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San Martín C, Laborda MA, Miguez G, Sánchez A, Vervliet B, Quezada-Scholz V. Relation among, trait anxiety, intolerance to uncertainty and early maltreatment experiences on fear discrimination learning and avoidance generalization online task. J Behav Ther Exp Psychiatry 2023; 81:101886. [PMID: 37343426 DOI: 10.1016/j.jbtep.2023.101886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/20/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Early aversive experiences, which have been associated with elevated anxiety and intolerance of uncertainty (IUS), may contribute negatively to fear conditioning learning. The aim of the present study was to analyze the relation among individual differences in childhood maltreatment experiences, trait anxiety, and IUS in adulthood; and to determine how these variables could affect fear learning discrimination and avoidance generalization. METHODS We adapted an avoidance procedure in an online fear learning task. Two pictures of different lamp colors (CS+) were first associated with two aversive images (US), while a third color was not (CS-). Next, clicking a button during one CS + could effectively avoid the US (CS + av), but not during the other (CS + unav). Finally, avoidance generalization was tested to lamp colors that were between CS- and CS + av (safety dimension) and CS + av and CS + unav (avoidability dimension). With a sample of 67 participants, we measured ratings of relief, expectancy, and anxiety, as well as button presses and individual differences (STAI, IUS and MAES). RESULTS Aversive early experiences were positively related to trait anxiety and intolerance of uncertainty. The results of the task further suggested that maltreatment experience contributes to be more attentive to aversive signals, which could be implicated in leading to difficulties in discrimination learning. LIMITATIONS Online experiments implies some loss of control over subjects and environment that can threaten internal validity. Likewise, the commitment of participants may be low. CONCLUSIONS Results suggest that early aversive experience and anxiety could contribute to the development of IUS, which likely contributes to the development of avoidance behavior.
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Affiliation(s)
- Consuelo San Martín
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile; Universidad de los Andes, Escuela de Psicología, Chile
| | - Mario A Laborda
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Gonzalo Miguez
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Andrea Sánchez
- Multimodal Functional Brain Imaging and Neurorehabilitation Hub, Diagnostic Imaging department, St. Jude Children's research Hospital, USA
| | - Bram Vervliet
- Department of Brain and Cognition, KU, Leuven, Belgium; Leuven Brain Institute, KU, Leuven, Belgium
| | - Vanetza Quezada-Scholz
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile.
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Alfasi Y. We only know that we don't know: attachment patterns and psychological coping during the COVID-19 pandemic - the mediation role of intolerance of uncertainty. THE JOURNAL OF SOCIAL PSYCHOLOGY 2023; 163:806-825. [PMID: 35430955 DOI: 10.1080/00224545.2022.2061326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
The global outbreak of the COVID-19 pandemic created sudden changes in many areas of daily life and increased uncertainty about the future. Two studies examined the association between attachment patterns and mental well-being during the pandemic, the mediating role of intolerance of uncertainty (IOU), and factors related to social relationships and self-perceptions. The results of the first study, conducted at the outbreak of the pandemic, indicated that individuals with high levels of attachment anxiety experienced more negative emotions and fewer positive emotions at that time, and that IOU and perceived social support mediated these associations. The results of the second study, conducted several months into the pandemic, indicated an association between attachment anxiety and avoidance, and perceived stress during the time of the pandemic. Results of Study 2 also indicated that IOU mediated the association between attachment anxiety and stress, and that sense of coherence (SOC) mediated the association between attachment anxiety and avoidance, and stress. These findings underscore the adverse psychological effects of uncertain situations, especially for individuals with a fragile foundation of interpersonal support, thus emphasizing the need for action to reduce uncertainty, especially in times of emergency.
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Ye H, Chen C, Chen S, Jiang N, Cai Z, Liu Y, Li Y, Huang Y, Yu W, You R, Liao H, Fan F. Profiles of Intolerance of Uncertainty Among 108,540 Adolescents: Associations with Sociodemographic Variables and Mental Health. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01603-z. [PMID: 37659028 DOI: 10.1007/s10578-023-01603-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
Intolerance of uncertainty (IU) is widely considered a transdiagnostic risk and maintaining factor for psychiatric disorders. However, little is known about the overall nature and profile of IU among adolescents. This study aims to investigate the profiles of IU among Chinese adolescents and explore their associations with sociodemographic characteristics and mental health problems. A sample of 108,540 adolescents provided data on IU, sociodemographic characteristics, and mental health via an online platform. Latent profile analysis revealed three profiles: Low IU, Medium IU, and High IU. Girls, older adolescents, and those with specific sociodemographics were more likely to belong to the "High IU" profile. Furthermore, the "High IU" profile was associated with the highest risk of several mental health problems. These findings provided valuable information for early prevention and intervention strategies targeting IU and highlighted the importance of IU-based interventions for mental health among adolescents.
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Affiliation(s)
- Haoxian Ye
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Chunling Chen
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Shiying Chen
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Nan Jiang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Zifan Cai
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Yixin Liu
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Yunyi Li
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Yike Huang
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Wanqing Yu
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Ruiyan You
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Haiping Liao
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China
| | - Fang Fan
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Shipai Road, Guangzhou, 510631, China.
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4
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Llewelyn-Williams JL, Oliver AM, Wright KD, Runalls S, Lahti DS, Bradley TJ, Kakadekar A, Pharis S, Pockett C, Erlandson MC, Tomczak CR. Health anxiety and associated constructs in school-age children and adolescents with congenital heart disease and their parents: A children's healthy-heart activity monitoring program in Saskatchewan cohort study. J Child Health Care 2023; 27:450-465. [PMID: 35238665 DOI: 10.1177/13674935221075896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Youth with congenital heart disease (CHD) have been found to experience higher levels of health anxiety and associated constructs than typically developing peers. The association between youth and parent health anxiety has been explored in typically developing youth but this association remains unknown in youth with CHD. This association was explored using a prospective, cross-sectional study that included 36 school-age children and adolescents with CHD (median age =10.5 years, IQR = 4) and 35 parents (median age = 44 years, IQR = 10.5). Participants completed a demographic form and measures of health anxiety, anxiety sensitivity, intolerance of uncertainty, and anxiety disorder symptom categories (youth) or general anxiety (parent). Associations were observed between child and adolescent panic/agoraphobia symptoms and parent state anxiety (r = .41), child and adolescent intolerance of uncertainty and parent state and trait anxiety (r = .37; r = .46, respectively), and child and adolescent anxiety sensitivity and parent state anxiety (r = .40). No association was observed between health anxiety in children and adolescents and parents nor between child and adolescent health anxiety and parent associated constructs. For parents, associations between health anxiety and all measures of associated constructs of interest were observed. Study findings will facilitate improved understanding of the psychological needs of school-age children and adolescents with CHD.
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Affiliation(s)
| | - Amanda M Oliver
- Department of Psychology, University of Regina, Regina, SK, Canada
| | - Kristi D Wright
- Department of Psychology, University of Regina, Regina, SK, Canada
| | - Shonah Runalls
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Dana S Lahti
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Timothy J Bradley
- Department of Pediatric Cardiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ashok Kakadekar
- Department of Pediatric Cardiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Scott Pharis
- Department of Pediatric Cardiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Charissa Pockett
- Department of Pediatric Cardiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Corey R Tomczak
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
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Gao P, Wu H, Fan Z, Tao M. Exploring the Relationship Between Intolerance of Uncertainty and Trust in Physicians from Spousal and Parent-Child Perspectives. Psychol Res Behav Manag 2023; 16:2173-2186. [PMID: 37334403 PMCID: PMC10276597 DOI: 10.2147/prbm.s413821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Objective The present study aimed to probe the intergenerational transmission of intolerance of uncertainty (IU) and trust in physicians. Besides, through the actor-partner interdependence model (APIM), the predictive effect of parents' IU on their own and their spouses' trust in physicians was examined. A mediation model was further constructed to probe the mechanisms by which parents' IU affects children's trust in physicians. Methods The Intolerance of Uncertainty Scale-12 (IUS-12) and the Wake Forest Physician Trust Scale (WFPTS) were employed to conduct the questionnaire survey among 384 families (each family with a father, mother, and one child). Results IU and trust in physicians were found to be intergenerationally transmitted. The results of the APIM analyses showed that fathers' total IUS-12 scores negatively predicted their own (β = -0.419, p < 0.01) and mothers' (β = -0.235, p < 0.01) total WFPTS scores. Mothers' total IUS-12 scores negatively predicted their own (β = -0.353, p < 0.01) and fathers' (β = -0.138, p = 0.017) total WFPTS scores. The results of mediation analyses indicated that parents' total WFPTS scores and children's total IUS-12 scores mediated the effect of parents' total IUS-12 scores on children's total WFPTS scores. Conclusion The public's IU is a crucial influencing factor of their trust in physicians. Besides, the IU between couples and between parents and children could be mutually affected. On the one hand, husbands' IU could affect their own and their wives' trust in physicians, and vice versa. On the other hand, parents' IU and trust in physicians could affect their children's IU and trust in physicians, respectively.
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Affiliation(s)
- Peng Gao
- Department of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China
| | - Hanwei Wu
- Department of Foreign Studies, Hunan Normal University, Changsha, Hunan, People’s Republic of China
| | - Zhiguang Fan
- Department of Psychology, School of Teacher Education, Shaoxing University, Shaoxing, Zhejiang, People’s Republic of China
| | - Min Tao
- Department of Education, Jilin International Studies University, Changchun, Jilin, People’s Republic of China
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Soltani S, Noel M, Neville A, Birnie KA. Intolerance of Uncertainty in Pediatric Chronic Pain: Dyadic Relationships Between Youth and Parents. THE JOURNAL OF PAIN 2022; 23:1581-1593. [PMID: 35470088 DOI: 10.1016/j.jpain.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/27/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
The current study used a dyadic analytic approach (actor-partner interdependence models) to assess the stability and interrelationships of intolerance of uncertainty (IU) among a cohort of youth with chronic pain and their parents (n = 156 dyads). Relationships between parent and youth IU, parent and youth pain interference, and parent and youth internalizing mental health symptoms were examined. At baseline and follow-up, youth and parents completed psychometrically-sound questionnaires to assess their respective IU, pain characteristics, and clinical outcomes (pain interference, anxiety, depressive, and posttraumatic stress symptoms). Our findings support the construct stability of IU over time, as well as intrapersonal (ie, actor) effects of IU on follow-up youth pain interference and mental health symptoms and parents' mental health symptoms (but not parent pain interference). There were no interpersonal (ie, partner) effects over time between youth and parent IU or between youth and parent IU and pain interference or mental health symptoms. These findings align with previous research evidencing IU as a transdiagnostic risk factor for a range of mental health concerns and extend previous findings by showing the stability of parent and youth IU over time and its potential predictive relevance to outcomes in a clinical sample of youth with chronic pain. PERSPECTIVE: This article presents dyadic analyses assessing intrapersonal and interpersonal associations between intolerance of uncertainty (IU) and pain and mental health symptoms in youth with chronic pain and their parents. Analyses evidenced short-term construct stability of IU and intrapersonal (but not interpersonal) effects of IU on pain and mental health symptoms.
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Affiliation(s)
- Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, Calgary, Alberta, Canada
| | - Alexandra Neville
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn A Birnie
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research & Education, Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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7
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Beatty CC, Ferry RA, Nelson BD. Intolerance of uncertainty and psychophysiological reactivity in anticipation of unpredictable threat in youth. Int J Psychophysiol 2022; 179:110-118. [PMID: 35787438 DOI: 10.1016/j.ijpsycho.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Intolerance of uncertainty (IU) is a key transdiagnostic feature of internalizing psychopathology. An increasing body of research suggests that IU is associated with increased psychophysiological reactivity in anticipation of unpredictable threat. However, most studies examining the psychophysiological correlates of IU have been conducted in adults. There is a critical need to understand the relationship between IU and psychophysiological reactivity in anticipation of unpredictable threat during adolescence, a key developmental period associated with increased exploration of situations with uncertain outcomes. Thus, the present study examined the association between (1) youth IU and (2) parental IU (as an indicator of risk) in relation to youth defensive motivation (startle reflex) and attention (startle probe N100 and P300) in anticipation of unpredictable threat. METHODS The sample included 193 13 to 22-year-old (M = 17.33, SD = 1.97) females and a biological parent. Participants and their parent completed a self-report measure of prospective and inhibitory IU. Youth startle potentiation, probe N100 enhancement, and probe P300 suppression (indicating increased attention to threat) were measured in anticipation of predictable and unpredictable threat. RESULTS Youth prospective IU and inhibitory IU were not related to youth psychophysiological reactivity to predictable or unpredictable threat. Greater parental prospective IU was associated with greater youth startle potentiation and probe N100 enhancement in anticipation of unpredictable threat. CONCLUSION The present study suggests that parental IU, but not concurrent IU, is associated with heightened defensive motivation and attentional engagement in anticipation of unpredictable threat in youth.
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Affiliation(s)
- Clare C Beatty
- Department of Psychology, Stony Brook University, United States of America.
| | - Rachel A Ferry
- Department of Psychology, Stony Brook University, United States of America
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, United States of America
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Konstantellou A, Sternheim L, Hale L, Simic M, Eisler I. The experience of intolerance of uncertainty for parents of young people with a restrictive eating disorder. Eat Weight Disord 2022; 27:1339-1348. [PMID: 34292530 PMCID: PMC9079010 DOI: 10.1007/s40519-021-01256-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to explore how parents of young people with a restrictive eating disorder (ED) experience and manage uncertainty. METHODS Seventeen parents of young people with a restrictive ED were recruited from multi-family therapy groups run within a specialised ED clinic. Five focus groups were conducted asking parents about their experience of uncertainty both prior and after the onset of their child's illness. RESULTS Data were analysed using interpretative phenomenological analysis which yielded seven superordinate themes. (1) Anorexia nervosa and uncertainty, (2) Positive and negative experiences of uncertainty (3), Helpful and unhelpful ways of coping with uncertainty, (4) Parent's self-efficacy and uncertainty (5), Needs of parents, (6) Parents' perceptions of intolerance of uncertainty in their children and (7) Impact of uncertainty on family life. CONCLUSION Parents caring for young people with a restrictive ED exhibit a strong intolerance of uncertainty, particularly in relation to their child's illness. This 'negative uncertainty' was thought to reduce their confidence as parents in how they managed their child's ED. Targeting high levels of intolerance of uncertainty in parents caring for young people with an ED could be beneficial for supporting parents when faced with their child's illness, increasing parental self-efficacy, decreasing accommodating behaviours and ultimately contributing to improved treatment outcomes. LEVEL OF EVIDENCE Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Anna Konstantellou
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lot Sternheim
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Lucy Hale
- Department of Psychology, University of Surrey, Guildford, UK
| | - Mima Simic
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ivan Eisler
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.
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Exploring the Link Between Transdiagnostic Cognitive Risk Factors, Anxiogenic Parenting Behaviors, and Child Anxiety. Child Psychiatry Hum Dev 2021; 52:1032-1043. [PMID: 33068211 DOI: 10.1007/s10578-020-01078-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
Theoretical models suggest parent anxiety leads to increased anxiogenic parenting, an important etiological factor for child anxiety disorders. Evidence suggests that parents engage in anxiogenic parenting to reduce distress in response to their child's anxiety; however, further study of this mechanism is needed. Cognitive risk factors, including distress intolerance, anxiety sensitivity, emotion-related impulsivity, and repetitive negative thinking are promising to examine as they impact emotion regulation. This study examined whether an indirect association between parent anxiety and anxiogenic parenting via these risk factors exists, and if child anxiety moderated this effect. Findings demonstrated evidence for an indirect association via distress intolerance in mothers at high levels of child anxiety, but not low levels. An unmoderated indirect effect via emotion-related impulsivity was found. Anxiety sensitivity and repetitive negative thinking did not demonstrate significant indirect effects. These findings suggest distress intolerance and emotional-related impulsivity may be targets for parent-focused child anxiety treatments.
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10
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Intolerance of uncertainty in youth: Psychometrics of the Intolerance of Uncertainty Index-A for Children. J Anxiety Disord 2020; 71:102197. [PMID: 32126335 DOI: 10.1016/j.janxdis.2020.102197] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/26/2020] [Accepted: 02/10/2020] [Indexed: 01/04/2023]
Abstract
Intolerance of uncertainty (IU) is a cognitive vulnerability for pathological anxiety. The current study adapted the Intolerance of Uncertainty Index-A for Children (IUI-A-C), and created a single-item Intolerance of Uncertainty Clinician-Rated Index (IUCR), both of which assess a youth's general inability to endure uncertainty. Psychometric properties of these two measures were evaluated. Participants were 146 youth aged 7-17 years seeking treatment for anxiety. The IUI-A-C evidenced individual item performance (i.e., correlations between each item and the total remainder score > .40, ps <.001), internal consistency, convergent validity with the IUCR and self-report measures of anxiety and functional impairment, divergent validity with ADHD severity, and retest reliability with a mean interval of over four weeks. The IUCR also evidenced convergent validity with the IUI-A-C and self-report measures of anxiety and functional impairment and divergent validity with ADHD severity. The IUI-A-C predicted composite principal diagnosis severity but did not predict composite GAD diagnosis severity. The IUI-A-C and IUCR have utility as measures of IU in youth. The role of IU in specific anxiety disorders and future research are discussed.
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11
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Bottesi G, Gürdere C, Cerea S, Sica C, Ghisi M. Familial Patterns of Intolerance of Uncertainty: Preliminary Evidence in Female University Students. Int J Cogn Ther 2019. [DOI: 10.1007/s41811-019-00063-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Feinberg L, Kerns C, Pincus DB, Comer JS. A Preliminary Examination of the Link Between Maternal Experiential Avoidance and Parental Accommodation in Anxious and Non-anxious Children. Child Psychiatry Hum Dev 2018; 49:652-658. [PMID: 29352362 PMCID: PMC6029431 DOI: 10.1007/s10578-018-0781-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Studies point to parental experiential avoidance (EA) as a potential correlate of maladaptive parenting behaviors associated with child anxiety. However, research has not examined the relationship between EA and parental accommodation of child anxiety, nor the extent to which parental negative beliefs about child anxiety help explain such a relationship. In a sample of mothers (N = 45) of anxious and non-anxious children, the present study investigated the potential link between maternal EA and accommodation of child anxiety and whether this link may be indirectly accounted for via maternal negative beliefs about child anxiety. EA was significantly and positively associated with accommodation of child anxiety, but when negative beliefs about child anxiety were incorporated into the model this direct effect was no longer significant. Findings highlight the contribution of parental emotions and cognitions to behaviors that may exacerbate child anxiety, and may inform treatment and prevention efforts with families of anxious youth.
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Affiliation(s)
- Leah Feinberg
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Caroline Kerns
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Donna B Pincus
- Department of Psychology, Boston University, Boston, MA, USA
| | - Jonathan S Comer
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA.
- Mental Health Interventions and Technology (MINT) Program, Department of Psychology, Center for Children and Families, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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Osmanağaoğlu N, Creswell C, Dodd HF. Intolerance of Uncertainty, anxiety, and worry in children and adolescents: A meta-analysis. J Affect Disord 2018; 225:80-90. [PMID: 28802117 DOI: 10.1016/j.jad.2017.07.035] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Intolerance of uncertainty (IU) has been implicated in the development and maintenance of worry and anxiety in adults and there is an increasing interest in the role that IU may play in anxiety and worry in children and adolescents. METHOD We conducted a systematic review and meta-analysis to summarize existing research on IU with regard to anxiety and worry in young people, and to provide a context for considering future directions in this area of research. The systematic review yielded 31 studies that investigated the association of IU with either anxiety or worry in children and adolescents. RESULTS The meta-analysis showed that IU accounted for 36.00% of the variance in anxiety and 39.69% in worry. Due to the low number of studies and methodological factors, examination of potential moderators was limited; and of those we were able to examine, none were significant moderators of either association. Most studies relied on questionnaire measures of IU, anxiety, and worry; all studies except one were cross-sectional and the majority of the studies were with community samples. LIMITATIONS The inclusion of eligible studies was limited to studies published in English that focus on typically developing children. CONCLUSIONS There is a strong association between IU and both anxiety and worry in young people therefore IU may be a relevant construct to target in treatment. To extend the existing literature, future research should incorporate longitudinal and experimental designs, and include samples of young people who have a range of anxiety disorders.
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Affiliation(s)
- Nihan Osmanağaoğlu
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK
| | - Cathy Creswell
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK
| | - Helen F Dodd
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK.
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Cornacchio D, Sanchez AL, Coxe S, Roy A, Pincus DB, Read KL, Holaway RM, Kendall PC, Comer JS. Factor structure of the intolerance of uncertainty scale for children. J Anxiety Disord 2018; 53:100-107. [PMID: 28797680 DOI: 10.1016/j.janxdis.2017.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 07/23/2017] [Accepted: 07/28/2017] [Indexed: 12/01/2022]
Abstract
Intolerance of uncertainty (IU), a dispositional negative orientation toward uncertainty and its consequences, has been studied in adults, but research has only recently examined IU in youth. Despite some advances, little is known about the factor structure of measures of IU in youth. The present study used confirmatory factor analysis to examine the structure of IU as measured by the Intolerance of Uncertainty Scale for Children (IUSC; Comer et al., 2009) in a sample of youth (N=368) 9-18 years of age (Mage=12.47) with and without anxiety disorders and their mothers. Findings demonstrated multiple acceptable factor structures: a correlated factors 2-factor structure and a bifactor model where a general factor underlies all items. While the bifactor model provides better fit and reliability to the data, multivariate analyses indicated that the 2-factor structure distinguishes apprehensive anxiety regarding future events (prospective IU) from present-focused inhibition of behavior due to uncertainty and negative reactions to the presence of uncertainty (inhibitory IU); a total IU score predicted all anxiety domains for self- and parent-reports except for parent-report harm avoidance. Findings are discussed in terms of consistency of IU across adult and youth samples, and how results can inform treatment efforts and etiologic models of IU and anxiety.
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Affiliation(s)
- Danielle Cornacchio
- Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, FL, United States.
| | - Amanda L Sanchez
- Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, FL, United States
| | - Stefany Coxe
- Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, FL, United States
| | - Amy Roy
- Department of Psychology, Integrative Neuroscience Program, Fordham University, Bronx, NY, United States
| | - Donna B Pincus
- Department of Psychology, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA, United States
| | - Kendra L Read
- Department of Psychiatry and Behavioral Sciences, University of Washington/Behavioral Sciences, Seattle Children's Hospital, Seattle, WA, United States
| | | | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Jonathan S Comer
- Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, FL, United States
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15
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Intolerance of uncertainty mediates the relationship between adult attachment and worry. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.02.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Riskind JH, Sica C, Bottesi G, Ghisi M, Kashdan TB. Cognitive vulnerabilities in parents as a potential risk factor for anxiety symptoms in young adult offspring: An exploration of looming cognitive style. J Behav Ther Exp Psychiatry 2017; 54:229-238. [PMID: 27614663 DOI: 10.1016/j.jbtep.2016.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Given that anxiety runs in families, it is critical to understand the cognitive factors that may be responsible for this intergenerational transmission. The present study offers a first step by exploring the link between mother and father tendencies to view potentially threatening situations as rapidly escalating toward dreaded outcomes (i.e., looming cognitive style) and the emotional disturbances and looming cognitive styles of their adult offspring. METHODS We assessed cognitive vulnerabilities, anxiety, and depressive symptoms in a non-clinical sample (N = 382) of Italian college students and their parents. RESULTS The looming cognitive style of fathers, but not mothers, was significantly related to greater anxiety in adult offspring. This finding was obtained for both sons and daughters, and remained even after statistically controlling for the anxiety, worry, depressive symptoms, and anxiety sensitivity (AS) of parents). Notably, the association between fathers' looming cognitive style and offspring symptoms was not related to their child's depressive symptoms, and similar to prior work, served as a cognitive marker specific to anxiety. LIMITATIONS The present study relied on a cross-sectional design and did not use clients diagnosed with anxiety disorders. CONCLUSIONS The findings suggest that it may prove fruitful to consider parental vulnerabilities such as looming cognitive styles in comprehensive cognitive and interpersonal models of anxiety. The intergenerational transmission of emotional difficulties seems to extend beyond anxiety to beliefs about the escalation of threat.
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Affiliation(s)
- John H Riskind
- Department of Psychology, George Mason University, Fairfax, VA, USA.
| | - Claudio Sica
- Department of Human Health Sciences, University of Firenze, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Italy
| | - Todd B Kashdan
- Department of Psychology, George Mason University, Fairfax, VA, USA
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17
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Sanchez AL, Cornacchio D, Chou T, Leyfer O, Coxe S, Pincus D, Comer JS. Development of a scale to evaluate young children's responses to uncertainty and low environmental structure. J Anxiety Disord 2017; 45:17-23. [PMID: 27907833 DOI: 10.1016/j.janxdis.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Abstract
Intolerance of Uncertainty (IU), defined as the dispositional interpretation of uncertain or ambiguous events as stressful and problematic, has been linked to excessive worry and other anxiety-related problems in adults and youth. IU has been conceptualized as a vulnerability factor for excessive worry and anxiety, but the historical absence of a supported measure of IU in young children has hampered longitudinal research needed to evaluate temporal relationships between IU and anxiety and the differential developmental pathways of IU leading to different anxiety disorders and depression. The present study evaluated the psychometric properties of a newly developed 17-item parent-report measure of younger children's Responses to Uncertainty and Low Environmental Structure (i.e., the RULES questionnaire). We examined the preliminary structure, reliability, and validity of the RULES within a treatment-seeking sample of children aged 3-10 (N=160) with anxiety. Findings from an exploratory factor analysis supported a one-factor model that retained all 17 items. The RULES demonstrated strong internal consistency, and predictive, convergent, and divergent validity. In this early childhood sample, the RULES also showed stronger associations with anxiety than did a previously supported measure of IU developed for older youth, and showed preliminary sensitivity to treatment-related change. Findings provide preliminary psychometric support for the RULES as a parent-report measure of children's responses to uncertainty and low environmental structure that may inform etiologic models of anxiety.
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Affiliation(s)
- Amanda L Sanchez
- Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States.
| | - Danielle Cornacchio
- Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States
| | - Tommy Chou
- Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States
| | - Ovsanna Leyfer
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA 02215, United States
| | - Stefany Coxe
- Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States
| | - Donna Pincus
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA 02215, United States
| | - Jonathan S Comer
- Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States
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