Abstract
This doctoral research explores the experience, assessment, and potential treatment of social anxiety in Autism Spectrum Disorder (ASD). ASD is a neurodevelopmental disorder characterised by social difficulties, repetitive behaviours, and limited areas of interest. Social Anxiety Disorder (SAD) is fear of negative judgement which causes distress in, and avoidance of social situations. Changes to the diagnostic criteria of ASD have only recently allowed concurrent diagnoses of these conditions. Therefore, there is a paucity of literature regarding SAD in the ASD population.
In Study 1 a popular social anxiety measure (the LSAS-CA) was utilised to assess for SAD in the ASD population. Adolescents with ASD, and parents of adolescents with ASD completed an online survey. Results suggest that the LSAS-CA is inappropriate for use with the ASD population, and leads to overscoring. The findings also demonstrated that participants perceived social anxiety to be both prevalent and experienced at high level of severity by this population.
Study 2a, Study 2b and Study 3 sought to explore the social cure as a potential approach to intervention for SAD. Research conducted using this framework has demonstrated that social identities provide various benefits to both physical and mental health. To date, however, no research has investigated the effects of social identities on social anxiety. In an attempt to rectify this, Study 2a and Study 2b sought to investigate the relationship between social identity and social anxiety amongst neurotypical populations. Findings suggested that social identity is associated with lower levels of social anxiety. Furthermore, statistical analysis revealed that it is through increased perceptions of personal control and decreases in negative attribution style that social identity benefits are apparent.
Study 3 manipulated the salience of social identity in order to assess whether this would lead to lower social anxiety in a subsequent social performance task. No significant effects emerged, indicating increasing the salience of a pre-existing social identity was insufficient to reduce social anxiety.
Study 4 conducted semi-structured interviews with adolescents with ASD to investigate how social identities might impact this population. Transcripts were analysed using interpretative phenomenological analysis. Participants spoke about effects of both ASD, and ASD identity. The young people strongly valued their membership in the ASD group, which was found to be one of few, or their only group memberships. Findings also demonstrated that individuals with ASD use various methods to maintain positive self-esteem, personal and social identities.
Overall, the thesis provided novel and valuable findings regarding how individuals with ASD experience social anxiety. SAD appears to be commonly experienced in this population, but there is a need for assessment tools designed specific to this purpose. Social identity and the social cure provide a novel approach to protecting against and reducing social anxiety. It seems that within the ASD population, where individuals have few group memberships, ASD provides a sense of belonging and a valued identity. As a result social identity may contribute to reduced social anxiety and isolation, and therefore provide opportunities to increase social skills and form new friendships.