Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

The relationship between intolerance of uncertainty and anxiety in autism: a systematic literature review and meta-analysis

Jenkinson, Richard, Milne, Elizabeth and Thompson, Andrew ORCID: 2020. The relationship between intolerance of uncertainty and anxiety in autism: a systematic literature review and meta-analysis. Autism 24 (8) , 1933--1944. 10.1177/1362361320932437

[thumbnail of Autism 1362361320932437.pdf] PDF - Published Version
Available under License Creative Commons Attribution.

Download (323kB)


The association between intolerance of uncertainty and anxiety has proved robust in neurotypical populations and has led to effective interventions targeting intolerance of uncertainty. The aim of this systematic review and meta-analysis was to investigate this association in autistic people, given the high prevalence of anxiety in this population and the limited effectiveness of therapies used currently to treat anxiety in autism. A protocol was published on the Prospero database (CRD42019125315), and electronic databases were searched using terms related to intolerance of uncertainty, anxiety and autism. Included in the systematic review were 12 studies, of which 10 were included in a meta-analysis. Results showed that anxiety and intolerance of uncertainty were consistently elevated in autistic participants. Examining the correlation between these two constructs, the meta-analysis revealed a large sample-weighted effect size, r = 0.62, 95% confidence interval = [0.52, 0.71], p < 0.001. The strength of this association was comparable to meta-analyses conducted on neurotypical populations, and therefore, it was concluded intolerance of uncertainty may be an appropriate target for intervention for autistic individuals. However, conclusions were limited due to the small number of relevant studies that were available and due to issues with methodological quality. Lay abstract People who find it especially hard to cope with the unexpected or unknown are said to have an intolerance of uncertainty. Autistic individuals often report a preference for certainty and experience levels of anxiety that can interfere with their daily life. Understanding more about the link between the intolerance of uncertainty and anxiety in autistic people might lead to better treatments for anxiety being developed. Therefore, this work aimed to review previous research in order to explore this link. Twelve studies were found and their results were compared and contrasted. The autistic people who participated in the studies completed questionnaires that suggested a large number of them experienced very high levels of anxiety and intolerance of uncertainty. Of 10 studies that used relevant statistics, nine found a statistically significant link between anxiety and the intolerance of uncertainty. In general, the strength of the link was about the same as previous research found in people who did not have a diagnosis of autism. This might mean that interventions that aim to help people who are intolerant of uncertainty could be effective for autistic individuals.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 License
Publisher: SAGE Publications
ISSN: 1362-3613
Date of First Compliant Deposit: 23 April 2021
Last Modified: 04 May 2023 13:42

Citation Data

Cited 25 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item


Downloads per month over past year

View more statistics