Quality of life in young adults with ASD: Exploring the ...

Quality of life in young adults with ASD: Exploring the role of anxiety Isaac C. Smith

Thesis submitted to the faculty of Virginia Polytechnic Institute and State University in partial fulfillment of the requirements for the degree of Master of Science In Psychology

Susan W. White, Committee Chair Thomas H. Ollendick Jungmeen Kim-Spoon

May 4, 2017 Blacksburg, Virginia

Keywords: autism spectrum disorder; anxiety; quality of life

Quality of life in young adults with ASD: Exploring the role of anxiety Isaac C. Smith ABSTRACT

The comorbidity of anxiety disorders and autism spectrum disorder (ASD) is wellestablished. Although research on the comorbidity of anxiety disorders in adults with ASD is limited, preliminary studies suggest rates of comorbidity comparable to those found in children and adolescents. Little is known about the manifestation of anxiety symptoms in adults with ASD or the potential for these symptoms to impact quality of life in this population. The current study aimed to examine the role of anxiety symptoms in quality of life among young adults with ASD. We collected online survey data from a large sample (N = 224) of parents of young adults with ASD and a subsample of adults with ASD. Parent- and self-report data suggested a substantial proportion of adults with ASD exceeded clinical cutoffs for anxiety symptoms. Anxiety moderated the relationship between ASD severity and the social relations domain of quality of life. Anxiety symptoms did not, however, significantly moderate the effect on the psychological domain. Exploratory analyses also demonstrated significant indirect effects of ASD severity on social and psychological quality of life through anxiety symptoms. Results provide preliminary evidence that anxiety symptoms contribute to quality of life in adults with ASD independently of core ASD symptomatology. Future research should aim to further characterize anxiety symptoms among adults with ASD, as well as evaluate the impact of anxiety symptoms on quality of life and overall outcome through the use of prospective longitudinal studies.

Quality of life in young adults with ASD: Exploring the role of anxiety Isaac C. Smith

ABSTRACT (GENERAL AUDIENCE) The comorbidity of anxiety disorders and autism spectrum disorder (ASD) is wellestablished. Although research on the comorbidity of anxiety disorders in adults with ASD is limited, preliminary studies suggest rates of comorbidity comparable to those found in children and adolescents. Little is known about the manifestation of anxiety symptoms in adults with ASD or the potential for these symptoms to impact quality of life in this population. The current study aimed to examine the role of anxiety symptoms in quality of life among young adults with ASD. We collected online survey data from a large sample (N = 224) of parents of young adults with ASD and a subsample of adults with ASD. Parent- and self-report data suggested a substantial proportion of adults with ASD have clinically significant levels of anxiety. Anxiety symptoms contributed to poor quality of life above and beyond ASD symptoms alone. Exploratory analyses also demonstrated significant effects of ASD severity on quality of life through the path of anxiety symptoms. Results provide initial evidence that anxiety symptoms contribute to quality of life in adults with ASD independently of core ASD symptoms. Future research should aim to further characterize anxiety symptoms among adults with ASD, as well as evaluate the impact of anxiety symptoms on quality of life and overall outcome through the use of prospective longitudinal studies.

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Acknowledgements First, I would like to express my gratitude to the parents and young adults who took the time to participate in the study. I'd also like to thank Alison Marvin and Elisabeth Mekosh from the Interactive Autism Network (IAN), who helped with the design and launch of this project. I greatly appreciate the work of Hannah Esmacher, the project's undergraduate research assistant, who helped to manage and send thousands of emails to all study participants. I would also like to acknowledge the funding sources for this study, which was conducted with support from Virginia Tech's Graduate Research Development Program and the Virginia Tech Center for Autism Research. I also wish to express my sincere thanks for Dr. Susan White, my thesis chair and advisor, for encouraging me to take on a sizable project in my first semester as a graduate student and for helping me to see it through to its conclusion. Her consistent support and advice, on this project and on all my work, play an instrumental role in my development as a clinical scientist. In addition, I would like to thank Drs. Thomas Ollendick and Jungmeen Kim-Spoon for serving on my thesis committee and offering their suggestions and advice. Finally, I would like to thank my family, friends, and labmates for the role they've played in supporting my work.

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Table of Contents Introduction ..........................................................................................................................1 Method .................................................................................................................................8 Results ................................................................................................................................13 Discussion ..........................................................................................................................17 References ..........................................................................................................................25 Tables .................................................................................................................................33 Figures................................................................................................................................40 Appendix A ........................................................................................................................44 Appendix B ........................................................................................................................45 Appendix C ........................................................................................................................49 Appendix D ........................................................................................................................61 Appendix E ........................................................................................................................63 Appendix F.........................................................................................................................65 Appendix G ........................................................................................................................68

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