Cited by 408Autism Spectrum Disorder ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional Development

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Exploring the nature and function of anxiety in youth with autism spectrum disorders.

Wood, Jeffrey J., Gadow, Kenneth D.·2010·Clinical Psychology: Science and Practice

DOI 10.1111/j.1468-2850.2010.01220.x

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Abstract

[Clin Psychol Sci Prac 17: 281–292, 2010] This article considers the nosology and pathogenesis of anxiety disorders in youth with autism. The comparability of anxiety in the autism spectrum disorder (ASD) population in relation to the typically developing population has been suggested by some recent findings, but conceptual and empirical ambiguities remain. It is suggested that anxiety may play at least three roles: (a) a downstream consequence of ASD symptoms (e.g., via stress generation through social rejection); (b) a moderator of ASD symptom severity, such that certain core autism symptoms like social skill deficits and repetitive behaviors may be exacerbated by anxiety; and (c) as a proxy of core ASD symptoms. Suggestions for clarifying the nature and function of anxiety in autism are made.

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Anxiety Symptoms Predict Subsequent Depressive Symptoms in Neurodivergent Youth: A 10-Year Longitudinal Study
Orm, S., Wood, J. J., Fossum, I. N., Adams, K., Andersen, P. N., Fjermestad, K. W., Øie, M. G., & Skogli, E. W. (2025) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-025-01292-3 · Cited by 8
“Wood and Gadow ( 2010) proposed that core autism features such as social cognitive difficulties, repetitive behav - iors, and sensory sensitivities can lead to aversive everyday youth as well as those diagnosed with ADHD allows for the inclusion of a relatively large sample of youth with highly…”
InfluentialSelf-citation
Estudiantes universitarios con trastornos del espectro del autismo: revisión de sus necesidades y notas para su atención
Alcantud-Marín, F., & Alonso-Esteban, Y. (2021) · Siglo Cero: Revista Española sobre Discapacidad Intelectual · doi:10.14201/scero202152283100 · Cited by 6
Factors associated with mental health symptoms among UK autistic children and young people and their parents during the COVID-19 pandemic
Palmer, M. L., Chandler, S., Leno, V. C., Mgaieth, F., Yorke, I., Hollocks, M. J., Pickles, A. R., Slonims, V., Scott, S., Charman, T., et al. (2023) · Autism · doi:10.1177/13623613231153694 · Cited by 8
“…processing, emotional insight and difficulties with goal-directed behaviour, may further reduce autistic CYP’s adaptive strategies during times of change/uncertainty and in turn lead to a trauma-type response (Mazefsky et al., 2013; Wood & Gadow, 2010), manifested by mental health symptoms.”
Background
Comparing psychopathology rates across autism spectrum disorders and intellectual disabilities
Matthews, M., Bell, E. M., & Mirfin‐Veitch, B. F. (2018) · Advances in Mental Health and Intellectual Disabilities · doi:10.1108/amhid-04-2018-0023 · Cited by 7
Anxiety and Interpretation of Ambiguity in Autistic Children, Typical Children and Their Mothers
Neil, L., White, H., Warren, K., & Pellicano, E. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3781-9 · Cited by 11
A Case Study of Parent-Child Interaction Therapy for a Young Child with Autism Spectrum Disorder: Behavioral and Developmental Considerations
Papadopoulos, D. (2020) · Psychology · doi:10.4236/psych.2020.116058 · Cited by 7
“Problems associated with ASD include lifelong care and education costs related to high rates comorbidity and stress throughout development (Wood & Gadow, 2010).”
Background
Bridging the gap: unveiling key links between autism and anxiety symptoms in autistic children and youth using a network analysis in pooled data from four countries
Zaidman‐Zait, A., Hollocks, M. J., Kerns, C. M., Magiati, I., McVey, A. J., Smith, I. M., Bedford, R., Bennett, T. A., Duku, E., Georgiades, S., et al. (2025) · Child and Adolescent Mental Health · doi:10.1111/camh.70026 · Cited by 7
Brief Report: Prevalence and Predictors of DSM-Specific and Distinct Anxiety in Cognitively Impaired Autistic Preschool Children
Klein, J., Kerns, C. M., Hills, K. J., Hogan, A. L., Matherly, S., & Roberts, J. E. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-05978-9 · Cited by 6
“Comorbid symptoms of anxiety result in more severe impairments that reduce quality of life and impact functioning in autistic individuals (Lever & Geurts, 2016; Matson & Cervantes, 2014; Wood & Gadow, 2010).”
Cognitive behaviour therapies for youth with autism spectrum disorders
Wood, J. J., & Schwartzman, B. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139344456.019 · Cited by 6
Self-citation
A Comparison of Self-vs Parent Reports of Generalised Anxiety Disorder Symptomatology Across Six Age Groups for Boys with an ASD
Bitsika, V., & Sharpley, C. F. (2014) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-014-9413-1 · Cited by 6
Infant Effortful Control Mediates Relations Between Nondirective Parenting and Internalising-Related Child Behaviours in an Autism-Enriched Infant Cohort
Smith, C. G., Jones, E. J. H., Wass, S. V., Pasco, G., Johnson, M. H., Charman, T., Wan, M. W., The BASIS Team, Baron‐Cohen, S., Blasi, A., et al. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05219-x · Cited by 9
“…and ASD, with varying interpretations available: (a) internalising constitutes a part of ASD; (b) ASD symptoms cause internalising disorders, or (c) internalising disorders and ASD are phenotypically distinct but overlap with regard to early risk factors (Kerns & Kendall, 2012; Wood & Gadow, 2010).”
Background
A comparison of the content and nature of worries of autistic and neurotypical young people as they transition from school
Waldman, J., McPaul, A., & Jahoda, A. J. (2022) · Autism · doi:10.1177/13623613221111313 · Cited by 10
“Estimates show that the most common anxiety disorders among autistic children and adolescents are obsessive-compulsive disorder (OCD) (17%−37%), specific phobias (30%−44%), GAD (15%−35%), Separation Anxiety Disorder (9%−38”
Background
Associations between early trajectories of amygdala development and later school-age anxiety in two longitudinal samples
Burrows, C. A., Lasch, C., Gross, J., Girault, J. B., Rutsohn, J., Wolff, J. J., Swanson, M. R., Lee, C.-M., Dager, S. R., Cornea, E. A., et al. (2023) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2023.101333 · Cited by 7
“…anxiety and ASD symptoms has been notoriously difficult, and researchers have grappled with the question of whether anxiety truly ‘co-occurs ’ with ASD, or whether behaviors traditionally interpreted as anxiety are instead a manifestation of ASD (Kerns and Kendall, 2012; Wood and Gadow, 2010).”
Background
Caregiver and Youth Inter-Rater Assessment Agreement in Autism Spectrum Disorder, Developmental Coordination Disorder, and Typical Development
Shipkova, M., Butera, C., Flores, G. D., Kilroy, E., Jayashankar, A., Harrison, L. A., Cermak, S. A., & Aziz-Zadeh, L. (2024) · Autism Research · doi:10.1002/aur.3110 · Cited by 7
“Moreover, prior work posits that difficulties in differentiating anxiety and ASD symptoms (Wood & Gadow, 2010) and increased parental anxiety may augment parents ’ perceptions of clinical anxiety in their child (Lebowitz et al., 2016), which may drive some of these between-study differences.”
Background
Cannabis and cannabidiol use among autistic and non-autistic adults in the UK: a propensity score-matched analysis
Hua, D. Y.-H., Lees, R., Brosnan, M., & Freeman, T. P. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-053814 · Cited by 6
Cognitive-behavioral therapy for children with autism and anxiety
Johnson, A. R., Wolpe, S., Tien, I. S., Muscatello, V. S., & Wood, J. J. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85757-4.00007-9 · Cited by 6
Self-citation
Mindfulness and Autism Spectrum Disorder
Cachia, R. L. (2017) · InTech eBooks · doi:10.5772/65394 · Cited by 6
“Similar to the role of anxiety in adults as described by Kanner [1] and Gillott and Standen [16], Wood and Gadow [19] suggest that anxiety may play three roles for adolescents with ASD: (1) a downstream consequence of ASD symptoms (e.g., via stress generation through social rejection), (2) a moderator of ASD symptom s…”
Repetitive behaviours, anxiety and sensory problems in children with autism and correlates of anxiety in their parents
Uljarević, M. (2013) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 6
Coocurrencia entre ansiedad y autismo. Las hipótesis del error social y de la carga alostática
Pérez, I. P. (2013) · Revista de Neurología · doi:10.33588/rn.56s01.2012652 · Cited by 9
“Por ello se hace complicado determinar si la coocurrencia de ansiedad y autismo representa [11]: – Una comorbilidad ‘real’, donde la condición comórbida –la ansiedad– es fenotípica y etiológicamente idéntica a lo que supondría dicha ansiedad en personas con un desarrollo neurotípico.”
Background
Cognitive Behavioral Therapy (CBT) and ASD
Perihan, C., Burke, M. D., Bowman-Perrott, L. J., & Gallup, J. L. (2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_102461 · Cited by 6
Association Between Autism and PTSD Among Adult Psychiatric Outpatients
Agebjörn, J., Gillberg, C., Eberhard, J., Billstedt, E., & Nyrenius, J. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06439-7 · Cited by 7
“Individuals with ASD have found to have poorer coping strategies during and after traumatic events (Hirvikoski & Blomqvist, 2014), such as social isolation (Wood & Gadow, 2010).”
Effects of Medical Cannabis Treatment for Autistic Children on Anxiety and Restricted and Repetitive Behaviors and Interests: An Open-Label Study
David, A., Stolar, O. E., Berkovitch, M., Kohn, E., Hazan, A., Waissengreen, D., & Gal, E. (2024) · Cannabis and Cannabinoid Research · doi:10.1089/can.2024.0001 · Cited by 5
“20 Ben-Sasson and Stephenson 21 offered three possible explanations for co-occurring anxiety and RRBI symptoms and their relationship in ASD: RRBI are a response to anxiety, anxiety results from RRBI, and neurobiological mechanisms (e.g., greater amygdala activation or oxytocin) and common…”
Investigating associations between cognitive empathy, affective empathy and anxiety in adolescents with autism spectrum disorder
Sönmez, D., & Jordan, T. R. (2023) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2022.2163605 · Cited by 6
“Individuals with ASD have various ASD related stressors (Wood and Gadow 2010), such as bullying, peer rejection, repetitive behaviours, and impairments in empathy, executive functions, language, and social communication skills (Acker et al. 2018, Bellini 2006, Church et al. 2000, Czermainski et al.…”
Influential
The History of Comorbidity in Autism Spectrum Disorders (ASD)
Mazurek, M. O. (2015) · Autism and child psychopathology series · doi:10.1007/978-3-319-19183-6_1 · Cited by 5
Anxiety Disorders and Obsessive-Compulsive Disorders (OCD)
Maddox, B. B., Kerns, C. M., Franklin, M. E., & White, S. W. (2016) · Autism and child psychopathology series · doi:10.1007/978-3-319-27171-2_13 · Cited by 5
A Parent-Mediated, Cognitive Behavioral Therapy Group Treatment for Young Children With High-Functioning Autism Spectrum Disorder and Comorbid Anxiety: Development and Case Illustration of the Fun With Feelings Program
Cook, J. M., Donovan, C. L., & Garnett, M. S. (2017) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.31.3.204 · Cited by 5
“…be more prone to experiencing anxiety symptoms than their typically developing peers because of impairments in social interaction and communication (Wood & Gadow, 2010), sensory hypersensitivities (Green, Ben-Sasson, Soto, & Carter, 2012), and difficulties recognizing and regulating emotions…”
Background
Relationship Among Anxiety, Depression, and Family Impact in Adolescents With Autism Spectrum Disorder and Average-Range IQ
Iadarola, S., Oakes, L. A., Shih, W., Dean, M., Smith, T. H., & Orlich, F. (2016) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/1088357616672416 · Cited by 5
“Anxiety in ASD may differ both in terms of topography and content (Kerns, & Kendall, 2012; Wood & Gadow, 2010).”
Background
Where should we go from here? Identified gaps in the literature in psychosocial interventions for youth with autism spectrum disorder and comorbid anxiety
Slaughter, A. M., McNeel, M. M., Storch, E. A., & Mire, S. S. (2020) · Children s Health Care · doi:10.1080/02739615.2020.1756818 · Cited by 5
Effects of Age on the Types and Severity of Excessive Fear or the Absence of Fear in Children and Young Adults With Autism
Richman, D. M., Dotson, W. H., Rose, C. A., Thompson, S., & Abby, L. (2012) · Journal of Mental Health Research in Intellectual Disabilities · doi:10.1080/19315864.2011.596614 · Cited by 5
A cognitive help or hindrance? A systematic review of cognitive behavioural therapy to treat anxiety in young people with autism spectrum disorder
Roberts, K., & Rankin, P. M. (2025) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045251314906 · Cited by 4
“Anxiety in autistic youth is a common and often debilitating condition that affects an individual ’ s daily functioning, social interactions, and overall quality of life (Wood & Gadow, 2010).”
Intolerance-of-uncertainty and anxiety as serial mediators between emotional dysregulation and repetitive patterns in young people with autism
Beneytez, C. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102116 · Cited by 5
A Measurement Invariance Analysis of the Anxiety Scale for Autism–Adults in a Sample of Autistic and Non-Autistic Men and Women
Moore, H. L., Freeston, M. H., Rodgers, J., & Cassidy, S. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06260-2 · Cited by 5
Psychiatric Comorbidities in Autistic Adolescents Without Intellectual Impairment: A Focus on Parent- and Self-Reported Psychopathological Assessment
Cagiano, R., Mancini, A., Berni, M., Maccarrone, F., Arena, B., Cosenza, A., Pecini, C., Igliozzi, R., Calderoni, S., & Tancredi, R. (2025) · Brain Sciences · doi:10.3390/brainsci15020187 · Cited by 4
“This is further supported by cross-sectional studies indicating that increasing age is a risk factor for the development of anxiety and mood disorders in both children [55] and adolescents [10].”
Disentangling the association between cognitive flexibility and anxiety in autistic youth: real-world flexibility versus performance-based task switching
Mahmud, F., Kang, E., McDonald, R. G., Wallace, D., & Warner, C. M. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1570185 · Cited by 5
“Indeed, a number of studies have documented the prevalence of autism-speci ﬁ c symptoms of anxiety, which do not get captured by standard anxiety measures (15 – 17, 54, 55).”
The Role of Anxiety Symptoms in Understanding Restricted, Repetitive Behaviours and Interests in Autism Spectrum Disorders
Ben‐Sasson, A., & Stephenson, K. G. (2021) · Autism and child psychopathology series · doi:10.1007/978-3-030-66445-9_11 · Cited by 6
Mixed methods analysis of an exploratory apprenticeship model employment program for young adults with developmental disabilities
Schwartzman, B. (2021) · Journal of Vocational Rehabilitation · doi:10.3233/jvr-211156 · Cited by 6
“Also, among youth with developmental disabilities, other anxiety disorders, attention deﬁcit problems, disruptive behavior, and depressive disorders are very common and often increase during adolescence (Wood & Gadow, 2010).”
Psychopathologies Associated with ASD: Anxiety, OCD, Depression, and ADHD
Braconnier, M. L., Garza, I., & Moskowitz, L. J. (2022) · Autism and child psychopathology series · doi:10.1007/978-3-030-88538-0_2 · Cited by 4
Incorporating autism symptoms into a transdiagnostic model of anxiety and depression symptoms results in an improved model and distinct factor structure for autistic youth
Rosen, T. E., Rodriguez-Seijas, C. A., Gadow, K. D., & Lerner, M. D. (2022) · Research in Autism · doi:10.1016/j.rasd.2024.102413 · Cited by 4
Self-citation
Association among internalizing problems, white matter integrity, and social difficulties in children with autism spectrum disorder
Yu, F., Huang, X., Zhao, W., Ming, Y., Zhou, Y., Feng, R., Xiao, J., Shan, X., Kang, X., Duan, X., et al. (2024) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2024.111109 · Cited by 5
Autism Spectrum Disorder and Co-Existing Conditions: A Lexical Decision ERP Study
Saunders, A., & Kirk, I. J. (2015) · Clinical and Experimental Psychology · doi:10.4172/2471-2701.1000101 · Cited by 3
“The current findings also suggests that when ASD and ADHD present together, they are indeed separate conditions [46], and early lexical processing is differentially affected in this group versus those with a pure version of each condition.”
Background
The role of social anxiety in autism and the broader autism phenotype
Dickter, C. L., & Burk, J. A. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817986-4.00047-x · Cited by 6
Exposure Therapy for Anxiety and Obsessive-Compulsive Disorders Among Individuals with Autism Spectrum Disorder
Landry, L. N., Clayton, R. J., Mcneel, M. M., Guzick, A., Berry, L. N., Schneider, S. C., & Storch, E. A. (2022) · Clinical Guide to Exposure Therapy · doi:10.1007/978-3-031-04927-9_6 · Cited by 5

Authors: Wood, J. J., & Gadow, K. D.
Affiliations: University of California, Los Angeles (US)
Stony Brook University (US)
ORCID: Wood, Jeffrey J.
Venue: Clinical Psychology: Science and Practice
Publisher: American Psychological Association (APA)
Published: 2010-12
Volume: 17
Issue: 4
Pages: 281-292
ISSN: 0969-5893 (ISSN-L)
1468-2850
DOI: 10.1111/j.1468-2850.2010.01220.x
OpenAlex: W1528335495
Cited by: 407
References: 72
Citations by year: 2026: 8 · 2025: 22 · 2024: 23 · 2023: 25 · 2022: 36 · 2021: 35 · 2020: 29 · 2019: 32 · 2018: 29 · 2017: 32 · 2016: 21 · 2015: 30 · 2014: 32 · 2013: 27 · 2012: 22
FWCI: 10.25
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1735 d)
Locations: Clinical Psychology Science and Practice (publishedVersion)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: autism spectrum disorder, anxiety disorders, youth, disease classification, pathogenesis, social rejection, stress, social skills deficits, repetitive behavior, symptom severity, moderation

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Exploring the nature and function of anxiety in youth with autism spectrum disorders.

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