Objective: The aim of this study was to compare cognitive flexibility
and executive functions in adolescents diagnosed with social anxiety
disorder (SAD) who have autistic traits with those who do not, and to
investigate whether there is a significant difference compared to healthy
controls.
Method: The study included 36 adolescents diagnosed with SAD and
36 healthy controls. All participants completed the Cognitive Flexibility
Scale (CFS), and the Liebowitz Social Anxiety Scale was administered
to the SAD group. Neuropsychological tests including the Stroop
Test TBAG Form, the Wisconsin Card Sorting Test (WCST), Raven’s
Standard Progressive Matrices Test, and Visual-Auditory Digit Span
Test-B were applied. Autistic traits were assessed using the Autism
Spectrum Quotient-Adolescent’s Version (AQ-Adolescent) and the
Childhood Autism Rating Scale.
Results: There was no statistically significant difference in CFS scores
between the social anxiety disorder and control groups. The SAD
group showed poorer performance in the subdomains of the WCST.
Additionally, in all subtestes of the Stroop test, the SAD group took
significantly longer to complete the test. The AQ-Adolescent scores
were significantly higher in the SAD group compared to the controls. In
25% (n=9) of the cases, autistic traits were above the cutoff. There were
no significant difference in neuropsychological test results between the
groups who have and do not have autistic traits within the case group.
A weak negative correlation was found between the Liebowitz total
and avoidance subscale scores and the AQ-imagination and attention
to detail scores, while no correlation was found between the Liebowitz
dimensions and CFS scores.
Conclusion: This is the among the first studies to examine autistic
traits and executive functions among adolescents with SAD. While no
difference was found in cognitive flexibility scale scores between the
SAD and control groups, the SAD group showed poorer performance in
tests measuring other executive functions. However, this difference was
not significantly influenced by the presence of autistic traits.
Keywords: Adolescent, autistic traits, cognitive flexibility, executive
function, neuropsychological test, social phobia