Anxiety is one of the most frequently reported co-occurring conditions for autistic children and adolescents. The relationship between anxiety and social outcomes in autistic youth has been the focus of a range of studies, with mixed results. This meta-analysis aimed to identify the strength of the association between anxiety and a frequently researched social outcome (social competence) in autistic young people and whether that association is influenced by individual or research design factors. A previous preregistered systematic review was updated with a search of the same three databases (CINAHL, ERIC, and PsycINFO) as the original review. Through this, 20 studies with sufficient data on a neurotypically-defined measure of social competence and anxiety were identified. Results were synthesised using a mixed effects model. The meta-analysis on 2,321 participants (from 22 samples) highlighted wide heterogeneity in results. The findings show that anxiety has a significant, small negative impact on social competence (d = − 0.48; 95% CI = − 0.71, − 0.26), meaning that as scores on measures of anxiety increase, scores on measures of social competence decrease. This relationship between anxiety and social competence was moderated by age, becoming weaker as age increased. Whilst this is an important finding for supporting mental health and well-being of autistic young people, the large amount of variance left unexplained suggests that multiple factors, including the use of measures designed for neurotypical people and the potential impact of camouflaging on such measures, need to be considered in future designs.

焦虑是自闭症儿童和青少年最常报告的并发病症之一。自闭症青少年的焦虑与社会结果之间的关系一直是一系列研究的焦点，但结果好坏参半。这项荟萃分析旨在确定自闭症年轻人的焦虑与经常研究的社会结果（社交能力）之间关联的强度，以及这种关联是否受到个人或研究设计因素的影响。之前的预注册系统综述已更新为与原始综述相同的三个数据库（CINAHL、ERIC 和 PsycINFO）检索。通过这项研究，我们确定了 20 项研究，这些研究在神经典型定义的社交能力和焦虑测量方面拥有足够的数据。使用混合效应模型综合结果。对 2,321 名参与者（来自 22 个样本）的荟萃分析强调了结果的广泛异质性。研究结果表明，焦虑对社交能力有显着但较小的负面影响（d  = − 0.48；95% CI  = − 0.71，− 0.26），这意味着随着焦虑测量得分的增加，社交能力测量得分会下降。焦虑和社交能力之间的这种关系随着年龄的增长而减弱，并且随着年龄的增长而减弱。虽然这是支持自闭症年轻人心理健康和福祉的重要发现，但大量无法解释的差异表明，多种因素，包括使用为神经正常人群设计的措施以及伪装对这些措施的潜在影响，需要在未来的设计中考虑。