An Investigation into the Relationship Between Uncertainty and Negative Affect in Individuals with Autism Spectrum Disorder

People who find it especially hard to cope with the unexpected or unknown are said to have an intolerance of uncertainty (IoU). Individuals with autism often report a preference for certainty and experience levels of anxiety that can interfere with their daily life. Understanding more about the association between IoU and anxiety in people with autism might lead to better treatments being developed. Therefore, a systematic review and meta-analysis was conducted of research examining the correlation between IoU and anxiety in people with autism. Twelve studies were found and their results compared and contrasted. In general, people with autism reported very high levels of anxiety and IoU. Of the ten studies that used relevant statistics, nine found a statistically-significant correlation between anxiety and IoU. The strength of the association was broadly equivalent to that reported by research conducted with people who do not have autism. A person’s age and gender did not change the strength of the association, but it appeared slightly stronger in people with autism who scored higher on intelligence tests. There were limitations with this part of the thesis and these are discussed, together with the implications of this work.

Some adults report being dissatisfied with the assessment process they went through when they were diagnosed with autism; particularly because they felt stressed and anxious due to not knowing what to expect beforehand. Therefore, in the second part of this thesis, an intervention was created to address this. The intervention was essentially a short story (with accompanying photographs), describing what it was like to attend an assessment. It was written in a way that research has suggested is helpful for people with autism. Interventions of this type are known as Social Stories.
The people who took part were adults awaiting an assessment at one of two NHS services in the UK. They were divided at random into two groups; those in the first group read a standard leaflet about what to expect, whereas those in the second group read both the Social Story and the leaflet. People in both groups completed questionnaires at home and on arrival at their assessment. It was expected most would experience an increase in unpleasant emotions (such as anxiety, fear and frustration) on arrival at their assessment, compared to how they felt at home. The results showed that, on average, people who read the Social Story reported significantly less of an increase in unpleasant emotions than those who only read the leaflet. This suggested the intervention was effective. However, the results from a different questionnaire suggested that, in general, the Social Story and the leaflet were equally effective at helping people know what to expect. People in both groups were also equally satisfied with the assessment. The limitations and implications associated with this study are discussed.