Autism related traits and anxiety in the general population are linked through intolerance of uncertainty and affect labeling

Abstract

Abstract Anxiety is prevalent in autism spectrum disorder and linked to intolerance of uncertainty (IU). As a cognitive strategy, affect labeling (AL) reduces distress by structuring ambiguous sensations. However, autistic individuals frequently exhibit AL deficits, raising a critical dilemma: a strategy alleviating uncertainty-driven anxiety is inherently difficult to access. It is unclear whether IU paradoxically motivates AL use despite these deficits. In this cross-sectional study, 505 adults completed measures of autistic traits, IU, AL, and anxiety. We tested two serial mediation models: the Cognitive-Motivational Model (CMM; IU motivates AL) and Emotion Regulation deficit Model (ERM; AL deficits increase IU). While both fit well, CMM was selected based on theoretical consistency. This was consistent with established risk pathways where autistic traits relate to anxiety via higher IU and lower AL. Crucially, a novel adaptive pathway emerged: higher autistic traits were associated with higher IU, which were linked to higher AL and lower anxiety. While these pathways represent theoretical assumptions rather than proven causality, the findings suggest a dual role of IU as risk factor and motivational driver. This may point to a conflict in individuals with high autistic traits: struggling with AL deficits yet motivated to use AL to cope with uncertainty.