Maladaptive cognitive appraisals in children with high-functioning autism: associations with fear, anxiety and theory of mind

Despite the well-documented success of cognitive restructuring techniques in the treatment of anxiety disorders, there is still little clarity on which cognitions underpin fear and anxiety in children with high-functioning spectrum disorders (HFASD). This study examined whether certain cognitive appraisals, known to be associated with fear and anxiety in non-HFASD groups, may help explain these emotions in children with HFASD. It also investigated relations between these cognitive appraisals and theory-of-mind (TOM). Using a vignette approach, appraisals, fear and anxiety were assessed in 22 children with HFASD and 22 typically developing (TD) children. The two groups differed significantly on all four appraisal types. Anxiety was negatively correlated with future expectancy and positively with problem-focused coping potential in the HFASD group, but was not correlated with appraisals in the TD group. Emotion-focused coping potential was the only appraisal correlated with fear in the HFASD group and only self-accountability in the TD group. Linear regression analysis found appraisals of emotion-focused coping potential, problem-focused coping potential and future expectancy to be significant predictors of TOM ability in the HFASD group. These findings indicate that specific, problematic patterns of appraisal may characterise children with HFASD.