Specificity of autonomic arousal to anxiety in children with autism spectrum disorder.

Anxiety is one of the most concerning comorbidities in autism spectrum disorder (ASD) due to its high prevalence, negative impact on physical and psychological well-being, and interaction with core deficits of ASD. Current assessment and treatment of anxiety, which rely on the observation of behavior and self-reports, are often ineffective as ASD is associated with deficits in communication and diminished introspective ability. In this light, autonomic nervous system (ANS) activity has been suggested as a marker of physiological arousal associated with anxiety. However, physiological arousal measured by ANS indices also occurs with other cognitive and emotional processes, and it is unclear whether anxiety-related arousal can be differentiated from that related to other cognitive processes. To address this gap, we investigated the use of linear and nonlinear classification techniques for differentiating anxiety-related arousal from arousal due to three cognitive processes (attention, inhibitory control, and social cognition) and physical activity based on electrocardiography signal features. Our results indicate that over 80% classification accuracy can be achieved, suggesting that ANS response can be used as a specific marker of anxiety-related arousal in a subgroup of children with ASD who demonstrate an increase in heart rate in response to anxiogenic stimuli.