Exploring Alexithymia, Uncertainty, Anxious Arousal, and Social Anxiety as Mediators of the Relationship Between Sensory Processing Differences and Restricted and Repetitive Behaviors in Autistic Adults.
Heather L Moore, Samuel Brice, Natalya Spraggon and 4 others
PMID 41268714WHAT IT FOUND
In autistic adults, sensory differences link to repetitive motor behaviors through anxious arousal and to insistence on sameness through intolerance of uncertainty.
Social anxiety was not a mediator. Clinicians should assess these specific anxiety facets rather than assuming general social anxiety drives repetitive behaviors.
Key findings
01Sensory processing differences had significant direct effects on both repetitive motor behaviors (RMB) and insistence on sameness behaviors (ISB).
02For RMB, anxious arousal was a significant single mediator, along with serial pathways involving alexithymia and uncertainty leading to anxious arousal. Social anxiety did not mediate this relationship.
03For ISB, uncertainty was a significant single mediator, along with a serial pathway through alexithymia and uncertainty. Neither anxious arousal nor social anxiety mediated this relationship.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional and correlational, so it cannot prove that sensory differences cause anxiety or repetitive behaviors; reverse causality or feedback loops are possible. The sample was recruited from a cohort specifically interested in anxiety, which may not represent the broader autistic population. The sensory measure used did not distinguish between sensory hypersensitivity and hyposensitivity. Participants included those with a formal diagnosis and those who suspected they were autistic, though no significant differences in autistic traits were found between these groups.
Declared interests
The authors declare no conflicts of interest. The study was funded by Autistica.
The easy way to misread this
Do not interpret the significant correlations between social anxiety and other variables as evidence that social anxiety drives repetitive behaviors. The mediation analysis showed social anxiety played no significant role in the link between sensory processing and either type of repetitive behavior.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →