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Social anxiety in autism spectrum disorder: A systematic review
Open accessAbstract
Social anxiety (SA) commonly co-occurs with autism spectrum disorders (ASD). It is conceivable that inherent socio-communication impairments, or their impact on social experiences, contribute to the development of SA. We undertook a systematic review to summarise English-language research about relationships between core ASD symptoms and SA in individuals with ASD. We searched five databases for studies published up until 28 July 2017. Of 1481 publications retrieved, 24 cross-sectional studies (described in 25 papers) met the inclusion criteria. Given methodological and clinical heterogeneity, data were synthesised narratively. SA, in individuals with ASD, was associated with poorer social skills and functioning, and reduced social motivation. There were associations between self-report SA and ASD measures, but a trend towards non-significant relationships between parent-ratings of these symptoms. Tentative evidence indicated that SA symptoms were not associated with restricted, repetitive behaviours or sensory sensitivities. These findings support the notion that there are links between core ASD characteristics and SA. Further studies, employing qualitative and quantitative designs are needed to enhance understanding of causal, maintaining and protective mechanisms for SA in ASD.
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“Anxiety in social situations (Spain et al., 2018) and phobias/situation specific anxiety (Lever & Geurts, 2016) are particularly common for autistic people”
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Metadata
- Authors
- Spain, D., Sin, J., Linder, K. B., McMahon, J., & Happé, F.
- Affiliations
- King's College London (GB)
- St George's, University of London (GB)
- Australian National University (AU)
- Corresponding author
- Spain, Debbie
- Venue
- Research in Autism Spectrum Disorders
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 52
- Pages
- 51-68
- ISSN
- 1878-0237 (ISSN-L)
- 1750-9467
- OpenAlex
- W2803156436
- Cited by
- 302
- References
- 73
- Citations by year
- 2026: 41 · 2025: 53 · 2024: 46 · 2023: 35 · 2022: 38 · 2021: 45 · 2020: 28 · 2019: 14 · 2018: 2
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Research in Autism (publishedVersion, cc-by)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- City Research Online (City University London) (acceptedVersion)
- CentAUR (University of Reading) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (CDRF-2012-03-059)
- Department of Health and Social Care
- King's College London
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- social anxiety, autism spectrum disorder, comorbidities, social skills, social motivation, restricted and repetitive behaviors, sensory sensitivity, parent ratings, self-report measures
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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