A Narrative Review on the Relationship Between Autistic Traits and Anxiety

Buket Kılıç ^1,* , Dilek Ünal ² 

1. Şanlıurfa Balıklıgöl State Hospital, Child and Adolescent Psychiatry Department, Şanlıurfa, Turkey

2. Hacettepe University, Child and Adolescent Psychiatry Department, Ankara, Turkey

* Correspondence: Buket Kılıç 

Academic Editor: Fabrizio Stasolla

Received: May 31, 2025 | Accepted: October 19, 2025 | Published: October 27, 2025

OBM Neurobiology 2025, Volume 9, Issue 4, doi:10.21926/obm.neurobiol.2504307

Recommended citation: Kılıç B, Ünal D. A Narrative Review on the Relationship Between Autistic Traits and Anxiety. OBM Neurobiology 2025; 9(4): 307; doi:10.21926/obm.neurobiol.2504307.

© 2025 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

1. Introduction

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication and interaction across different environments, along with restricted or repetitive behaviors, unusual interests, and sensory sensitivities [1]. Its prevalence worldwide is estimated to be around 1% [2]. Approximately 40% of individuals with ASD also experience anxiety disorders [3], which are marked by persistent and excessive worry or avoidance of perceived threats, often impairing daily functioning [4]. Anxiety disorders include separation anxiety disorder, selective mutism, specific phobias, social anxiety disorder, generalized anxiety disorder, and panic disorder [1].

People who do not have a formal diagnosis of ASD but still display some autistic traits have been identified [5]. These subthreshold traits are often referred to as the Broad Autism Phenotype [6]. They are heritable and are spread throughout the general population in a continuous spectrum [7,8]. In our clinical practice, we often see that children and adolescents who do not have an ASD diagnosis but do display autistic traits frequently experience various anxiety disorders, such as specific phobias, separation anxiety disorder, and social anxiety disorder. Recent research has increasingly focused on this relationship, with several studies emphasizing the connection (see Table 1, Table 2, Table 3). The wide range of symptoms within autism spectrum disorder, the overlap with other conditions, and the high occurrence of autistic traits in families show why it's essential to approach ASD and related conditions from a dimensional perspective [9,10,11].

Table 1 Studies on the relationship between autistic traits and anxiety in children.

Table 2 Studies on the relationship between autistic traits and anxiety in emerging adults.

Table 3 Studies on the relationship between autistic traits and anxiety in adults.

Numerous studies have demonstrated that the presence of autistic traits alongside Attention Deficit Hyperactivity Disorder (ADHD) leads to a more complex clinical presentation [12,13]. Similar to ADHD, based on our clinical observations and the existing literature, we believe that autistic traits influence the clinical features and severity of anxiety disorders in a manner that varies from patient to patient. Consequently, there is a need to develop more targeted treatment approaches for individuals with anxiety disorders who also exhibit autistic traits.

While there has been substantial research on anxiety disorders in individuals diagnosed with ASD, studies focusing on anxiety symptoms in individuals with subthreshold autistic traits remain relatively limited [45]. To our knowledge, no comprehensive review has yet explored the detailed relationship between subthreshold autistic traits and anxiety disorders. Understanding this relationship from a dimensional perspective is essential, as it can help identify overlapping symptoms and support the development of personalized treatment approaches for these individuals.

Furthermore, distinguishing anxiety disorders in individuals with and without autistic traits can help create more homogeneous patient groups in neurobiological research. This may improve the detection of specific findings and increase the accuracy of such studies. Additionally, with this review, we hope to raise clinicians' awareness of the potential role that autistic traits may play in anxiety disorders presenting with atypical symptoms. Therefore, this review aims to examine the specific types and manifestations of anxiety disorders associated with autistic traits.

2. Materials and Methods

While writing this review, the SANRA (Scale for the Assessment of Narrative Review Articles) guidelines were followed. A comprehensive PubMed search was conducted for articles published up to September 1, 2024. The search utilized keywords such as ‘anxiety’, ‘autistic trait’, ‘autism trait’, ‘autism-like symptom’, and ‘ASD-like symptom’ in titles and abstracts.

Included were research articles, reviews, and case reports that explored the relationship between autistic traits and anxiety in individuals without a formal diagnosis of ASD. Studies that examined this relationship in both ASD-diagnosed and non-diagnosed groups were also considered, provided the focus was on the non-diagnosed subgroup. Studies exclusively focusing on individuals with ASD were excluded. Only articles published in English were considered. A total of 32 research articles and one case report were included, with a combined participant count of 48,268.

This review aims to synthesize existing findings on the relationship between autistic traits and anxiety in individuals without an ASD diagnosis, thereby increasing clinician awareness of this critical topic.

3. Results

Recent years have seen a rise in studies exploring the connection between anxiety and autistic traits in individuals without a formal ASD diagnosis (see Table 1, Table 2, Table 3). These investigations have included both members of the general population and individuals with various psychiatric conditions.

3.1 Studies on ADHD and Other Psychiatric Disorders

It has been observed that studies examining the relationship between autistic traits and anxiety in children diagnosed with ADHD are somewhat more numerous compared to those focusing on other psychiatric diagnoses. In one such study, children with ADHD who exhibit emotional dysregulation tend to have higher rates of anxiety disorders and autistic traits [14]. Another study found a link between restrictive and repetitive behaviors and anxiety disorders in children with ADHD [12]. Additionally, research involving children with ADHD displaying autistic traits has indicated a higher prevalence of anxiety disorders [13], although another study did not find such a difference [15]. The discrepancies in findings regarding the relationship between autistic traits and anxiety across these studies may be attributed to differences in sample sizes, methods of diagnosing anxiety disorders—one using semi-structured clinical interviews and the other relying on parent reports—as well as variations in the scales used to measure autistic traits.

The relationship between autistic traits and anxiety is much less studied in other psychiatric disorders. In one study, among individuals with functional neurological disorders, those who exhibit autistic traits tend to have a higher prevalence of anxiety and social phobia symptoms compared to those without these traits. The same study also showed that alexithymia is related to anxiety disorders. Data on anxiety disorders and autistic traits were collected using self-report scales [33].

It is essential to investigate the factors that may contribute to the higher prevalence of anxiety disorders in patients with psychiatric diagnoses such as ADHD and functional neurological disorders who also exhibit autistic traits. These traits can influence the symptoms and functioning of individuals with these conditions. Furthermore, studying how autistic traits affect other psychiatric disorders is also considered crucial.

3.2 Studies Based on Age and Ethnic/Cultural Variables

The age at which psychiatric symptoms are examined is significant. Longitudinal studies provide valuable information about the persistence of these symptoms. However, there are very few long-term studies that investigate the relationship between autistic traits and anxiety [16,17]. In one of these studies, a population-based twin sample was followed. It found that autistic traits at age 7 predict internalizing characteristics at age 12. Communication difficulties were identified as the most significant autistic trait contributing to these internalizing problems. The study also showed that both characteristics were stable over time. It suggested that shared environmental factors, rather than genetics, might play a role in the relationship between the traits [16]. The authors noted that the findings were based only on parent reports. Additionally, the study did not specifically examine anxiety disorders. Instead, it looked at depressive symptoms, anxiety symptoms, and somatic symptoms together as internalizing traits. This makes it harder to connect the results to anxiety directly.

Studies with university students have shown that autistic traits are linked to anxiety [25,26]. It has also been found that loneliness and social connections with peers mediate this relationship [26]. In these studies, information about autistic traits and social relationships was obtained through self-report measures. Another study with university students found that autistic traits predict self-harm behaviors, with anxiety acting as a mediating factor. The authors emphasized that targeting anxiety could be clinically significant in reducing self-harm among individuals with autistic traits [27]. It is also noticeable that different scales were used to identify autistic characteristics in these studies.

Several studies have examined the relationship between autistic traits and anxiety in specific populations exhibiting certain characteristics. For example, one study involving mothers in the first month postpartum found that autistic traits are associated with anxiety. In this study, both autistic traits and anxiety were measured using self-report scales [34]. Another study observed a stronger link between autistic traits and anxiety symptoms among participants who identified as Black compared to those who identified as non-Hispanic White. The researchers noted a limitation: most participants in this study identified as White, which made it difficult to draw definitive conclusions [28]. Despite this, the findings suggest that race-related stress is an important psychosocial factor. Future research should consider it when exploring the relationship between autistic traits and anxiety.

Similar to autism, research is now being conducted on older adults with autistic traits. Studies involving individuals over 50 show that autistic traits are associated with higher levels of anxiety and post-traumatic stress disorder (PTSD) symptoms. These studies include both large and small sample groups, and all of them have used self-report scales [35,36,37]. The authors emphasize that in older adults, autistic traits have a greater impact on the development of anxiety and depression than issues with executive functions or reductions in social support [37]. Therefore, as the global population continues to age, there is a growing need for more research on autistic traits in older individuals.

3.3 Studies in Specific Anxiety Disorders

Autistic traits have been most notably studied within the context of anxiety disorders, especially social anxiety disorder. Many studies have reported a positive correlation between autistic traits and social anxiety disorder [29,30,38]. When examining these studies individually, specific autistic characteristics associated with anxiety have been identified. For example, one study found that social skills, attention switching difficulties, and communication challenges predict social anxiety [29]. In a study of Chinese university students, it was found that coping styles and sense of security mediate the relationship between autistic traits and social anxiety. Additionally, the same study identified that the rs3800373 polymorphism in the FK506 binding protein 5 (FKBP5) gene moderated this association. However, the authors noted that convenience sampling could cause selection bias [30]. In a study involving adult participants, although the sample size was small, non-verbal communication and empathy difficulties were reported to be related to social anxiety [38].

In a study with a strong methodology, information was gathered from children, parents, and teachers, and structured autism diagnostic interviews were used to rule out ASD cases. The study found that among autistic traits in children, only social-communicative difficulties were related to social anxiety [18]. In another study involving children, all anxiety disorders were found to be associated with autistic traits. However, earlier in childhood, only social anxiety was linked to autistic traits. The authors suggest two possible explanations for this. First, children with autistic traits may be more likely to develop social anxiety disorder from an early age. Second, different scales were used to measure autistic traits during toddlerhood and later childhood, which could account for the differences. In this study, the authors specifically noted that communication-related autistic traits are mainly responsible for the association with social anxiety. They also mention some limitations, such as the relatively small number of participants and the retrospective assessment of early childhood autistic traits. These factors could introduce recall bias [19].

Another study involving children found that autistic traits are associated with social anxiety disorder and specific phobias. Additionally, parental reports indicated that interpersonal worry was more commonly observed in anxiety disorders, while children's self-reports highlighted that fear of doctor visits was more prominent. The authors suggested that interpersonal worry in children with autistic traits might be related to concerns about appearing socially acceptable. In contrast, fear of medical visits could be linked to hypersensitivity to sounds and tactile stimuli experienced during medical procedures [20].

Some authors emphasize the importance of caution when interpreting measurements, due to the overlap of symptoms between autistic traits and social anxiety. In their study, adults with social anxiety scored significantly higher on a scale measuring autistic traits, especially in the social skills subscale. However, the study had limitations. For example, it did not screen for ASD diagnosis using structured assessments, and the sample size was limited. The authors suggest that individuals with autistic traits tend to have deficits in social skills that are not specific to a particular context. In contrast, those with social anxiety experience difficulties related to social performance due to anxiety, which is context-specific [39].

Researchers aiming to distinguish between autistic traits and social anxiety symptoms have examined features such as eye contact and facial emotion recognition. These studies have found that social anxiety and autistic traits differ notably in the duration and phases of eye contact [21,31]. For example, one study suggested that social anxiety affects only the initial fixations on the eyes, while autistic traits influence attention to the eyes throughout the entire viewing period. Additionally, they discovered an interactive effect between social anxiety and autistic traits on attention to the eyes [31]. In another study, when controlling for social anxiety, elevated autistic traits were associated with delayed orienting to the eyes presented among distractors. Conversely, higher levels of social anxiety were linked to faster orienting away from the eyes, even when controlling for autistic traits [21]. Another research focused on emotion recognition. It found that individuals with autistic traits often struggle to accurately recognize emotions from faces, whereas those with social anxiety tend to lack confidence in their social predictions. The authors argued that high social anxiety traits might not directly impact emotion recognition itself but could affect the top-down evaluation of one's own ability to recognize emotions. In contrast, high autistic traits might be related to a reduced integration of sensorimotor stimuli that promote emotion recognition. They also noted that since their study was conducted in a laboratory setting and predominantly involved female participants, caution should be exercised when generalizing these findings to real-life situations [32].

Few studies have examined the relationship between other anxiety disorders and autistic traits. In one study, selective mutism symptoms were clearly linked to social anxiety and behavioral inhibition. The study also suggested that autistic characteristics might play a role in the selective non-speaking behavior of children. However, the authors advised caution in interpreting these findings due to several methodological limitations. These included the fact that some children in the selective mutism group had not yet received a definitive diagnosis, autistic traits were also elevated in the control group, and the sample size was relatively small [22]. Another study examining the relationship between autistic traits and other anxiety disorders found that children exhibiting autistic traits—such as those with an ASD diagnosis among twin siblings—showed higher symptom levels compared to typically developing children. The observed symptoms included generalized anxiety, separation anxiety, social anxiety, and panic disorder. These results were based on parental reports [23].

In a longitudinal study, children with siblings diagnosed with ASD were followed from infancy up to the age of 7. At age 7, high-risk infants for autistic traits exhibited more symptoms of separation anxiety compared to healthy controls. In this study, the use of structured diagnostic tools to identify risk groups is one of the strengths of the research [17]. Besides these, there is an interesting case presentation in which autistic traits are observed alongside separation anxiety. In this case, an adult male patient with Behçet's disease was reported to have diagnoses of anorexia nervosa and separation anxiety disorder, along with autistic traits. The authors discussed how neurodevelopmental challenges, such as autistic traits, might predispose individuals to separation anxiety. Furthermore, they linked the patient’s Behçet's syndrome to the still-investigated autoimmune hypothesis in autism [40].

3.4 Studies on Mediators between Autistic Traits and Anxiety

Research suggests that the relationship between autistic traits and anxiety may be influenced by certain variables, particularly in adolescent and adult populations. Studies conducted on the general adult population have indicated that alexithymia, sensory hypersensitivity, and stress serve as mediators in the link between autistic traits and anxiety. The authors emphasize that therapeutic interventions targeting alexithymia, as well as creating sensory-neutral environments in daily life, could be effective in reducing anxiety disorders in individuals with autistic traits. Similar studies, replicated under laboratory conditions, are also recommended to minimize recall bias that may arise from completing scales [41,42].

Recent research has increasingly explored the relationship between anxiety and autistic traits, focusing on concepts such as social camouflaging and pathological demand avoidance. Social camouflaging involves behaviors aimed at hiding or compensating for autistic traits. However, it can lead to adverse outcomes like anxiety and burnout over the long term [46]. A study found that social camouflaging in adults can cause adverse mental health effects, including increased anxiety, beyond the impact of autistic traits alone. It also noted that camouflaging behaviors are more strongly associated with poorer mental health outcomes in women. The researchers acknowledged some limitations, such as an unbalanced gender representation and the lack of consideration for sociodemographic factors like ethnicity and sexual identity, which could influence the relationship between camouflaging and mental health. They also emphasized the importance of identifying which specific autistic traits are most linked to camouflaging behaviors [43]. Another study showed that social camouflaging predicted anxiety in both autistic and non-autistic adolescents. The study found that camouflaging caused more distress in girls. This may be because girls are more sensitive to peer relationship issues during adolescence and have more opportunities to open up socially. The authors highlighted that reducing anxiety caused by camouflaging and strengthening self-esteem, social skills, and self-acceptance should be key goals in therapy. However, they noted limitations such as the small number of girls in the sample, limited exploration of sociodemographic variables, and not accounting for IQ [24].

Another concept that has gained popularity recently is pathological demand avoidance, which is characterized by an extreme resistance to everyday demands. There is an ongoing debate about whether this concept falls within the autism spectrum [47]. Conversely, some authors believe that anxiety is the primary determinant of pathological demand avoidance [48]. Research involving adults from the general population indicates that both autistic traits and anxiety are significant predictors of pathological demand avoidance. The authors suggest that strategies aimed at reducing anxiety could be effective in decreasing pathological demand avoidance [44].

Based on the studies summarized above, the relationship between autistic traits and anxiety disorders has been examined across different age groups, from early childhood to old age. Most studies involving the general population focus on university students, while a few include children. These studies find that autistic traits are linked to anxiety disorders, especially social anxiety symptoms. Many of them also show that this positive link is mediated by factors like social competence, loneliness, coping skills, alexithymia, and social camouflaging.

Studies with individuals over 50 show that those with autistic traits have more anxiety symptoms. The adult groups vary and include postpartum women, people with functional neurological disorders, and individuals from different ethnic and cultural backgrounds. Across all groups, those with autistic traits tend to experience higher anxiety levels.

Studies involving children often include those diagnosed with anxiety disorders and ADHD. Research has shown a connection between autistic traits and anxiety in children with ADHD, although some studies have not found this relationship. These inconsistent findings may be due to differences in study methods. In children, social anxiety disorder is most commonly associated with autistic traits, similar to what is seen in adults. Two longitudinal studies with children also found that autistic traits are linked to anxiety. Furthermore, children at high risk for autistic traits tend to experience separation anxiety more frequently. Communication-related autistic traits are associated with anxiety in both children and adults. Nearly all studies on children with anxiety disorders report higher levels of autistic traits compared to children without such conditions.

Research generally indicates a relationship between autistic traits and anxiety. Most studies have used self-report scales for adults and parent-report scales for children. However, some studies have used structured interviews to identify autistic traits and exclude ASD diagnoses. The sample sizes across studies vary. Additionally, different scales have been used to measure autistic traits and anxiety disorders. In some studies, the main research question was to determine the relationship between autistic traits and anxiety. In others, additional questions were also explored. Despite methodological differences, a common finding in most studies is that there is a positive correlation between autistic traits and anxiety disorders.

4. Discussion

We found that studies on the relationship between autistic traits and anxiety disorders cover different age groups, the general population, and some psychiatric conditions. The studies with children and adults differ in sample characteristics and data collection methods, with many using self-report or parent-report scales. Although there are few, some longitudinal studies have also been done. These differences should be considered when interpreting the results.

We found that most of the studies demonstrated a positive relationship between autistic traits and anxiety disorders or symptoms. While some research directly showed this link, other studies indicated that various mediating variables influenced the relationship. We observed that these mediators—particularly in adult populations, including university students—were often related to feelings of loneliness, social competence, a sense of social connectedness, and coping styles. We think these issues may be associated with the social difficulties faced by young adults, especially those living independently after starting university, without support from families who are aware of their autistic traits. Another study involving university students showed that autistic traits were associated with an increase in self-harming behaviors mediated by anxiety [22]. In adults, it has been demonstrated that autistic traits relate to anxiety through intermediaries such as alexithymia, stress, and sensory hypersensitivity [41,42]. Based on these findings, autistic traits in late adolescence and early adulthood may not directly cause anxiety, but are linked to it through the challenges they create. In children, on the other hand, the relationship between autistic traits and anxiety has generally been examined without considering other mediating factors. Therefore, it is plausible that, during an individual's developmental process, autistic characteristics may contribute to anxiety when interacting with different environmental factors. Longitudinal studies supporting this view are necessary.

Communication difficulties are noteworthy both in children and adults with social anxiety disorder. While most studies examine autistic traits as a single factor, consistent findings have emerged from research that investigates these traits separately. Children who experience communication problems from early childhood are more likely to develop negative beliefs about their social skills as a result of negative feedback from those around them, which can increase the likelihood of avoiding social situations [49]. Similar to other age groups, autistic traits are most strongly associated with social anxiety disorder in children. Additionally, children with autistic traits are more frequently diagnosed with separation anxiety disorder and specific phobias compared to their typically developing peers. In social anxiety disorder, individuals with subthreshold symptoms related to social skills and communication difficulties may experience negative social encounters and heightened awareness of these experiences throughout their lives, potentially contributing to the disorder.

Separation anxiety disorder is also expected to be more common among children with autistic traits, as stress related to changes in routines and difficulties with mentalization can make unfamiliar environments challenging, especially when supportive parents who understand their struggles are absent [50,51]. Moreover, it is noteworthy that interpersonal worry and fear of doctor visits are more prevalent in children with autistic traits. Interpersonal worry may be linked to feelings of social inadequacy. At the same time, fear of medical procedures could relate to sensory sensitivities—such as discomfort with tactile and auditory stimuli—common in children with autistic traits [33,52].

Many studies examining the relationship between autistic traits and anxiety in children have been conducted on those diagnosed with ADHD. It is known that autistic traits are present in approximately 30% of individuals with ADHD, leading to a more complex clinical presentation [13,53]. Most of these studies found that children with ADHD who also exhibit autistic traits experience higher rates of anxiety disorders compared to those without such characteristics. This suggests that autistic traits may exacerbate emotional dysregulation in children with ADHD [13,54]. Indeed, some research has reported that children with ADHD and comorbid emotional dysregulation tend to display more autistic traits and higher levels of anxiety [15].

Researchers warn clinicians to interpret the results of scales measuring autistic traits and social anxiety symptoms with caution, as there is symptom overlap between the two. It is well known that social anxiety is primarily related to difficulties in social performance and is context-specific. In contrast, social problems in autistic traits are associated with widespread deficits in social skills [34]. Additionally, studies have been conducted to distinguish autistic traits from social anxiety symptoms. For example, research has shown that autistic traits and social anxiety have different impacts on eye contact and emotion recognition from faces [35,36,37]. In this regard, developing a scale specifically to assess autistic traits in individuals with social anxiety disorder could help reduce the current uncertainty in this area.

Some studies examining the relationship between autistic traits and anxiety have also been conducted on older populations. In addition to the increased recognition of elderly individuals on the autism spectrum and the rise in research involving these individuals [55], it has been reported that older adults with subthreshold autistic traits experience higher rates of anxiety compared to controls without these traits [25,26,27]. A striking finding in this age group is that autistic traits contribute more to anxiety and depression than to issues related to executive function problems and reduced social support [27]. Therefore, conducting more studies that include autistic traits within geriatric psychiatry will enhance our understanding of this topic.

In recent years, there has been growing interest in topics like social camouflaging and pathological demand avoidance among individuals with autistic traits. Research has shown that social camouflaging is linked to increased anxiety in adolescents and adults, beyond the effects of autistic traits alone [44,45]. Notably, the frequent use of camouflaging as a coping strategy is particularly evident in women with autistic traits or an autism diagnosis, which often leads to delayed diagnosis [56]. Adolescence is a critical period for identity development, during which peer perceptions hold significant importance [57]. In this context, despite its costs, it is understandable that adolescents and young adults with autistic traits utilize social camouflaging more frequently to improve social integration. To prevent the adverse outcomes of social camouflaging, it is essential for families, teachers, and clinicians to be informed about this concept and to provide support to young people. Moreover, another new concept is pathological demand avoidance (PDA). There are different views on whether PDA is part of the restrictive features of autism or if anxiety is the primary trigger [46,47]. A study in the general population found that both autistic traits and anxiety influence PDA [48]. More research is needed to understand better the relationship between autistic traits, anxiety, and PDA.

Some studies on the relationship between autistic traits and anxiety have examined the contributions of genetic and environmental factors. In one of these studies, it was demonstrated that the rs3800373 polymorphism in the FKBP5 gene plays a mediating role in the relationship between autistic traits and social anxiety [29]. In a longitudinal twin study, it was reported that shared environmental factors, rather than genetic factors, may have a more prominent role in the relationship between autistic traits and internalizing traits [18]. It is also known that both genetic and environmental factors are involved in the relationship between ASD and anxiety disorders [58,59]. One of the environmental factors could be the reflection of ethnic/cultural differences on individuals. For example, a study found that the relationship between autistic traits and anxiety symptoms was stronger in individuals who identified as Black compared to those who identified as White [24]. Additionally, the prevalence of social anxiety disorder is known to vary according to the culture in which an individual lives [60]. Considering all these factors, there is a need for further research to explore the extent of the contribution of genetic and environmental factors in the relationship between sub-threshold autistic traits and anxiety.

It is believed that understanding the effects of autistic traits in various anxiety disorders can significantly contribute to the diagnostic and treatment processes for clinicians. On the other hand, research in this area is also valuable for identifying which intermediary variables can be targeted to prevent anxiety disorders in individuals with autistic traits. The existing literature consistently demonstrates a positive relationship between autistic traits and anxiety. However, most studies have generally focused on overall anxiety symptoms or specifically on social anxiety disorder in relation to autistic traits. Only a limited number of studies have explored other anxiety disorders. Therefore, a notable gap in the literature is the relatively scarce research on the impact of autistic traits across different anxiety disorders. Additionally, there is a lack of studies specifically investigating the role of subthreshold autistic traits—such as social deficits, repetitive behaviors, and sensory sensitivities—in anxiety disorders. While there are studies on autistic traits and anxiety in the general population and children diagnosed with ADHD, the relationship between autistic traits and anxiety in other psychiatric conditions has not yet been sufficiently explored.

Most adult studies in data collection have relied on self-report measures, while parent-report scales have been predominantly used in studies involving children. It has been observed that the number of studies excluding ASD diagnoses through structured clinical interview tools is limited. This can be considered a general limitation applicable to many studies. Since data obtained via scales may introduce various biases, it is also essential to conduct more objective observation-based research in this field. Although there are studies involving different age groups examining the relationship between autistic traits and anxiety disorders, research exploring the role of cultural differences is minimal. Therefore, investigating the relationship between autistic traits and anxiety disorders in different cultures is deemed to be of significant importance.

Since no review currently explores autistic traits and anxiety in individuals without a formal ASD diagnosis, this study is expected to make a valuable contribution. In this review, studies examining the relationship between autistic traits and anxiety will be classified according to different age groups and diagnostic categories, to identify gaps in the existing literature and provide guidance for future research. Furthermore, as a result of our study, we believe it will raise clinicians’ awareness about the role of autistic traits in anxiety disorders that exhibit atypical symptoms.

Furthermore, our study has some limitations. Since the work is a narrative review, the findings of the included studies have not undergone statistical analysis. As a result, the level of scientific evidence is not as high as that of systematic reviews. Another limitation is that the studies related to the topic were sourced from a single, albeit comprehensive, database. Lastly, variables that could potentially influence the relationship between autistic traits and anxiety were not included to stay focused on our primary research question. While this provides an overall overview related to our central inquiry, it may have also limited the in-depth exploration of other variables that could impact the relationship between autistic traits and anxiety.

5. Conclusion

Numerous studies show that autistic traits are positively linked to anxiety disorders in individuals of all ages without a formal ASD diagnosis. Among these, social anxiety disorder has been identified as the most frequently studied and significantly linked to autistic traits. However, some authors emphasize the need for caution when interpreting scale results, as there is an overlap between autistic traits and social anxiety symptoms. Particularly in young adults, the relationship between autistic traits and anxiety is influenced by individual or environmental mediating factors. Additionally, it has been observed that autistic traits are less extensively examined in other anxiety disorders, and that structured interview tools are used less frequently in research compared to self-report scales.

Our suggestions for future research are as follows: 1) investigating the role of autistic traits in different types of anxiety disorders; 2) using structured diagnostic tools that can provide more objective data in identifying autistic traits and anxiety disorders; 3) examining this relationship in populations with diverse cultural and ethnic backgrounds; 4) classifying autistic traits and studying their relationship with anxiety in a more specific manner; 5) investigating the effect of social camouflaging on the relationship between autistic traits and anxiety in samples of different age groups; 6) developing a scale to assess autistic traits in individuals with social anxiety disorder; 7) developing a scale to examine sensory sensitivities in specific phobias. Through these approaches, it may become possible to detect the presence of autistic traits in some patients presenting with anxiety disorders and to modify treatment accordingly.

Author Contributions

Buket Kılıç: Conceptualization, methodology, writing-original draft. Dilek Ünal: Conceptualization, methodology, writing-review and editing.

Funding

The study did not receive funding support from any individuals or organizations.

Competing Interests

The authors have declared that no competing interests exist.

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