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Intolerance of Uncertainty Predicts Anxiety Outcomes Following CBT in Youth with ASD

  • S.I. : Anxiety in Autism Spectrum Disorders
  • Published:
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Abstract

Modified cognitive–behavioral therapy (MCBT) has been demonstrated to reduce anxiety in youth with autism spectrum disorder (ASD). However, non-response rates are fairly high. Few studies have investigated factors associated with response. Intolerance of uncertainty (IU) is a treatment target for anxiety and worry in neurotypical populations and has been linked to anxiety and ASD. We sought to examine whether IU affects outcomes following MCBT in 43 children, ages 8–14 years, with ASD without intellectual disability. Consistent with prior data, there was a significant reduction in parent reported anxiety following MCBT. Higher levels of pre-intervention IU predicted higher anxiety and worry pre- and post-intervention. These findings suggest that targeting IU may improve outcomes following MCBT in youth with ASD and anxiety.

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Acknowledgments

Drs. Reaven, Keefer, Duncan, and Klinger and Ms. Johnson were supported by NIH Grant 4R33MH089291-03 which was awarded to Dr. Reaven. Recruitment at TEACCH Autism Program was supported by NICHD Grant U54HD079124. Dr. Vasa’s effort was supported by Autism Speaks Grant 8790.

Funding

This study was funded in part by NIH Grant #4R33MH089291-03, Autism Speaks Grant #8790, and NICHD Grant #U54HD079124.

Author Contributions

AK conceived of the study, participated in its design and coordination, and drafted the manuscript; NK participated in the design and interpretation of the data and drafting the manuscript; VS participated in the design and performed the statistical analysis; ABS participated in drafting the manuscript; AD participated in the measurement and drafting the manuscript; CJ participated in the measurement and design; LK participated in drafting the manuscript; AM participated in the measurement and drafting the manuscript; JR contributed to the interpretation of the data and drafting the manuscript; RV conceived of the study, participated in its design and drafting the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Center for Autism and Related Disorder, Kennedy Krieger Institute, Baltimore, MD, 21286, USA

    Amy Keefer, Nicole L. Kreiser, Vini Singh, Catherine Johnson & Roma A. Vasa

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Amy Keefer, Nicole L. Kreiser & Roma A. Vasa

  3. University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA

    Audrey Blakeley-Smith & Judy Reaven

  4. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Amie Duncan

  5. TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Laura Klinger

  6. TEACCH Autism Program, Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Allison Meyer

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  1. Amy Keefer
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  2. Nicole L. Kreiser
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  3. Vini Singh
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  4. Audrey Blakeley-Smith
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  5. Amie Duncan
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  6. Catherine Johnson
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  7. Laura Klinger
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  8. Allison Meyer
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  9. Judy Reaven
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  10. Roma A. Vasa
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Corresponding author

Correspondence to Amy Keefer.

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Conflict of interest

Drs. Keefer, Kreiser, Duncan, Klinger, Meyer, and Vasa and Ms. Johnson and Ms. Singh have no conflicts of interest. Drs. Reaven and Blakeley-Smith receive royalties from Paul H. Brookes, publisher of the Facing Your Fears treatment manual.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Keefer, A., Kreiser, N.L., Singh, V. et al. Intolerance of Uncertainty Predicts Anxiety Outcomes Following CBT in Youth with ASD. J Autism Dev Disord 47, 3949–3958 (2017). https://doi.org/10.1007/s10803-016-2852-z

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