Intolerance-of-uncertainty and anxiety as serial mediators between emotional dysregulation and repetitive patterns in young people with autism

Abstract

BackgroundPrevious research on anxiety in autism has largely focused on direct relationships. The overlap between symptoms of autism and anxiety and the influence that transdiagnostic variables exert on them make necessary explanatory models that consider all the factors involved in the triggering and maintenance of anxiety and its expression through typical features of autism. MethodThe main objective of this study was to examine the relationship between two transdiagnostic mechanisms (emotional dysregulation (ED) and intolerance of uncertainty (IU)) and repetitive and restricted patterns (RRP) and the role that anxiety has in this relationship. IU and anxiety were configured as serial mediators between ED and two subtypes of restricted patterns: sameness behaviors and sensory over-responsiveness. The sample included 87 children and adolescents on the autism spectrum aged from 6 to 18 years. Variables were assessed using a number of well-known outcome measures. ResultsThe results of our simple mediation model show that the indirect effect of anxiety is higher between transdiagnostic variables and sensory over-responsiveness than between transdiagnostic variables and sameness behaviors. Our model suggests that ED predicts sameness behaviors and sensory over-responsiveness through the serial indirect effect of IU and anxiety. ConclusionsOur findings contribute to clarify the role that anxiety and transdiagnostic mechanisms may play on RRP and may have important implications for the assessment and treatment of anxiety in people with ASD.