Does uncertainty drive anxiety in autistic adults?

Welsh academics are investigating whether coping with the unknown or unexpected is a distinct contributor to anxiety in autistic adults.

The new study, led by academics in the Department of Psychology at Aberystwyth University, focuses on a trait known as ‘intolerance of uncertainty’ – the tendency to find unpredictable situations particularly stressful – and how it may shape anxiety experiences in autism.

Autism affects at least 1% of the population, with diagnoses rising in the UK and more people seeking assessment in adulthood.

Anxiety frequently occurs alongside autism – while social situations can make many people anxious, those with autism often report that unpredictability itself is especially challenging.

The new project will explore how uncertainty influences both physiological and psychological anxiety in autistic adults, and whether these patterns differ between men and women.

The research team will use surveys and focus groups alongside laboratory-based behavioural tasks that measure accuracy, reaction time, heart rate and skin conductance in response to social and non-social stimuli presented in either predictable or unpredictable sequences.

By highlighting the role of uncertainty as a potential driver of distress, the researchers hope to contribute to a more nuanced understanding of anxiety in autism and inform practical changes in clinical, educational and workplace settings to reduce avoidable anxiety.

For example, improving how clinicians prepare patients for unexpected schedule changes, or guiding educators and employers to offer clearer communication and more predictable workflows.

Eleanor Gamble, PhD researcher from the Department of Psychology at Aberystwyth University is leading the study.  She said: “Many autistic adults report that last‑minute changes – such as a sudden room change before a lecture – can cause anxiety to spike, even when the change seems small.

“It’s not the room change in itself that is stressful, but rather, for example, its unknown location or seating arrangement.

“If we can demonstrate that uncertainty itself is a key trigger, services could be redesigned to prioritise clear information, preparation time and predictability. That could make everyday life meaningfully easier.”

Support

Dr Catherine O’Hanlon, Department of Psychology, added: “Anxiety is common in autism, yet most support still focuses on generalised or social anxiety.

“This study asks a different question: is intolerance of uncertainty a separate, measurable pathway to anxiety in autism?

“If we can identify a trait that is distinct within autistic experiences, it could refine diagnostic processes and strengthen the case for targeted interventions that reduce uncertainty – ultimately improving clinical outcomes and the day-to-day lives of autistic adults.”

The team will use surveys to determine respondents’ intolerance of uncertainty, anxiety, and autistic traits.

They will also run focus groups to understand how autistic adults experience uncertainty in daily life.

Professor Charles Musslewhite, Department of Psychology, added: “Focus groups will enable us to examine, discuss and debate the lived experience of autistic people and their own anxiety and coping methods in everyday situations.

“Autistic people often have to be very creative and resilient to overcome barriers faced in everyday situations, at work, in leisure – in shops, bars, restaurants and the like and in services – healthcare settings and on public transport for example.

“Sharing these experiences in focus groups brings out key barriers, innovation and tactics used to be resilient, which will be crucial to working towards solutions that public places could put in place.”