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Exploring the role of uncertainty in anxiety in autism

Lennuyeux-Comnene, L. (2023). Exploring the role of uncertainty in anxiety in autism. (Unpublished Doctoral thesis, City, University of London)


Intolerance of uncertainty (IoU) is a tendency to interpret uncertain situations as inherently negative. In autism research, anxiety has consistently been highlighted as having a significant impact on people’s lives. In theoretical models regarding the make-up and aetiology of anxiety in autism, IoU has been shown to play a key role in its instigation, maintenance or exacerbation. What has been unclear, however, is whether the world is more uncertain for autistic people or whether they are more intolerant of uncertainty. Nor was it clear what uncertainty itself has meant, both in the research community and for autistic people themselves. This mixed-methods research project sought to clarify this by first conducting a systematic review of the way uncertainty had been operationalised in the autism and anxiety experimental research literature. The findings of this review show that although uncertainty is assumed to have a shared meaning by all, there are different types of uncertainty with different consequences and aetiologies. Next, autistic people were interviewed about the way in which they conceptualised and experienced uncertainty. The resulting grounded theory conceptualised uncertainty as different levels of ‘knowns’: from the certainty of a ‘known known’ to the anxiety-provoking ‘unknown unknown’ or ‘unknowable’ in which there was no way of making the unknown known or exercising control over how to manage the uncertainty. Lastly, a probabilistic inference task was designed to test the different levels of uncertainty by operationalising different levels of knowns as access to different amounts of information. The outcomes of interest were how much information the participants sought in order to alleviate the uncertainty and how confident they were about their decision or the outcome. Autistic participants needed more information than their non-autistic counterparts and were less confident. While anxiety, IoU and autistic traits as measured by the Social Responsiveness Scale were not predictive of how much information people sought, they were predictive of confidence but not independently of each other. The findings overall, therefore, show that uncertainty is far from a unified concept but may be experienced in similar ways by autistic and non-autistic people. However, it is possible that because of differences in social interaction, in sensory processing and in making use of prior information to make predictions, autistic people may need more certainty and may be less confident that things will turn out the way they think they will. The world may be more uncertain for autistic people

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
[thumbnail of Lennuyeux-Comnene thesis 2023 PDF-A.pdf] Text - Accepted Version
This document is not freely accessible until 31 March 2027 due to copyright restrictions.


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