ORIGINAL PAPER Intolerance of Uncertainty as a Framework for Understanding Anxiety in Children and Adolescents with Autism Spectrum Disorders Christina Boulter • Mark Freeston • Mikle South • Jacqui Rodgers Published online: 24 November 2013 Ó Springer Science+Business Media New York 2013 Abstract Anxiety is a problem for many children diag- nosed with Autism Spectrum Disorders (ASDs). There is a paucity of models of the cognitive processes underlying this. Intolerance of Uncertainty (IU) has utility in explaining anxiety in neurotypical populations but has only recently received attention in ASD. We modelled the relationship between anxiety and IU in ASD and a typically developing comparison group, using parent and child self- report measures. Results confirmed significant relationships between IU and anxiety in children with ASD which appears to function similarly in children with and without ASD. Results were consistent with a causal model sug- gesting that IU mediates the relationship between ASD and anxiety. The findings confirm IU as a relevant construct in ASD. Keywords Autism Spectrum Disorders Á Anxiety Á Intolerance of Uncertainty Á Children Á Adolescents Introduction Anxiety is common in children with Autism Spectrum Disorders (ASD) and a significant source of distress (White et al. 2009; Wood and Gadow 2010). Developing ways to understand and characterise anxiety in this population with the ultimate aim of developing effective, theoretically robust treatments is therefore of critical importance and a priority for current research. This study aims to take the first steps towards examining the relevance of the construct of Intolerance of Uncertainty (IU), which has proven utility in the formulation and treatment of anxiety disorders in neurotypical populations, to the understanding of anxiety and its presentation in children with ASD. Intolerance of Uncertainty (IU) is defined as a ‘broad dispositional risk factor for the development and mainte- nance of clinically significant anxiety’ in neurotypical populations (Carleton 2012, p. 939). The construct of IU was initially postulated as a key construct in generalised anxiety disorder (Dugas et al. 1998; Freeston et al. 1994). Since it’s inception it has received increasing attention in a wide range of contexts both within clinical psychology and in other areas of applied psychology (see Carleton 2012). Indeed Carleton et al. (2012b) using taxometric analysis suggests that IU is a dimensional construct across non- clinical and clinical samples and not simply an aspect of anxiety. Grupe and Nitscke (2013) support this position positing an interconnected set of neurobiological and psy- chological processes which are involved in adaptive anticipatory responding under conditions of uncertainty, and that it is deficits in one or more of these processes underlie maladaptive responses in anxious individuals. Among adults, evidence from large clinical studies has also linked IU to symptoms of GAD, OCD, social anxiety dis- order, agoraphobia and panic disorder, and depression (e.g. C. Boulter School of Psychology, Newcastle University, Newcastle Upon Tyne, UK C. Boulter Á M. Freeston Northumberland, Tyne and Wear NHS Trust, Newcastle, Tyne and Wear NE3 3XT, UK M. Freeston Á J. Rodgers (&) Institute of Neuroscience, Clinical Psychology, Newcastle University, Ridley Building, Newcastle Upon Tyne NE1 7RU, UK e-mail: Jacqui.rodgers@ncl.ac.uk M. South Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA 123 J Autism Dev Disord (2014) 44:1391–1402 DOI 10.1007/s10803-013-2001-x