Autism spectrum disorders (ASD) and social anxiety: A comorbidity or a related symptom?

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by deficits in social interaction and communication and limi-ted, repetitive interests and behaviours. ASD represents a heterogeneous group and its prevalence is increasing. Some individuals diagnosed with ASD may have different diagnoses at the same time as ASD, while others may only be diagnosed with ASD. Comorbidity is the presence of two or more conditions or disorders in an individual simultaneously. Comorbid psychiatric disorders in individuals with ASD are among the most uncertain issues. Social anxiety disorder (SAD) is one of the most common and cont-roversial psychiatric disorders in ASD for which there are still not enough consistent findings. The main question in the debate on ASD and SAD is ‘Is SAD a comorbidity or one of the features associated with ASD?’. The answer to this fundamental question is still elusive due to the scarcity of studies in the literature, lack of emphasis by researchers, overlapping ASD and SAD symptoms, heterogeneity of the ASD population, the fact that psychiatric disorders can be based on introspection, the difficulty of objecti-ve and reliable measurements, the limitations of assessment tools, and expert and clinician bias. However, the lack of information about SAB pre-vents determining and deciding on appropriate intervention, misdiagnosis or incomplete diagnosis, social isolation, social inadequacies, and indepen-dence. This study aims to summarise the current discussions by examining the information, findings, and different opinions in the literature by focusing on the question ‘Is SAD in individuals with ASD a comorbidity or a related symptom?’, to eliminate the uncertainty on this issue and to provide infor-mation to experts, researchers and clinicians.

Keywords

• Autism spectrum disorder
• autism
• anxiety
• social anxiety disorder
• comorbidity

Otizm Spektrum Bozukluğu (OSB) ve Sosyal Anksiyete: Komorbidite mi İlişkili bir Semptom mu?

Öz

Otizm spektrum bozukluğu (OSB), sosyal etkileşim ve iletişimde görü-lenyetersizliklerle, sınırlı, yineleyici ilgi ve davranışlarla karakterize edilen bir nöro-gelişimsel bozukluktur. Heterojen bir grubu temsil eden ve yaygın-lığı giderek artan OSB, tanılanan bazı bireylerde OSB ile aynı anda farklı tanılar bazılarında ise yalnızca OSB tanısı söz konusu olabilir. Komorbidite, bireyde aynı anda iki ya da daha fazla durumun, bozukluğun bulunmasıdır. OSB olan bireylerde komorbid psikiyatrik bozukluklar en belirsiz konular-dandır. Sosyal anksiyete bozukluğu (SAB), OSB’de en çok görülen ve halen yeterince tutarlı bulgulara ulaşılamayan, tartışmalı psikiyatrik bozukluklar-dandır. OSB ve SAB’a ilişkin tartışmaların ana sorusunu “SAB’ın bir ko-morbidite mi yoksa OSB ile ilişkili özelliklerden birisi mi?”oluşturmaktadır. Bu temel sorunun yanıtı alanyazında yapılan çalışmaların azlığı, araştırma-cılar tarafından üzerinde yeterince durulmaması, OSB ve SAB semptomla-rının örtüşmesi, OSB popülasyonun heterojenliği, psikiyatrik bozuklukların içsel gözlemlere dayalı olabilmesi, nesnel ve güvenilir ölçümlerinin zorluğu, değerlendirme araçlarının sınırlılığı, uzman ve klinisyen yanlılığı gibi neden-lerle halen bulunamamaktadır. Oysa SAB’a ilişkin bilgi azlığı uygun müda-haleyi belirleme ve karar verme, yanlış ya da eksik tanılama, sosyal izolas-yon, sosyal yetersizlikler ve de bağımsızlaşmaya engel olmaktadır. Bu çalış-manın amacı OSB olan bireylerde SAB’ı “bir komorbidite mi yoksa ilişkili bir semptom mu?” sorusu odağında ele alarak alanyazındaki bilgileri, bulguları ve farklı görüşleri inceleyip mevcut tartışmaları özetlemek, bu konudaki belirsizliği gidermek ve uzmanlara, araştırmacılara, klinisyenlere bilgi ver-mektir.

Anahtar Kelimeler

• Otizm spektrum bozukluğu
• otizm
• anksiyete
• sosyal anksiyete bozukluğu
• komorbidite

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