HPA and SAM axis responses as correlates of self- vs parental ratings of anxiety in boys with an Autistic Disorder

• Anxiety and Autistic Disorder (AD) often overlap.
• Self- and parental ratings of anxiety in children with an AD may disagree.
• Physiological indicators of anxiety can be used to confirm these ratings.
• In a sample of 32 AD boys, only self-ratings agreed with physiological indicators.
• Correlations between cortisol and self-rated anxiety suggested hypocortisolism.

Anxiety and Autistic Disorder (AD) are both neurological conditions and both disorders share some features that make it difficult to precisely allocate specific symptoms to each disorder. HPA and SAM axis activities have been conclusively associated with anxiety, and may provide a method of validating anxiety rating scale assessments given by parents and their children with AD about those children. Data from HPA axis (salivary cortisol) and SAM axis (salivary alpha amylase) responses were collected from a sample of 32 high-functioning boys (M age = 11 yr) with an Autistic Disorder (AD) and were compared with the boys' and their mothers' ratings of the boys' anxiety. There was a significant difference between the self-ratings given by the boys and ratings given about them by their mothers. Further, only the boys' self-ratings of their anxiety significantly predicted the HPA axis responses and neither were significantly related to SAM axis responses. Some boys showed cortisol responses which were similar to that previously reported in children who had suffered chronic and severe anxiety arising from stressful social interactions. As well as suggesting that some boys with an AD can provide valid self-assessments of their anxiety, these data also point to the presence of very high levels of chronic HPA-axis arousal and consequent chronic anxiety in these boys.