The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis.
Richard Jenkinson, Elizabeth Milne, Andrew Thompson
PMID 32564625WHAT IT FOUND
Intolerance of uncertainty is strongly linked to anxiety in autistic children and young adults.
This association is as strong as in neurotypical people. Targeting uncertainty tolerance may help treat anxiety in this group, though current evidence is correlational.
Key findings
01The meta-analysis found a large, significant positive correlation between intolerance of uncertainty and anxiety in autistic participants.
02The strength of this association in autistic people is comparable to that found in neurotypical populations.
03Intolerance of uncertainty may partially mediate the relationship between autism severity and anxiety.
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
All included studies used cross-sectional questionnaire data, so the analysis cannot determine whether intolerance of uncertainty causes anxiety or vice versa. The measures of intolerance of uncertainty used in the studies had not been validated specifically for autistic populations. The review included few adult participants; the primary meta-analysis covered ages 4 to 24, limiting generalizability to older adults. Study quality was variable, and all studies were included regardless of quality scores due to the small number of available studies. There was significant heterogeneity in the data, and publication bias could not be fully ruled out despite statistical tests.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication of this article.
The easy way to misread this
Do not interpret the strong correlation as proof that targeting intolerance of uncertainty reduces anxiety. The evidence is cross-sectional and correlational, so it identifies a risk factor, not a proven treatment mechanism.