Intolerance of Uncertainty and Anxiety (but not Alexithymia) Mediate the Association Between Autistic Traits and Quality of Life

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Lin, Y., Mason, D., Hirsch, C., & Happé, F. (2024). Intolerance of Uncertainty and Anxiety (but not Alexithymia) Mediate the Association Between Autistic Traits and Quality of Life. Journal of Autism and Developmental Disorders, 55(4), 1389-1401. https://doi.org/10.1007/s10803-024-06310-9

Publication date: 6 Mar 2024 Added to AutiHub: 18 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
4
Publication authors identified as autistic
1 / 4 (25.0%)
  1. Yeju Lin
  2. David Mason *
  3. Colette Hirsch
  4. Francesca Happé

Abstract

Abstract Previous research has indicated that autistic individuals report lower quality of life (QoL) than non-autistic people. It is unclear whether it is the autism traits themselves or co-occurring thinking styles or mental health difficulties that most impair QoL. This study tested a hypothesised model to explore how ‘intolerance of uncertainty’ (IU), alexithymia (difficulty in identifying and describing own emotions), and anxiety play into the association between autistic traits and QoL. Online survey data were analysed from 116 autistic and 51 non-autistic adults who completed six standardised questionnaires measuring autistic traits, alexithymia, IU, anxiety and QoL (physical health, psychological health, social relations, and environment domains). The autistic group reported higher scores for alexithymia, IU and anxiety, and lower scores for QoL across domains, compared to the non-autistic group. Across the entire sample, autistic traits, alexithymia, IU and anxiety were positively correlated with one another, and negatively related to the four domains of QoL. Finally, IU and anxiety partially serially mediated the pathways from autistic traits to physical health and environment domains of QoL, and fully mediated the pathways from autistic traits to psychological health and social relations domains of QoL, across the full sample. The lower QoL experienced by autistic people may be explained in part by the mediating effect of both IU and anxiety (but not alexithymia). This study highlights the need for evidence-based interventions to address both IU and anxiety to improve QoL for autistic people/those with high levels of autistic traits.

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These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:01.

Cited references
84
With a DOI
76
Without a DOI, from raw bibliography text
7
9 / 84 (10.7%) cited references include at least one author identified as autistic.
References with data to complete
9 / 84 (10.7%)
References with detected author names
77 / 84 (91.7%)
Without detected author names
7
Without a structured title
9
Without a stable identifier
7
References with raw author names still to review
7
References with external metadata lookup issues
2
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
303
From DOI or external metadata
303
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
10
164 / 303 (54.1%) names are linked to an author already present in AutiHub. 139 / 303 (45.9%) names are not yet linked.
Names linked to a person identified as autistic
10 / 303 (3.3%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 10 / 164 (6.1%). Distinct people identified as autistic: 6 / 233 (2.6%).
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