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

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Abstract

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.

Section snippets

What this paper adds?

This article is one of the first to analyze the mediating role of a set of transdiagnostic variables (executive functioning, emotional dysregulation and intolerance to uncertainty) on the relationship between severity of ASD and anxiety symptoms in adults with ASD and ID. Most of the research on anxiety and ASD examines children who did not have ID. The omission is problematic since comorbid psychopathologies seriously influence members of this group. This study recognizes the important link

Participants

The sample included 121 participants (81 male, 40 female), ages 18–62 (M = 35.46 years, SD = 9.46) diagnosed with ASD and ID (Table 1). Researchers recruited participants from health care facilities consisting of individual homes under 24 -h supervision providing medical, educational, nursing and mental health services, in the Community of Madrid and Galicia, Spain. Primary inclusion criteria for participants were that they must be at least18-years-old with a diagnosis of ASD and ID. Prior to

Statistical analysis

Data were analysed with the statistical program SPSS (version 22; IBM Corp. Released, 2013). A Pearson correlation analysis was conducted for ASD symptoms, anxiety symptoms, and other clinical variables. A hierarchical linear regression analysis occurred to identify predictors of anxiety in participants with ASD and ID. We tested three different sets of variables: the power of internalizing scores to predict anxiety, the power of externalizing scores to predict anxiety, and the predictive

Pearson correlation

Pearson’s bivariate correlations are shown in Table 2. We expected executive dysfunction to be associated with anxiety symptoms; however, the data did not support this relationship (r = .05; p = .52). Results identify an association between emotional dysregulation and anxious symptomatology (r = .28; p = .00). In addition, as expected, there was a positive and significant association between UI and anxiety (r = .53; p = .00). This result lead us to confirm partially hypothesis 1.

Hierarchical regression analysis

A three-stage

Discussion and conclusions

The objective of this research was to study anxiety symptoms in people with ASD and ID and their relationship with a group of transdiagnostic variables (executive dysfunction, ED and UI). Our findings support that there is a relationship between anxiety of adults with ASD and ID and transdiagnostic variables, especially in the case of uncertainty intolerance.

In our study, anxiety symptomatology correlated with the transdiagnostic variables of emotional dysregulation and intolerance to

Informed consent

Informed consent was provided by all guardians of the participants.

Funding

The authors declare that they have not any funding.

CRediT authorship contribution statement

Gema P. Sáez-Suanes: Investigation, Methodology, Resources, Software, Formal analysis, Writing - original draft. Domingo García-Villamisar: Conceptualization, Resources, Supervision. Araceli del Pozo Armentia: Conceptualization, Supervision. John Dattilo: Writing - review & editing.

Declaration of Competing Interest

The authors report no declarations of interest.

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