Relationships between autism spectrum disorder and intolerance of uncertainty
Open accessAbstract
Intolerance of uncertainty (IU) is a dispositional risk factor involving maladaptive responding under conditions of uncertainty. Recent data indicate that IU is likely elevated in youth with autism spectrum disorder (ASD) and is positively correlated with anxiety. This study examined whether IU may be associated with ASD independent of anxiety. Relationships between anxiety, ASD, and IU were examined in 57 children with ASD without co‐occurring intellectual disability and 32 control participants, ages 7–16 years. Hierarchal linear regressions were run to examine whether ASD variables, including emotion dysregulation, were predictive of IU when controlling for anxiety. Severity of social communication deficits, repetitive behaviors, and emotion dysregulation were each related to IU when controlling for the effects of anxiety. When these variables were entered into the regression model together, emotion dysregulation was the only significant predictor of IU. These findings suggest that IU is directly related to features of ASD possibly due to shared genetic, neurological, or psychological underpinnings. Autism Res 2018, 11: 636–644 . © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Youth with ASD without co‐occurring intellectual disability experience high levels of intolerance of uncertainty (IU), which is related to anxiety. This study found that IU may also have a relationship with certain aspects of ASD, particularly emotion dysregulation.
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High levels of intolerance of uncertainty are more prevalent in autistic people than non-autistic people.
“Studies have shown that high levels of IU are more prevalent in autistic people than non-autistic people (Boulter et al., 2014; Vasa et al., 2018)”
From The relationship between distress tolerance and behavioral activation on anxiety and depression symptomatology in autistic youth: Leveraging self and caregiver perspectives (2024) · cites this paper as Vasa et al., 2018
The relationship between intolerance of uncertainty and anxiety in autistic people has already been described.
“La relación entre la IIn y la ansiedad en las personas autistas ha sido ya descrita (Boulter et al., 2014;Neil et al., 2016;Vasa et al., 2018;Wigham et al., 2015).”
From Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa (2022) · cites this paper as Vasa et al., 2018
Children with ASD have higher levels of intolerance of uncertainty than neurotypical children.
“Children with ASD have higher levels of IU than neurotypical children”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [48]
Preliminary evidence suggests that intolerance of uncertainty may mediate the relationship between ASD and anxiety.
“and preliminary evidence suggests that IU may mediate the relationship between ASD and anxiety [4, 48].”
From DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD (2021) · cites this paper as [48]
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Self-citationAutistic traits associated with dichotomic thinking mediated by intolerance of uncertainty
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Disentangling “Bayesian brain” theories of autism spectrum disorderPreprint
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Anxiety relates to classroom executive function problems in students with ASD, but not ADHD
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A rule-based theoretical account of social stories to address the double empathy problem
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Dialectical Behavior Therapy in Autism
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“Very Misunderstood”: Self-Perceived Social Communication Experiences of Autistic Young Adults
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DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD
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Powell, H. J., He, J. L., Khalil, N., Wodka, E. L., Deronda, A. C., Edden, R. A. E., Vasa, R. A., Mostofsky, S. H., & Puts, N. A. J. (2023) · Development and Psychopathology · doi:10.1017/s0954579423001360 · Cited by 6 · see citing works
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Longitudinal relations between autistic-like features and functional somatic symptoms in adolescence
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Autistic Traits and Somatic Symptom Disorders: What Is the Link?
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Perception and adaptation of receptive prosody in autistic adolescents
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Exploring the Symptom Profiles of Intolerance of Uncertainty in Autistic Children
Keefer, A. J., Singh, V., Jang, Y. S., Alon, L., Surmacz, M., Holingue, C., Mostofsky, S. H., & Vasa, R. A. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05744-3 · Cited by 5 · see citing works
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Agency and reward across development and in autism: A free-choice paradigm
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Challenging Behaviors in Adults with Intellectual Disabilities and ASD: Related Variables
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A cross-cultural examination of bi-directional mentalising in autistic and non-autistic adults
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Transforming the Well-Being of Persons with Autism
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Altered category learning and reduced generalization in autistic adults
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“Studies have shown that high levels of IU are more prevalent in autistic people than non-autistic people (Boulter et al., 2014; Vasa et al., 2018), and IU is similarly correlated with anxiety and depression in autistic people (Conner et al., 2022; Keefer et al., 2018).”
Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa
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“La relación entre la IIn y la ansiedad en las personas autistas ha sido ya descrita (Boulter et al., 2014; Neil et al., 2016; Vasa et al., 2018; Wigham et al., 2015).”
BackgroundWhat Is Uncertainty? A Grounded Theory of the Role of Uncertainty in Anxiety in Autism
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Co-designed yoga nidra targeting anxiety in autistic children: A mixed methods feasibility study
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Uncertainty Processing in Autism
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Uncertainty Processing in Autism
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A computational lens on the transdiagnostic nature of intolerance of uncertaintyPreprint
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Cognitive Behavioral Therapy for Children and Adults with Autism
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Specialist Applications of Cognitive Behavioral Therapy for Anxiety Disorders and Depression
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The Relationship Between Intolerance of Uncertainty and Autism Spectrum Disorder
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Update in Autism Spectrum Disorder
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- Authors
- Vasa, R. A., Kreiser, N. L., Keefer, A., Singh, V., & Mostofsky, S. H.
- Affiliations
- Kennedy Krieger Institute (US)
- Eastern Virginia Medical School (US)
- Corresponding author
- Vasa, Roma A.
- Venue
- Autism Research
- Publisher
- Wiley
- Published
- 2018-01-07
- Volume
- 11
- Issue
- 4
- Pages
- 636-644
- ISSN
- 1939-3792 (ISSN-L)
- 1939-3806
- PMC
- PMC5903967
- OpenAlex
- W2784265812
- Cited by
- 117
- References
- 61
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 20 · 2023: 21 · 2022: 18 · 2021: 13 · 2020: 9 · 2019: 4 · 2018: 1
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Autism Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01 NS048527‐08, R21 MH098228)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- autism spectrum disorder, intolerance of uncertainty, emotional dysregulation, anxiety, social communication deficits, repetitive behavior, children and adolescents
- MeSH terms
- Social Communication Disorder, Autism Spectrum Disorder, Adaptation, Psychological, Adolescent, Affective Symptoms, Anxiety, Anxiety Disorders, Character, Child, Communication, Female, Humans, Male, Intellectual Disability, Risk Factors, Comorbidity, Motor Skills Disorders, Uncertainty
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