Exploring Trajectories of Anxiety Symptoms in Autistic and Non-Autistic Youth over Adolescence Using Parent- and...

Autistic youth frequently experience co-occurring anxiety. In non-autistic populations, females are more likely to be diagnosed with anxiety and demonstrate distinct symptom trajectories across adolescence. Prior research has demonstrated diagnostic group differences in parent- and self-reported anxiety symptoms; however, it is largely unknown if and how symptoms change over puberty. We examine trajectories of anxiety symptoms for autistic and non-autistic youth over a four-year (Y1-Y4) longitudinal study.

Autistic (N=140) and non-autistic (N=104) youth (ages 10-13 years at Y1) completed the parent- and self-report versions of the Multidimensional Anxiety Scale for Children, 2^nd Edition (MASC-2). Linear mixed effects models were used to examine the impact of age, sex, and diagnosis on anxiety symptoms.

There was a significant diagnosis-sex interaction (p _FDR =0.005) on the parent-report of anxiety and a main effect of age (p<0.001). Autistic and non-autistic females showed an increase in anxiety symptoms over time; autistic males showed a slight decrease. There was a main effect of diagnosis (p _FDR =0.003) on the child-report measure of anxiety symptoms; the effects of age (p _FDR =0.117) and sex were not significant (p _FDR =0.305). The relationship between pubertal development and anxiety symptoms differed between the subgroups.

Our main findings - that autistic youth demonstrate greater anxiety symptoms than non-autistic youth, with distinct symptom trajectories emerging in females versus males - add to the growing literature aimed at understanding the biopsychosocial factors impacting puberty and emotional functioning across adolescence.