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Infant Social Avoidance Predicts Autism but Not Anxiety in Fragile X Syndrome

Jane E Roberts1, Hayley Crawford2, Elizabeth A Will1

  • 1Department of Psychology, University of South Carolina, Columbia, SC, United States.

Frontiers in Psychiatry
|May 29, 2019
PubMed

Insights

Social avoidance in infancy predicts autism spectrum disorder (ASD) symptoms but reduces attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms in fragile X syndrome (FXS). This finding offers new insights into comorbid psychiatric disorders in FXS.

Area of Science:

  • Neurodevelopmental Disorders
  • Child Psychiatry
  • Genetics

Background:

  • Autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and anxiety are common childhood disorders.
  • Early social avoidance is linked to these disorders, but its differential prediction in high-risk groups is unclear.
  • Fragile X syndrome (FXS) is a genetic disorder with high rates of social avoidance, ASD, ADHD, and anxiety.

Purpose of the Study:

  • To examine the association between social avoidance trajectories from infancy and later ASD, ADHD, and anxiety outcomes in preschool-aged children with FXS.
  • To understand how social avoidance differentially predicts comorbid psychiatric disorders in a genetically defined high-risk subgroup.

Main Methods:

  • A longitudinal study of 78 males with FXS (aged 4-62 months) with 201 assessments.
  • Social avoidance was measured using the Social Avoidance Scale (SAS) across three domains: physical movement, facial expression, and eye contact.
  • ASD, ADHD, and anxiety symptoms were assessed via parent-report questionnaires at preschool age.

Main Results:

  • Increased social avoidance during infancy and preschool predicted higher ASD symptom severity.
  • Conversely, increased social avoidance predicted reduced ADHD and anxiety symptom severity in males with FXS.
  • These findings indicate an inconsistent relationship between social avoidance and symptoms of ASD, ADHD, and anxiety.

Conclusions:

  • The study provides novel insights into the debate regarding the independence or overlap of ASD, ADHD, and anxiety in FXS.
  • The developmental and temporal aspects of social avoidance may improve the accuracy of differential diagnoses for comorbid psychiatric disorders in FXS.
  • Understanding these nuanced profiles is crucial for targeted interventions and support for individuals with FXS.

Keywords:
FMR1anxietyautismfragile X syndromesocial avoidance

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