(PS2-72) Sex and Age Differences in Self-reported Anxiety, Executive Functioning, and Quality of Life in Autistic and Non-autistic Youth

Abstract Text:

Background: Autistic youth experience higher rates of anxiety symptoms and executive functioning (EF) challenges compared to non-autistic peers (Thiele-Swift & Dorstyn, 2024; Sankalaite et al., 2025). Furthermore, autistic youth’s quality of life (QOL) is influenced by EF problems (Dijkhuis et al., 2017) and anxiety symptoms (Oakley et al., 2021). Sex and age also appear to play a role in these domains, with non-autistic adolescent females reporting lower QOL and higher anxiety than male peers across domains (Bender et al., 2012; Hijkoop et al., 2021). Sex and age influence EF development, with females sometimes outperforming males early on and EF improving with age (Jacobsen et al., 2017; Gordon-Murer et al., 2021). Additionally, adolescence brings heightened emotionality and peer influences, increasing vulnerability to anxiety (Rapee et al., 2019). Examining the effects of sex and age concurrently on anxiety, EF, and QOL is important because these factors interact to shape developmental and mental health outcomes and can inform targeted intervention.

Methods: The sample included autistic (n = 85) and nonautistic youth (n = 65), with (Mage = 11.001, SDage = 3.052, 43 females and 60 males). The study utilized two self-report measures to assess anxiety, a general anxiety measure (Multidimensional Anxiety Scale-2; MASC-2; March, 2012) and one designed specifically for autistic youth (Anxiety Scale for Children—Autism Spectrum Disorder (ASC-ASD; Rodgers et al., 2016). Youth also completed measures of EF (Behavior Rating Inventory of Executive Function-2, [BRIEF-2; Gioia et al., 2015) and QOL (Pediatric Quality of Life Scale, PedsQL; Varni, 1998).

Results: Sex, but not age, was correlated with anxiety scores on the ASC-ASD (r = -.239, p = .015), with higher scores in females. This pattern was seen only in the ASD sample (r = -.309, p = .016). Only child age, but not sex, was related to anxiety levels on the MASC-2-SR (r = .258, p = .020). This pattern was seen only in the ASD sample (r = .361, p = .005). For PedQL, child sex, but not age, significantly predicted QOL (B = -18.974, p = .016) for teenage youth, with males reporting lower values. When assessing only in the ASD sample, both child age (B= -2.245, p = .028) and sex (B = -25.805, p = .003) significantly predicted QOL. BRIEF-2 SR was unrelated to child sex or age (p = .882).

Conclusion: Sex appears to be linked to anxiety on an autism-specific measure (higher in females), whereas age is linked to anxiety on a traditional measure (higher in older youth), with autistic youth driving these effects. Both sex and age predicted QOL in teens (males and older youth reported lower QoL), while EF (BRIEF-2 SR) showed no significant associations. These findings highlight the distinct roles of sex and age in shaping anxiety and QOL that may be unique in autistic youth, suggesting that autism-specific anxiety interventions may need to be sex-specific, while traditional anxiety presentation may warrant consideration of developmental stages. QOL support should consider both developmental stage and sex differences Future research should examine additional biopsychosocial determinants that contribute to anxiety, EF, and QOL in youth.