|Good morning, gentlemen, |
the temperature is 110 degrees
As far as I can ascertain, intolerance of uncertainty with autism in mind was first described in the peer-reviewed literature by Christina Boulter and colleagues  and subsequently by Sarah Wigham and colleagues ; both papers originating from the University of Newcastle, here in the bracing North East of England. The Boulter paper initially looked at how intolerance of uncertainty (IU) tied into the expression of anxiety in paediatric autism noting results "consistent with a causal model". The Wigham paper extended these findings, drawing on how the IU-anxiety relationship may also stretch to the presentation (interplay) of sensory issues among other things.
Focusing specifically on the Boulter paper, a few details might be in order (unfortunately the paper is not open-access)
- IU - defined as "a broad dispositional risk factor for the development and maintenance of clinically significant anxiety" - was assessed as part of a larger research platform looking at anxiety and autism.
- Derived from various sources (including the Daslne initiative), participants (N=224) including children/young adults diagnosed with an autism spectrum disorder (ASD) (n=114) and asymptomatic controls (n=110) were assessed for IU via the Intolerance of Uncertainty Scales (child and parent report versions). "The scale assesses IU by asking respondents to rate the extent to which statements relating to emotional, cognitive and behavioural responses to uncertainty are like them, or... like their child". Various other measures including the SRS and the Spence Children's Anxiety Scales (SCAS) were also delivered to participants.
- Results: well as if we needed telling "children with ASD showed higher levels of anxiety than TD [typically developing] children". As per previous discussion on quality of life and autism, the question of who reports anxiety (first person vs. second person reports) featured in the Boulter findings, although "disagreement appears to have been more pronounced in the TD group than in the ASD group".
- Children with ASD were also reported to have "significantly higher levels of IU" and such elevations in IU "accounted for the increased levels of anxiety in the children with autism" hence the previous chatter about causal models et al. Perhaps also importantly, the relationship between IU and anxiety "was the same in both children with ASD and those without" so "similar processes may be at work within both populations".
Still, I am rather intrigued by these initial findings on IU and how they may potentially fit into the often very disabling anxiety which can accompany a diagnosis of autism. If anything else, they may present a further target for intervention - bearing in mind the need for further research on the use of something like CBT for anxiety in autism - with the aim of improving quality of life.
Music to close, and continuing a recent theme on this blog: The Smiths and Ask (yes, I have been listening to their greatest hits, and yes, they probably were one of the best bands ever).
 Boulter C. et al. Intolerance of uncertainty as a framework for understanding anxiety in children and adolescents with autism spectrum disorders. J Autism Dev Disord. 2014 Jun;44(6):1391-402.
 Wigham S. et al. The Interplay Between Sensory Processing Abnormalities, Intolerance of Uncertainty, Anxiety and Restricted and Repetitive Behaviours in Autism Spectrum Disorder. J Autism Dev Disord. 2014 Sep 27.
 Yook K. et al. Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. J Anxiety Disord. 2010 Aug;24(6):623-8.
 Hare DJ. et al. Anxiety in Asperger's syndrome: Assessment in real time. Autism. 2014 May 8.
Boulter C, Freeston M, South M, & Rodgers J (2014). Intolerance of uncertainty as a framework for understanding anxiety in children and adolescents with autism spectrum disorders. Journal of autism and developmental disorders, 44 (6), 1391-402 PMID: 24272526