(PS3-B49) Intolerance of Uncertainty, Anxiety, and Autistic Traits in Autistic and Non-autistic Youth

Background: Intolerance of uncertainty (IU), broadly defined as fear of the unknown, has been established as a key construct involved in the development and maintenance of anxiety (South & Rodgers, 2017). Extant literature indicates that autistic individuals are particularly vulnerable to anxiety due to IU (Boulter et al., 2014), which has been documented to be elevated among autistic youth (Jenkinson et al., 2020). Therefore, it may be important to shed light on the specific features of autism spectrum disorder (ASD) that are associated with IU. Given that autistic traits are continuous in the general population (Hoekstra et al., 2008), better understanding of these variables and their relations to anxiety in both autistic and non-autistic youth can help inform appropriate treatment approaches for children across the broader autism phenotype.  

Method: Parents of 32 children (14 female, mean age = 12.7 years), aged 8-16 years, completed questionnaires assessing their children’s overall anxiety levels (MASC-2; March, 2013), autistic traits (SRS-2; Constantino & Gruber, 2012), and intolerance of uncertainty (IU subscale of ASC-ASD; Rodgers et al., 2016). The ADOS-2 (Lord et al., 2012) was administered to determine diagnostic groups (ASD = 16). Pearson’s correlations were used to examine bivariate relationships between autistic traits, IU, and overall anxiety. A multiple linear regression model was conducted predicting IU, with the five subscale scores of the SRS-2 (social awareness, social cognition, social communication, social motivation, and restricted/repetitive behaviors [RRB]) entered as predictors.

Results: In the overall sample, there was a strong correlation between overall anxiety and IU [r(30) = .702, p < .001]. There were also strong correlations between IU and RRB [r(30) = .559, p < .001] and social communication and interaction domain [r(30) = .583, p < .001]. According to the regression model, RRB and social motivation difficulties were significant predictors of higher IU (both Bs = .22, p < .006) above and beyond other subdomains. However, social communication difficulties negatively predicted IU (B = -.30, p < .001).

Conclusion: Results suggest that IU is strongly associated with overall anxiety across autistic and non-autistic youth. This study also provides preliminary evidence for RRBs and social motivation difficulties as being potential risk factors for IU. RRBs may be used as a coping strategy maintaining IU, and social motivation issues likely lead to less exposure to new and unpredictable situations, which may in turn contribute to higher IU. On the other hand, it is possible that children with communication difficulties may be less effective in expressing their IU, thus making it difficult for parents to be aware of it. These findings further demonstrate the importance of identifying correlates and predictors of IU and anxiety in youth presenting with autistic traits. Findings also support recent studies indicating the need for cognitive behavioral treatments to focus on increasing tolerance for uncertainty and reducing parental accommodation in autistic and non-autistic youth (Keefer & Vasa, 2021; Kendall et al., 2020).