Towards a Treatment for Intolerance of Uncertainty in Young People with Autism Spectrum Disorder: Development of the Coping with Uncertainty in Everyday Situations (CUES©) Programme

Abstract

Intolerance of uncertainty (IU) is indicated as an important transdiagnostic process variable in a range of anxiety disorders. Anxiety is very common in children with autism spectrum disorders (ASD). This study aimed to develop a parent group based manualised treatment programme for young people with ASD, which focused on IU. An eight session programme was developed and then delivered to 11 parents across three treatment groups, two recruited via a research data base and one via clinical services. Data regarding retention, acceptability and feasibility indicate that the parents valued the programme. Effect size analyses of outcome measures for potential use in larger trial indicate that the programme has promise as a treatment option of your people with ASD and IU.

Sensory, Emotional and Cognitive Contributions to Anxiety in Autism Spectrum Disorders

“…Rodgers et al (2016b) collected data from parent focus groups and factor analysis to modify an existing anxiety questionnaire in pursuit of increased relevance for both clinical and research use with ASD children. Sensory-based anxiety is a critical subscale along with subscales for difficulty with uncertainty and performance anxiety.…”

“…This has so far been taken up in the autism and anxiety literature, mostly for pediatric samples. Several studies suggest some relevance for existing measures but also recognize autism-unique aspects of anxiety that require additional attention (Kerns et al, 2014; Rodgers et al, 2016b). Standard measures for alexithymia include the Toronto Alexithymia Scale-20 (Bagby et al, 1994) and the Bermond-Vorst Alexithymia Questionnaire (Vorst and Bermond, 2001).…”

“…Kerns et al (2014) identified several aspects of anxious presentation in ASD that are similar to those found in standard diagnostic systems, but also a number of atypical expressions that seem specific to ASD, including social discomfort not associated with a fear of negative evaluation; compulsive behavior that does not seem motivated by distress relief, and highly unusual phobias. Improved understanding of the cognitive and emotional mechanisms which underlie anxiety in ASD may provide insight regarding the neurobiology of both conditions and create more specific targets for biological and behavioral intervention (Hashemi et al, 2016; Kerns et al, 2016; Rodgers et al, 2016b). …”

An evaluation of the effectiveness of psychological therapy in reducing general psychological distress for adults with autism spectrum conditions and comorbid mental health problems

“…Generally, this published evidence has focused on interventions targeted at specific co‐morbid mental health problems (e.g., OCD; Russell et al, ), or has taken a specific approach (e.g., CBT [Spain et al, ] and mindfulness [Spek, van Ham, & Nyklíček, ]). Although the data presented here do not demonstrate changes in specific problems, it does suggest that in general, CBT‐based approaches are helpful in ameliorating distress for adults with ASC, perhaps providing some support for non‐disorder specific or trans‐diagnostic approaches (Gaus, ; Rodgers et al, ; Weiss, ).…”

“…This is based on observed emotion regulation deficits in young people with ASC (Mazefsky & White, 2014;Mazefsky et al, 2013) and suggests that interventions should focus on developing adaptive emotion regulation skills in order to reduce ASC related difficulties and co-morbidities. Another trans-diagnostic approach posits intolerance of uncertainty as the primary driver of anxiety in ASC (Boulter, Freeston, South, & Rodgers, 2014;Rodgers et al, 2016) and therefore suggests that intervention should focus around developing the ability to cope with uncertainty. Both transdiagnostic models emphasize the importance of including parents and other important social contacts, perhaps reflecting that they have been developed with children and young people (Rodgers et al, 2016;Weiss, 2014).…”