Alonso-Esteban, Y. (2022) · Siglo Cero: Revista Española sobre Discapacidad Intelectual · doi:10.14201/scero2022534930 · Cited by 1
“También existen descripciones de una serie de miedos y preocupaciones atípicas que, aunque son comunes y clínicamente impactantes en el autismo, no encajan en los marcos de diagnóstico convencionales (Kerns y Kendall, 2012; Kerns et al., 2014; Mayes et al., 2013).”
BackgroundAnxiety-Related Problems in Developmental Disabilities
McNeel, M. M., Jellinek, E. R., & Storch, E. A. (2022) · Springer eBooks · doi:10.1007/978-3-031-14080-8_26 · Cited by 1
Rinaldo, E., & Perry, A. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102246 · Cited by 1
Assessment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Ledet, C., & Hansen, M. (2023) · Autism and child psychopathology series · doi:10.1007/978-3-031-41709-2_18 · Cited by 1
Trends in research related to anxiety disorders on the autism spectrum: a bibliometric study
Uribe-Bahamonde, Y. E., Fernández-Blanco, A., Spencer, R., & González, O. H. (2024) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2023.2283649 · Cited by 2
Durán-Bouza, M., Gómez-Ríos, S., Cañadas, M., & Brenlla-Blanco, J.-C. (2025) · PLoS ONE · doi:10.1371/journal.pone.0318408 · Cited by 1
Caregiver Satisfaction with Anxiety Treatment for Autistic Youth: A Mixed Methods Examination
Norris, L. A., Rabner, J. C., Marklin, M., Crane, M. E., Renschler, K., Jenkins, E., Kemp, J. J., Storch, E. A., Wood, J. J., Kerns, C. M., et al. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-06725-y · Cited by 1
Self-citationGutiérrez, B., Hudson, B. O., So, F. K., & Conn, B. M. (2025) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2025.05.003 · Cited by 1
Metadata
- Authors
- Kerns, C. M., Kendall, P. C., Berry, L., Souders, M. C., Franklin, M. E., Schultz, R. T., Miller, J., & Herrington, J.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Temple University (US)
- University of Pennsylvania (US)
- Corresponding author
- Kerns, Connor Morrow
- ORCID
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2014-06-06
- Volume
- 44
- Issue
- 11
- Pages
- 2851-2861
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- PMC
- PMC5441227
- OpenAlex
- W2073231072
- Cited by
- 405
- References
- 55
- Citations by year
- 2026: 24 · 2025: 40 · 2024: 36 · 2023: 33 · 2022: 42 · 2021: 49 · 2020: 40 · 2019: 40 · 2018: 34 · 2017: 36 · 2016: 19 · 2015: 9 · 2014: 3
- FWCI
- 12.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH086438, RC1MH088791, R01MH059087, MH063747, R01MH063747, MH086438, RC1 MH08879, U01MH063747)
- 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, DSM diagnostic criteria, comorbid anxiety disorders, sensory hypersensitivity, language skills, youth
- MeSH terms
- Adolescent, Anxiety, Anxiety Disorders, Child, Child Development Disorders, Pervasive, Cognition, Female, Humans, Male, Parents, Diagnostic and Statistical Manual of Mental Disorders, Symptom Assessment
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