The role of emotion dysregulation and intolerance of uncertainty in autism: Transdiagnostic factors influencing co-occurring conditions.
Targeting reactivity and dysphoria can block the path from uncertainty to anxiety and depression in autistic youth.
01Research in Context
What this study did
Sutton et al. (2022) looked at autistic teens and young adults who were already getting help for big emotions. The team wanted to know if two things, reactivity and dysphoria, carry the effect of intolerance of uncertainty into anxiety and depression.
They used surveys and stats tests to see if emotion dysregulation acts like a bridge. The youth were in treatment, so the data came from a real clinical sample.
What they found
Reactivity and dysphoria fully mediated the link. This means when uncertainty bothers the teen, the cranky mood and low feeling that follow are what turn into later anxiety or depression.
Fixing emotion skills, not just the worry, may be the key move.
How this fits with other research
Hwang et al. (2020) showed the same mediation trick in autistic adults, but they pointed at sensory issues and insistence on sameness as the carriers. M et al. move the lens down to youth and swap the carriers for emotion dysregulation, updating the model.
MacLennan et al. (2021) mapped the triangle in preschoolers and left the door open on what sits in the middle. M et al. walk through that door and name the middle pieces: reactivity and dysphoria.
Bettencourt et al. (2024) took the idea further by giving preschoolers lots of emotion and behavior hours. More hours predicted better autism and behavior scores one year later. Together the papers form a ladder: toddler sensory issues → youth emotion dysregulation → dose emotion work → better outcomes.
Why it matters
If you treat anxiety or depression in autistic teens, add modules that calm reactivity and lift dysphoria. Teach coping plans, body breaks, and mood tracking while you also handle uncertainty. The chain is worry → mood swing → clinical anxiety, so cut the middle link.
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02At a glance
03Original abstract
BACKGROUND: Individuals with autism spectrum disorders (ASD) are more likely to have co-occurring psychiatric conditions such as depression and anxiety. Transdiagnostic constructs such as intolerance of uncertainty (IU) and emotion dysregulation (ED) have both been shown to be individually associated with depression and anxiety in those with ASD. AIMS: The current study examined the relationship between IU and ED, depression, and anxiety in an ED treatment-seeking sample and examined whether ED acts as a mediator between IU-depression and IU-anxiety. METHODS AND PROCEDURES: We examined baseline scores for 78 adolescents and young adults (12-21 years old) who were participating in an ED treatment. We assessed for correlations between IU, Reactivity and Dysphoria, anxiety, and depression symptoms, and then conducted mediation analyses to determine whether Reactivity and Dysphoria functioned as a mediator in IU- anxiety and IU- depression relationships. OUTCOMES AND RESULTS: Concordant with prior research, ED, IU, anxiety, and depression scores were correlated. Both Reactivity and Dysphoria were found to mediate both IU-depression and IU-anxiety. CONCLUSIONS AND IMPLICATIONS: Findings suggest that ED contributes to how IU affects psychopathology. Furthermore, both IU and ED may be pertinent treatment targets for individuals with depression or anxiety and ASD.
Research in developmental disabilities, 2022 · doi:10.1016/j.ridd.2022.104332