Parent-rated anxiety symptoms in children with pervasive developmental disorders: frequency and association with core autism symptoms and cognitive functioning.
BACKGROUND
In addition to the core symptoms, children with Pervasive Developmental Disorders (PDD) often exhibit other problem behaviors such as aggression, hyperactivity, and anxiety, which can contribute to overall impairment and, therefore, become the focus of clinical attention. Limited data are available on the prevalence of anxiety in these children. We examined frequency and correlates of parent-rated anxiety symptoms in a large sample of children with PDD.


METHODS
The goals of this study were to examine the frequency and correlates of parent-rated anxiety symptoms in a sample of 171 medication-free children with PDD who participated in two NIH-funded medication trials. Twenty items of the Child and Adolescent Symptom Inventory (CASI) were used to measure anxiety.


RESULTS
Forty three percent of the total sample met screening cut-off criteria for at least one anxiety disorder. Higher levels of anxiety on the 20-item CASI scale were associated with higher IQ, the presence of functional language use, and with higher levels of stereotyped behaviors. In children with higher IQ, anxiety was also associated with greater impairment in social reciprocity.


CONCLUSIONS
Anxiety is common in PDD and warrants consideration in clinical evaluation and treatment planning. This study suggests that parent ratings could be a useful source of information about anxiety symptoms in this population. Some anxiety symptoms such as phobic and social anxiety may be closer to core symptoms of PDD. Further efforts to validate tools to ascertain anxiety are needed, as are studies to empirically test approaches to treat anxiety in PDD.
The Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT 06520, USA. denis.sukhodolsky@yale.edu
Denis G
DG
Sukhodolsky
Lawrence
L
Scahill
Kenneth D
KD
Gadow
L Eugene
LE
Arnold
Michael G
MG
Aman
Christopher J
CJ
McDougle
James T
JT
McCracken
Elaine
E
Tierney
Susan
S
Williams White
Luc
L
Lecavalier
Benedetto
B
Vitiello
D000293:Adolescent; D000374:Aggression / Q000187:drug effects; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D020817:Asperger Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D001321:Autistic Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007360:Intelligence; D007805:Language Development Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D010552:Personality Assessment; D016032:Randomized Controlled Trials as Topic; D018967:Risperidone / Q000627:therapeutic use; D012919:Social Behavior; D013239:Stereotyped Behavior / Q000187:drug effects
D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D018967:Risperidone