Dr Keren MacLennan, an MQ researcher, explains her research into the assessment and treatment of anxiety in individuals with autism.
My PhD was generously funded by MQ, in partnership with Autistica, via a grant awarded to the principal investigator, Dr Teresa Tavassoli. Over the past few years, I have investigated the links between sensory reactivity differences and anxiety in autistic individuals. I am excited to share some of the findings of this research, having concluded my PhD.
Why did I do this work?
Autism Spectrum Conditions (ASC) are neurodevelopmental conditions characterised by restricted and repetitive behaviours and interests (RRBs) and social interaction and communication differences that present early in childhood. Autistic people are more likely to experience poor mental health, such as anxiety and depression than the general population. This can significantly impact the quality of life and prospects for these individuals. So, it is essential to understand why they are at greater risk and what factors contribute to this.
Sensory reactivity differences are part of the RRB’s diagnostic criteria for autism, as autistic people commonly experience them. Individuals may experience hyperreactivity (finding sensory input, such as loud sounds challenging, painful or overwhelming), hyporeactivity (not noticing or responding to sensory input, such as if someone has touched their arm), or sensory seeking (being fascinated or fixated by sensory inputs, such as spinning objects).
Although some sensory experiences can be enjoyable, some can be highly distressing, such as sensory hyperreactivity, which may be linked with anxiety in autistic individuals. But few studies have yet aimed to understand the role of sensory hyporeactivity and seeking, or if sensory reactivity differences correlated with symptoms of specific anxiety conditions, such as generalised anxiety or social anxiety.
Also, research has often looked at the link between sensory reactivity differences and anxiety in school-aged children, but rarely in younger children and adults. So, my PhD work investigated the associations between sensory reactivity differences and symptoms of anxiety conditions in autistic individuals across a range of studies with school-aged children, preschool-aged children, and adults.
What are the key research findings?
Firstly, the results strongly support an association between sensory hyperreactivity and anxiety symptoms in autistic individuals. For example in children ages 3 – 14, and aged 3 – 5 years. Though sensory hyperreactivity was linked with symptoms of different anxiety conditions, a link with separation anxiety symptoms was consistently found across the studies. As for sensory hyporeactivity and seeking, we did find links with anxiety, but this was not consistent.
Another important finding is that intolerance of uncertainty, which is when an individual has difficulty with unpredictable situations or contexts, was found to be a mediating factor that may explain why sensory hyperreactivity is associated with the development of anxiety in autistic individuals, for example, this study in children aged 3 – 5 years.
Lastly, a study with autistic adults highlighted the complex nature of sensory reactivity differences from their perspective. For instance, sensory reactivity differences are still common in adulthood, and many individuals experience overlapping sensory hyperreactivity and seeking. Also, having sensory reactivity differences was reported to lead to certain outcomes, such as feeling overwhelmed and facing longer-term mental and physical health difficulties. But personal and external factors can influence these outcomes, such as current mood and energy levels, getting support from others, or using soothing sensory inputs as a management strategy.
Why are these findings important?
Anxiety in autistic individuals has previously been shown to present differently from the general population. This can mean that exiting assessments and treatments for anxiety are not as practical for autistic individuals. So, the findings from my PhD significantly improve our understanding of how sensory hyperreactivity and intolerance of uncertainty may be essential factors in the development of anxiety in autistic individuals and potentially important to target in treatments. For instance, this supports that targeting intolerance of uncertainty in treatment could reduce anxiety in autistic children. Therefore, my work contributes to research that aims to improve the assessment and treatment of anxiety in autistic people.
What was my experience of working on this project?
It was a privilege to complete my PhD as part of this grant and broader project. Alongside developing my research skills on an exciting project, I was able to access wider opportunities that were supported by the grant. For instance, I attended various national and international conferences to discuss our research. The team and I also travelled to London to support the MQ Swear Box campaign and talk to the public about the research project.
You can read more about the grant awarded to Dr Teresa Tavassoli and the broader research programme here.
