Understanding the experience of social anxiety in adolescent girls with autism spectrum disorders

Abstract

Literature Review: Pathways to social anxiety often reflect a set of complex and interacting factors including intrinsic and environmental factors. Theoretical models of social anxiety have highlighted that children and adolescents’ peer experiences can increase risk for social anxiety. This systematic review explored the role of peers in the development of social anxiety in adolescent girls. It aimed to identify peer-related risk factors (i.e., peer acceptance, peer attachment, friendship quality, peer support, and victimisation) that place adolescents at risk for social anxiety, including those specific to girls. The results showed that while some peer experiences were relevant to understanding risk across genders, others placed girls at increased risk. For example, low peer acceptance was significantly associated with increased social anxiety in boys and girls, both concurrently and over time. Those factors that placed girls at increased risk of social anxiety and avoidance, relative to boys, included limited close friendships, negative friendship experiences and relational victimisation. The review suggested that researchers might usefully start to develop frameworks that capture generic as well as gender-specific risk for social anxiety. These will facilitate the development of prevention and intervention methods to support girls at increased risk, that focus on improving the quality of their peer relationships.

Empirical Paper: The onset of adolescence represents an age where young people are at risk for the development of social anxiety. Increasingly, research has highlighted an increased risk of social anxiety in girls with Autism Spectrum Disorders (ASD). However, there remains a lack of understanding of their experiences and the extent to which they are consistent with current models of anxiety in ASD. This qualitative study aimed to develop an understanding of the experience of social anxiety in adolescent girls with ASD from the perspective of young people themselves, their parents and teachers. Semi-structured interviews were conducted with four triads, with girls interviewed using an ‘ideal classroom’ activity to explore their perception of school-based social situations. Four interrelated themes emerged from the data across all four triads including (1) barriers to social situations, (2) quality of relationships, (3) coping with social situations, and (4) desire to ‘fit in’. The results found that girls’ experiences were underpinned by factors present in typical pathways to social anxiety (e.g. negative peer experiences and poor social skills) and that girls’ sensory sensitivity to noise acted as an autism-specific pathway. Implications for professionals who work with adolescent girls diagnosed with ASD were discussed, including the delivery of targeted training and workshops to increase staff understanding and raise peer acceptance.

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ORCID for Hanna Kovshoff: orcid.org/0000-0001-6041-0376

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