Anxiety in autism may be caused by an inability to understand own emotions
Research suggests that mindfulness-based interventions may be particularly effective and could revolutionise the treatment of anxiety in people with autism
People with autism are around five times more likely to develop anxiety disorders than people without autism, for unknown reasons. A recent international collaboration between academics from City University London, Newcastle University and Brigham Young University, has shed new light on this issue by showing that high levels of anxiety in autism can be explained by people’s difficulties in identifying and understanding their own emotions.
The research suggests that mindfulness-based interventions may be particularly effective and could revolutionise the treatment of anxiety in people with autism. The paper is published in the Journal of Abnormal Psychology.
Previous research suggests that three main factors often contribute to people developing anxiety, including difficulties coping with uncertainty, problems in accepting emotional experiences and alexithymia, which can be described as a difficulty in identifying and understanding one’s own emotions. Earlier studies of anxiety in autism had focused on the first two of these factors, while this is the first paper to consider also the importance of alexithymia.
To explore how alexithymia might impact on anxiety in autism, the research team recruited 151 adults, including 76 people with and 75 people without a diagnosis of autism. All participants completed a number of questionnaires that measured core autism symptoms, anxiety, emotional acceptance, alexithymia, and intolerance of uncertainty.
The questionnaire results confirmed that people with autism experienced significantly higher levels of anxiety than people without autism. The researchers then developed a statistical model to examine which factors could explain this relationship between anxiety and autism and this model clearly showed that alexithymia, emotional acceptance and intolerance of uncertainty played a critical role. In fact, these factors together accounted for 64% of the relationship between autism and anxiety. This suggests that people with autism experience anxiety because they are more likely to react aversively to their emotional experiences, whilst finding it difficult to identify and understand their emotions.
Since emotional acceptance is targeted by mindfulness based therapies the team suggest that such therapies may be especially helpful in treating anxiety in people with autism. Specifically, mindfulness based therapies may reduce anxiety in people with autism by fostering emotional acceptance and by reducing difficulties in dealing with uncertainty and understanding own emotions.
Co-author Dr Sebastian Gaigg, of the Autism Research Group in the Psychology Department at City University London, said:
“Our study is the first to show that alexithymia and emotional acceptance could explain the high rates of anxiety in autism. Anxiety is one of the most common reasons why individuals with autism seek support from health professionals and our work has important implications for how anxiety might be treated effectively in those with the condition.
“In particular we think that mindfulness-based interventions may prove effective for alleviating anxiety in autism. Rather than worrying about the past or future mindfulness-based therapies are designed to foster an individuals' awareness of moment-by-moment experiences, including current thoughts and experiences such as emotions and sensations. We therefore think that such techniques would be effective in alleviating anxiety in autism by improving people’s ability to identify, understand, and accept their emotions.”