The Perceived Causal Relations Between Sensory Reactivity Differences and Anxiety Symptoms in Autistic Adults.

Background: Rates of anxiety are inordinately high in autistic adults. Sensory reactivity differences, such as hyperreactivity (e.g., strong reactions to sound), hyporeactivity (e.g., no, or slower reactions to pain), and seeking (e.g., fascination with spinning objects), are a diagnostic criterion of autism and have been linked with anxiety. Understanding how individuals perceive these to be causally related can impact the assessment and treatment of anxiety. Therefore, we examined the perceived causal relations (PCR) between sensory reactivity differences and anxiety in autistic adults. Method: Two hundred forty-six autistic adults aged 18-76 years took part in an online study. They completed self-report assessments of sensory reactivity differences, and anxiety, followed by the PCR scale, indicating whether they perceived their sensory reactivity differences to be more of a cause or an effect of their anxiety symptoms. Results: We found sensory reactivity hyperreactivity, hyporeactivity, and seeking to be significantly correlated with anxiety. Further, we found total sensory hyperreactivity, and visual, auditory, and olfactory hyperreactivity, to be perceived as significantly more of a cause of anxiety than an effect, and total sensory seeking, and tactile and vestibular seeking, to be perceived as significantly more of an effect of anxiety than a cause. Conclusion: Future individualized approaches to treating anxiety in autistic individuals may benefit from differentiating between potential sensory causes of anxiety (e.g. hypersensitivities) vs. potential sensory effects of anxiety (e.g. sensory seeking behaviors).

Why is this an important issue?: Autistic people are more likely to experience anxiety compared with the general population. Sensory reactivity differences, such as hyperreactivity (e.g., strong reactivity to sounds), hyporeactivity (e.g., not noticing touch), or seeking (e.g., being fascinated by spinning objects), are common in autistic individuals, and may be a risk factor for anxiety. However, existing anxiety treatments are not always effective for autistic people. Understanding how autistic people feel their anxiety and sensory reactivity differences are causally linked could be important to help clinicians understand the challenges that should be prioritized in anxiety treatment for autistic people. What was the purpose of this study?: In this study, we aimed at examining sensory reactivity differences and anxiety symptoms in autistic adults, and asking them whether they perceive their anxiety symptoms to be more of a cause or an effect of their sensory reactivity differences. What did the researchers do?: In our study, we measured sensory reactivity differences and anxiety symptoms using online surveys. For the sensory reactivity differences and anxiety symptoms that each individual reported to be present, they were then asked how much they felt each anxiety symptom was a cause of their sensory reactivity differences, and how much they felt each sensory reactivity difference was a cause of their anxiety symptoms. This study included 246 autistic adults aged 18­76 years. What were the results of the study?: Our results showed that the autistic individuals felt that their sensory hyperreactivity, including hyperreactivity related to vision, hearing, and scent, is more of a cause than an effect of anxiety. However, they also felt that their sensory seeking, especially touch- and balance-related seeking, is more of an effect than a cause of anxiety. What do these findings add to what was already known?: Although sensory hyperreactivity has been shown earlier to be a cause of anxiety for autistic individuals, our study was the first to suggest that anxiety may influence sensory seeking, which is something that can be tested in future research studies. What are potential weaknesses in the study?: We did not ask participants about co-occurring conditions, such as if they have additional diagnoses related to intellectual disability or attention deficit hyperreactivity disorder, which means there may be important differences between individuals that we did not examine. Also, we did not measure key symptoms associated with wider anxiety conditions and autism-related anxiety symptoms, such as social fears unrelated to negative self-assessment, which would be important for clinical understanding. How will these findings help autistic adults now or in the future?: Understanding how people perceive their traits and symptoms to be causally related can impact how effective anxiety treatments are for individuals. So, our findings can importantly help inform clinical approaches to the treatment of anxiety for autistic individuals.