Emotional dysregulation and uncertainty intolerance as transdiagnostic mediators of anxiety in adults with autism spectrum disorders and intellectual disability

Background: There is extensive documentation supporting the comorbidity of anxiety and autistic spectrum disorder (ASD). Transdiagnostic factors such as executive functions, emotion regulation, and uncertainty intolerance are associated with anxiety in ASD. Aim: The primary aim of this paper is to study anxiety symptoms in adults with ASD and ID and their relationship with transdiagnostic variables. Method: 121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities (ID) were evaluated to determine the predictive and mediating role of executive functioning, emotional regulation and intolerance to uncertainty. Results: Hierarchical linear regression showed uncertainty intolerance was a predictor of anxiety. A multiple mediation analysis supported the mediating role of uncertainty intolerance and emotional regulation between ASD and anxiety. Conclusions and implications: These findings suggest that interventions designed to reduce anxiety symptoms in people with ASD and ID should include among their goals emotional regulation and especially intolerance of uncertainty.