Exploring the suitability of the Clark and Wells (1995) model of Social Anxiety in Autistic Adults: The role of mental imagery and fear of negative evaluation

Jiedi Lei, Juliette Attwood, Ailsa Russell

Research output: Contribution to journalArticlepeer-review

Abstract

Around 50% of autistic adults meet diagnostic criteria for social anxiety disorder based on self-report questionnaires. Among non-autistic adults with social anxiety, distorted negative self-imagery in social situations stemming from fear of negative evaluation from observers can be corrected in cognitive therapy via video feedback. However, the role of social imagery in the maintenance of social anxiety has not been explored in autistic adults. This study examined in 62 autistic adults: (1) quality of social imagery elicited during social situations; (2) how image qualities were related to self-reported levels of social anxiety and fear of negative evaluation when accounting for co-occurring generalised anxiety. Many autistic adults reported social imagery from a field (i.e., looking through one’s own eyes) rather than observer perspective. Using response surface analysis (RSA), autistic adults wanted to escape from/avoid social imagery and found them more upsetting when social anxiety was greater than fear of negative evaluation from others. Social imagery may be linked to autistic adults’ somatic and sensory responses related to social anxiety rather than cognitive worries associated with fear of negative evaluation from others in social situations. Future studies can explore how qualitative differences in social imagery may influence maintenance of social anxiety and treatment efficacy in autistic and non-autistic adults over time.
Original languageEnglish
JournalAutism
Early online date30 Oct 2025
DOIs
Publication statusE-pub ahead of print - 30 Oct 2025

Data Availability Statement

Anonymised quantitative data can be made available upon request, please contact corresponding author for more information.

Acknowledgements

The authors would like to thank all participants who have given their time generously to take part in this study.

Funding

The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This research was completed as part of JA’s Doctoral Clinical Psychology studies, and the authors received no funding from an external source.

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