Refining our Understanding of Anxiety in Autistic Youth: Examining the Role of Behavioral Inflexibility

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Harrop, C., Bodfish, J., Lecavalier, L., Dallman, A., Jones, D., Pritchett, J., Whitten, A., & Boyd, B. A. (2023). Refining our Understanding of Anxiety in Autistic Youth: Examining the Role of Behavioral Inflexibility. Journal of Autism and Developmental Disorders, 54(10), 3620-3629. https://doi.org/10.1007/s10803-023-06079-3

Publication date: 2 Aug 2023 Added to AutiHub: 23 Oct 2026 Type: Article Article language: English
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Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Clare Harrop
  2. James Bodfish
  3. Luc Lecavalier
  4. Aaron Dallman
  1. Desiree Jones *
  2. Jill Pritchett
  3. Allison Whitten
  4. Brian A. Boyd

Abstract

Prior research has demonstrated that cognitive inflexibility is associated with anxiety in autistic individuals. Everyday patterns of behavioral inflexibility (e.g. observable inflexible behavior in the context of the need to change or adapt and that is manifested in real-world everyday settings) is common in autism and can be distinguished from performance on discrete cognitive tasks that tap flexible attention, learning, or decision-making. The purpose of this study was to extend this prior work on inflexibility in autism but with measures specifically developed with input from stakeholders (caregivers and clinicians) for autistic youth designed to measure everyday behavioral inflexibility (BI). We characterized anxiety in a large sample of autistic (N = 145) and non-autistic youth (N = 91), ages 3 to 17 years, using the Parent Rated Anxiety Scale for Autism Spectrum Disorder (PRAS-ASD). Further, we sought to understand how BI, measured via the Behavioral Inflexibility Scale (BIS), predicted anxiety compared to other variables known to increase anxiety in youth (chronological age, IQ, autism diagnosis, assigned sex at birth). Autistic youth had higher parent-related anxiety and BI compared to non-autistic youth. BI was the strongest predictor of anxiety scores, irrespective of diagnosis. Overall, our findings highlight the importance of BI to the understanding of anxiety in autistic youth.

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 23 Oct 2026 17:25.

Cited references
78
With a DOI
72
Without a DOI, from raw bibliography text
6
4 / 78 (5.1%) cited references include at least one author identified as autistic.
References with data to complete
5 / 78 (6.4%)
References with detected author names
73 / 78 (93.6%)
Without detected author names
5
Without a structured title
5
Without a stable identifier
6
References with raw author names still to review
5
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
422
From DOI or external metadata
422
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
19
209 / 422 (49.5%) names are linked to an author already present in AutiHub. 213 / 422 (50.5%) names are not yet linked.
Names linked to a person identified as autistic
15 / 422 (3.6%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 15 / 209 (7.2%). Distinct people identified as autistic: 14 / 313 (4.5%).
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