(PS7-31) Anxiogenic Parenting Among Autistic and Neurotypical Youth with Anxiety: Associations with Emotion Dysregulation, Anxiety Severity, and Social Responsiveness

Abstract Text:

Introduction:
Roughly 40% of autistic youth meet criteria for an anxiety disorder (van Steensel et al., 2011). Anxiety is associated with more social and emotional difficulties in both neurotypical and autistic youth (Settipani & Kendall, 2012; Mathews et al., 2016; Chang et al., 2012; Restoy et al., 2024). Some studies support developmental models suggesting that anxiogenic parenting practices, such as overcontrol and accommodation, contribute to the onset and maintenance of pediatric anxiety (Ginsburg & Schlossberg, 2002; Storch et al., 2015). However, less is known about whether these parenting behaviors differ between autistic and neurotypical youth with anxiety or how they relate to various socio-emotional outcomes. Understanding these relations may help inform family-based CBT for these populations. This study aims to (a) compare anxiogenic parenting between autistic and neurotypical youth with anxiety and (b) examine whether associations between anxiogenic parenting and socio-emotional outcomes vary by diagnostic group.

Methods:
Participants included 45 autistic youth with anxiety (M_age = 14.44, SD_age = 1.69) and 80 neurotypical youth with anxiety (M_age = 14.68, SD_age = 1.69) who were recruited for an observational study examining social and emotional behaviors. Participants completed the Screen for Child Anxiety Related Emotional Disorders (SCARED), and their parents completed the Parenting Anxious Kids Rating Scale (PAKRS), Emotion Dysregulation Inventory (EDI), and Social Responsiveness Scale (SRS-2).

Results:
Wilcoxon rank sum tests found no significant differences between autistic and neurotypical youth with anxiety on the following PAKRS subscales: Conflict (W = 1771.00, p = .883, r = -.02), Overinvolvement (W = 2099.50, p = .123, r = .17), Modeling (W = 1998.50, p = .308, r = .11), and Emotional Warmth/Support (W = 1732.50, p = .73, r = -.04). However, independent t-tests suggested that parents of autistic youth reported significantly higher levels of accommodation beliefs (M_A = 27.42, SD_A = 6.73 vs. M_N = 22.34, SD_N = 6.84), t(92.59) = 4.03, p < .001, d = .75, and total anxiogenic parenting (M_A = 136.42, SD_A = 21.11 vs. M_N = 128.48, SD_N = 19.56), t(85.61) = 2.07, p < .05, d = .39.

Additionally, PROCESS R macro analyses showed that higher total anxiogenic parenting predicted greater parent-reported reactivity (EDI; b = .28, p < .001), dysphoria (EDI; b = .07, p < .01), social impairment (SRS-2; b = .63, p < .001), and child-reported anxiety severity (SCARED; b = .27, p < .01). However, diagnostic group did not moderate any of these relations (ps > .05), suggesting consistent effects across groups.

Discussion:
Our findings support previous research suggesting that anxiogenic parenting predicts greater anxiety severity, and furthermore suggest positive associations with emotion dysregulation and social impairment across autistic and neurotypical youth with anxiety. Family-based CBT interventions that directly address parenting behaviors like overaccommodation may be beneficial to both populations. Future research should explore parental cognitive factors that maintain anxiogenic parenting to inform the design and application of family-based CBT with anxious youth.