Intolerance of uncertainty and perceived threat

Negative life events and sleep disturbance among adolescents: Intolerance of uncertainty as mediator and moderator

BACKGROUND

While negative life events (NLEs) have been linked to an increased risk of sleep disturbance among adolescents, the mechanisms of this impact still lack further examination. The current study aimed to explore whether intolerance of uncertainty (IU), a dispositional transdiagnostic vulnerability factor for psychopathology, could act as a mediator and/or moderator in the link from NLEs to sleep disturbance.

METHODS

A longitudinal nested subsample of 54,240 Chinese adolescents (aged 9-19) were surveyed at baseline (Timepoint 1) and six months later (Timepoint 2). They completed questionnaires to assess their IU, NLEs, sleep disturbance and sociodemographic characteristics. Mediation and moderation analyses were conducted to test our hypotheses.

RESULTS

Upon adjusting for covariates, IU was found to mediate the relationship between NLEs and residual changes in sleep disturbance over a six-month period, with the mediation effect accounting for 31.8%. Additionally, the moderating role of IU in this relationship was also identified, suggesting that a high level of IU exacerbated the effect of NLEs on sleep disturbance.

CONCLUSIONS

In conclusion, our findings shed light on the dual roles of IU in the link from NLEs to sleep disturbance, holding significant practical implications for preventing and intervening in sleep disturbance among adolescents. To mitigate the risk of sleep disturbance among adolescents experiencing NLEs, timely assessments of IU and tailored interventions to enhance uncertainty tolerance are necessary.

Trait and situation-specific intolerance of uncertainty predict affective symptoms during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic, a high-uncertainty situation, presents an ideal opportunity to examine how trait intolerance of uncertainty (IU) and situation-specific IU relate to each other and to mental health outcomes. The current longitudinal study examined the unique associations of trait and COVID-specific IU with general distress (anxiety and depression) and pandemic-specific concerns (pandemic stress and vaccine worry).

METHODS

A community sample of Florida adults (N = 2152) was surveyed online at three timepoints. They completed measures of trait IU at Wave 1 (April-May 2020) and COVID-specific IU at Wave 2 (May-June 2020). At Wave 3 (December-February 2021), they reported symptoms of depression, anxiety, pandemic stress, and vaccine worry.

RESULTS

We used structural equation modeling to test our overall model. Trait IU significantly predicted later COVID-specific IU, however there was no significant effect of trait IU on any outcome measure after accounting for COVID-specific IU. Notably, COVID-specific IU fully mediated the relationship between trait IU and all four symptom measures.

LIMITATIONS

There were several limitations of the current study, including the use of a community sample and high participant attrition.

CONCLUSIONS

Results suggest that COVID-specific IU predicts mental health outcomes over and above trait IU, extending the existing literature. These findings indicate that uncertainty may be more aversive when it is related to specific distressing situations, providing guidance for developing more specific and individualized interventions. Idiographic treatments which target situation-specific IU may be more efficacious in reducing affective symptoms and related stress during the COVID-19 pandemic or other similar events.

Dispositional factors in the explanation of symptoms of depression, anxiety, health anxiety and COVID-19 Phobia

Maladaptive personality, the motivational systems, and intolerance of uncertainty play important roles in the statistical explanation of depression and anxiety. Here, we notably examined for the first time whether symptoms of depression, anxiety, health anxiety, and fear of COVID-19 share similar associations (e.g., variance explained) with these important dispositional dimensions. For this cross-sectional study, data from 1001 participants recruited in Germany (50% women; mean age = 47.26) were collected. In separate models, we examined the cross-sectional associations of the symptoms of depression, anxiety, health anxiety, and fear of COVID-19 with the Personality Inventory for DSM Short Form Plus scales, the Behavioral Inhibition System / Flight-Fight-Freeze System / Behavioral Activation System scales, and Intolerance of Uncertainty scales. Relative weight analyses were used to determine the within-model importance of the different scales in the prediction of the symptoms. All in all, our study showed that maladaptive personality and intolerance of uncertainty dimensions are more important sets of predictors of the studied outcomes (with which depressive and anxious symptomatology feature very similar associations) than are the motivational system dimensions. Within predictor sets, the scales with the most important predictors were: Negative Affectivity, the Behavioral Inhibition System, and Burden due to Intolerance of Uncertainty. Our findings highlight the relevance of focusing behavioral targets of psychotherapy on these within-set traits and identify potential research priorities (maladaptive personality and intolerance of uncertainty) in relation to the symptoms of interest.

The association between uncertainty intolerance, perceived environmental uncertainty, and ego depletion in early adulthood: the mediating role of negative coping styles

Introduction

Uncertainty intolerance and perceived environmental uncertainty can influence an individual's emotions and behavioral responses. Previous research showed that high uncertainty intolerance and high perceived environmental uncertainty were both negatively associated with an individual's life satisfaction. We explored the interaction effects of uncertainty intolerance and perceived environmental uncertainty on ego depletion of early adulthood and its mechanisms.

Methods

Investigating 292 college students using an uncertainty intolerance scale, a perceived environmental uncertainty scale, a negative coping style questionnaire, and an ego depletion scale. The correlations among all variables were calculated using Pearson's product-moment correlation coefficient, and then we used the PROCESS macro (model 8) in SPSS to test the conditional process model in the relationship between uncertainty intolerance and ego depletion.

Results

The results showed that the interaction terms of uncertainty intolerance and perceived environmental uncertainty were significantly associated with negative coping styles. Only in the high perceived environmental uncertainty situations, uncertainty intolerance was positively associated with negative coping styles, and negative coping styles were positively associated with ego depletion.

Discussion

In general, compared with perceived environmental uncertainty, participants' cognition towards environmental uncertainty was much more associated with individual's coping styles and psychological state, individuals with high uncertainty intolerance would face great stress and experience more emotional problems. Our results suggest that it is important for individuals' mental health to gain a sense of control in an uncertain environment and improve the tolerance of uncertainty. Future research needs to pay attention to the intervention strategy of decreasing uncertainty intolerance.

Worry perception and its association with work conditions among healthcare workers during the first wave of the COVID-19 pandemic: a web-based multimethod survey at a university hospital in Sweden

OBJECTIVES

In this study, we explored healthcare workers' (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic.

DESIGN

A web-based multimethods survey including multiple choice and open-ended questions was used.

SETTING

The study was conducted at a university hospital in Sweden.

PARTICIPANTS

All HCWs who were working during the first wave of the COVID-19 pandemic in March-June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents).

MAIN OUTCOMES MEASURES

Worry perception and its association with work conditions among HCWs.

RESULTS

29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: 'ambiguity of feeling safe and secure', 'being obliged to adapt to a new reality' and 'into the unknown'. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends.

CONCLUSIONS

Worries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.

Sociability Alcohol Expectancies Shape Predictions of Drinking Behavior and Anxiety in a Novel Affective Forecasting Task

Background: Existing work proposes that people with higher social anxiety symptoms and sociability alcohol expectancies believe alcohol can lower their anxiety. However, studies have primarily analyzed retrospective reports, not anticipatory motives. Since predictions of future emotion (i.e., affective forecasts) strongly influence behavior, it is critical to understand how people predict alcohol will influence their anxiety. Additionally, intolerance of uncertainty (IU) is related to the use of alcohol as a coping tool, but there is a dearth of work testing whether IU influences alcohol-related forecasts. Objectives: Utilizing a novel affective forecasting task, we tested the prediction that social anxiety symptoms, sociability alcohol expectancies, and IU would relate to predictions about alcohol use. In an initial study and preregistered replication, participants imagined themselves in stressful social scenarios and forecasted how anxious they would feel when drinking and when sober. In the replication, participants also forecasted whether they would drink in the imagined scenarios. Results: Contrary to hypotheses, social anxiety symptoms and IU did not significantly predict higher forecasted anxiety across studies, nor did they predict forecasted drinking. Exploratory analyses showed that participants with higher sociability alcohol expectancies forecasted being more likely to drink, and forecasted feeling less anxious when drinking (versus being sober). Even after statistically controlling for social anxiety, the effect of sociability expectancies remained significant in predicting forecasted anxiety and forecasted drinking. Conclusions: Clinicians could consider specifically targeting sociability expectancies for alcohol use difficulties, and future research should continue utilizing affective forecasting paradigms to test links between social anxiety, alcohol expectancies, and alcohol-use problems.

The Moderating Role of Intolerance of Uncertainty in the Relationship Between Health Anxiety and Pandemic-Related Stress

Background and Objectives

Global pandemics, including COVID-19, have a significant effect on mental health, and this may be especially true for individuals with health anxiety. Although health anxiety is related to both pandemic-related fears and perceptions of health risks, there is a paucity of research on individual difference variables that might exert an influence on these relationships. The present study examined intolerance of uncertainty (IU) as a potential moderator of the relationship between health anxiety and COVID-related stress, and the relationship between health anxiety and perceived risk of contracting COVID.

Design and Methods

A nationally representative sample of North American adults (N = 204) completed self-report measures of health anxiety, IU, COVID-related stress, and perceived risk of contracting COVID.

Results

Prospective IU moderated the positive relationship between health anxiety and COVID-related stress, as the relationship was strengthened at average and higher levels of prospective IU. Neither IU subscale moderated the relationship between health anxiety and perceived risk.

Conclusion

These results suggest that individuals with elevated health anxiety and high prospective IU may be at higher risk of experiencing COVID-related stress, illuminating the interplay of risk factors that place anxious populations at an increased risk of experiencing stress during acute health risks.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10365-w.

Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review

Intolerance of uncertainty, a transdiagnostic factor manifested across emotional disorders, has been associated with difficulties in regulating emotions. This meta-analysis addresses the lack of synthesis of this relationship. PsycInfo, PubMed, Scopus, and ProQuest were systematically searched for relevant articles published up to and during November 2022. We combined 161 effect sizes from 91 studies (N = 30,239), separating the analysis into maladaptive and adaptive emotion regulation strategies and their association with intolerance of uncertainty. We found a moderate positive relationship between maladaptive, and a moderate inverse relationship between adaptive emotion regulation and intolerance of uncertainty. Analysing the magnitude of relationships revealed that cognitive avoidance and mindfulness were the maladaptive and adaptive strategies respectively which had the largest effect sizes and thus strongest relationships with intolerance of uncertainty. Combining all strategies, cognitive avoidance remained the largest effect size, while expressive suppression had the smallest effect size and was non-significant in its relationship. Further analyses testing study sample, design, and age as moderators found no significant moderator for the relationships between intolerance of uncertainty and emotion regulation strategies. These findings have implications for future intolerance of uncertainty interventions, with emotion regulation as a potential target of change.

Sensory sensitivity, intolerance of uncertainty and sex differences predicting anxiety in emerging adults

As multiple vulnerability factors have been defined for anxiety disorders, it is important to investigate the interactions among these factors to understand why and how some individuals develop anxiety. Sensory Sensitivity (SS) and Intolerance of Uncertainty (IU) are independent vulnerability factors of anxiety, but their unique relationship in predicting anxiety has rarely been studied in non-clinical populations. The objective of this investigation was to examine the combined effects of SS and IU on self-reported anxiety in a sample of university students. In addition, with the frequently reported sex bias in anxiety literature, we expected that the combined effects of vulnerability factors would be different for females and males. A convenience sample of 313 university students, ages 17-26 years was recruited. The participants completed the Intolerance of Uncertainty Scale (IUS-12), the Adult/Adolescent Sensory Profile (AASP), and the Beck Anxiety Inventory (BAI). Results of moderated mediation analyses demonstrated a strong partial mediation between SS and anxiety through IU, providing evidence that IU, a cognitive bias against the unknown, was one mechanism that explained how SS was related to anxiety. Further, the effect of IU on anxiety was approximately twice as strong in females. Our results highlight the importance of studying the unique relationships among multiple vulnerability factors to better understand anxiety susceptibility in emerging adults.

The relationship between intolerance of uncertainty, coping style, resilience, and anxiety during the COVID-19 relapse in freshmen: A moderated mediation model

Background

The repeated outbreaks of COVID-19 and the rapid increase in uncertainty have had many negative effects on the public's mental health, especially on emotional aspects such as anxiety and depression. However, in previous studies, there are few studies exploring the positive factors between uncertainty and anxiety. The innovation of this study is the first to explore the mechanism of coping style and resilience as people's psychological protective factors between uncertainty and anxiety caused by the COVID-19 pandemic.

Methods

This study explored the relationship between intolerance of uncertainty and anxiety of freshmen with coping style as mediating variable and resilience as moderating variable. A total of 1049 freshmen participated in the study and completed the Intolerance of Uncertainty Scale (IUS-12), Self-rating Anxiety Scale (SAS), Simplified Coping Style Questionnaire (SCSQ), and Connor-Davidson Resilience Scale (CD-RISC).

Results

SAS score of the surveyed students (39.56 ± 10.195) was significantly higher than that of the Normal Chinese score (29.78 ± 10.07, p < 0.001). Intolerance of uncertainty was significantly positively correlated with anxiety (β = 0.493, p < 0.001). Positive coping style has a significant negative impact on anxiety (β = -0.610, p < 0.001), negative coping style has a significant positive impact on anxiety (β = 0.951, p < 0.001). Resilience moderates the second half of the influence of negative coping style on anxiety (β = 0.011, t = 3.701, p < 0.01).

Conclusion

The findings suggest that high levels of intolerance of uncertainty had negative effects mental burden during the COVID-19 pandemic. The knowledge of the mediating role of coping style and the moderating role of resilience may be used by health care workers when consulting freshmen with physical health complaints and psychosomatic disorders.

The link between self-uncertainty and conspicuous consumption: Tolerance of uncertainty as a moderator

This study, based on self-affirmation theory, aims to investigate the impact of self-uncertainty on individual consumption behavior. Self-uncertainty was categorized into moral, cognitive, and interpersonal self-uncertainty, and different types of self-uncertainty were manipulated through four experiments, including a moral dilemma, a recall paradigm, and a picture quiz task written by E-Prime software to examine the effects of different types of self-uncertainty on conspicuous consumption and their possible boundary conditions. Our results show that moral, cognitive, and interpersonal self-uncertainty contribute to a stronger tendency to engage in conspicuous consumption. Our results also suggest that tolerance of uncertainty moderates the effect of self-uncertainty on conspicuous consumption, meaning that subjects with a high tolerance of uncertainty are less inclined to engage in conspicuous consumption than those with a low tolerance of uncertainty, even if they have high self-uncertainty. This study may provide an explanation for conspicuous consumption behavior, further validating the theory of compensatory consumption. Additionally, the results from this study also provide a reference for understanding people's decision-making behavior in an uncertain social context and can provide new guidance to control irrational consumption behavior.

Intolerance of uncertainty and functional connectivity of the anterior insula during anticipation of unpredictable reward

Individuals with high intolerance of uncertainty (IU) tend to display maladaptive cognitive, behavioral, physiological, and/or neural responses during anticipation of uncertain or ambiguous outcomes, both positive and negative in valence. Importantly, high IU has been proposed as a key transdiagnostic phenotypic risk factor for the onset and maintenance of several psychiatric disorders. Within the context of reward processing, high IU has been related to dysfunctional reward anticipation, which may be mediated by hyperactive anterior insula (AIC) response to uncertainty. The present study further investigated the relationship between the AIC and IU by examining the association between individual differences in IU and task-based functional connectivity of the right AIC using functional magnetic resonance imaging (fMRI). Participants (N = 171) completed a self-report measure of IU and a reward anticipation task during fMRI. Generalized psychophysiological interaction (gPPI) analyses were performed with a seed in the right AIC. In the U-threat model, we found that greater self-reported levels of IU were correlated with increased functional connectivity between the right AIC and the dorsal anterior cingulate cortex (dACC) and the right dorsolateral prefrontal cortex (dlPFC). In the P-threat model, we did not find these associations, perhaps indicating that they may be more robust during uncertainty. These preliminary findings suggest that parts of salience and central executive control networks may be impacted by and underlie the expression of IU. Future studies should examine the generalizability of these findings to clinical populations and investigate how disruption of these functional networks may contribute to psychopathology.

Intolerance of uncertainty, anxiety sensitivity, and health anxiety during the COVID-19 pandemic: Exploring temporal relationships using cross-lag analysis

Intolerance of uncertainty (IU) and anxiety sensitivity (AS) have been widely discussed and explored as factors that may contribute to health anxiety. We propose that IU and AS are salient issues for many during the COVID-19 pandemic, and may play a role in the development or exacerbation of health anxiety during the pandemic. Studies have examined links between IU and AS with health anxiety during the pandemic, but these relationships have not been tested together using a longitudinal study design. In the present study, measures of IU, AS, and health anxiety were collected from 301 adults at two time points 6 months apart during (early stages of) the COVID-19 pandemic using an online survey platform. Cross-lagged analysis was utilized to simultaneously estimate cross-sectional and longitudinal associations between these three variables. Robust cross-sectional associations were observed, and IU prospectively predicted changes in both health anxiety and AS. No other statistically significant prospective associations emerged. Present findings support the putative role of IU in health anxiety, suggesting that some observed links between AS and health anxiety could be driven by shared variance with IU. IU may be an important factor to monitor and target in health anxiety interventions during the pandemic.

Stimulus diversity increases category-based fear generalization and the effect of intolerance of uncertainty

Fear generalization refers to conditioned fear responses extending to related stimuli and fear overgeneralization is a key feature of pathological anxiety. Along with perception similarity, conceptual relations affect fear generalization. We investigated whether stimulus diversity-an important principle of category-based induction-influences fear generalization. Induction studies have shown that generalization from a premise involving diverse instances is stronger than that from non-diverse instances. We adopted this framework for fear learning and established two groups. The diverse group developed fear in response to diverse instances from one category, while the non-diverse group acquired fear of non-diverse instances from the same category. An effect of stimulus diversity was observed in shock-expectancy ratings, with the diverse group displaying higher fear generalization than the non-diverse group. We also tested whether intolerance of uncertainty (IU) might affect the difference in fear generalization between the two conditions. Individuals with higher IU showed reduced difference in fear generalization between two conditions, mainly driven by heightened fear generalization to novel stimulus with ambiguous threat levels in the non-diverse condition. This study helps illustrate the mechanisms behind differential category-based fear generalization and provides a potential explanation for why higher IU individuals may develop anxiety disorders following trauma.

The energetic cost of allostasis and allostatic load

Chronic psychosocial stress increases disease risk and mortality, but the underlying mechanisms remain largely unclear. Here we outline an energy-based model for the transduction of chronic stress into disease over time. The energetic model of allostatic load (EMAL) emphasizes the energetic cost of allostasis and allostatic load, where the "load" is the additional energetic burden required to support allostasis and stress-induced energy needs. Living organisms have a limited capacity to consume energy. Overconsumption of energy by allostatic brain-body processes leads to hypermetabolism, defined as excess energy expenditure above the organism's optimum. In turn, hypermetabolism accelerates physiological decline in cells, laboratory animals, and humans, and may drive biological aging. Therefore, we propose that the transition from adaptive allostasis to maladaptive allostatic states, allostatic load, and allostatic overload arises when the added energetic cost of stress competes with longevity-promoting growth, maintenance, and repair. Mechanistically, the energetic restriction of growth, maintenance and repair processes leads to the progressive wear-and-tear of molecular and organ systems. The proposed model makes testable predictions around the physiological, cellular, and sub-cellular energetic mechanisms that transduce chronic stress into disease risk and mortality. We also highlight new avenues to quantify allostatic load and its link to health across the lifespan, via the integration of systemic and cellular energy expenditure measurements together with classic allostatic load biomarkers.

The relationship between future self-continuity and intention to use Internet wealth management: The mediating role of tolerance of uncertainty and trait anxiety

This study aimed to analyze the mediating effect of tolerance of uncertainty (TU) and trait anxiety (TA) on future self-continuity (FSC) and intention to use Internet wealth management (IUIWM) systems. A questionnaire survey was distributed online and a total of 388 participants completed questionnaire, The questionnaire included the following scales: Chinese version of the FSC, Intention to Use the Internet Wealth Management, TU, and TA. Pearson correlation was used to investigate the correlation coefficient between variables while the sequential regression method was used to analyze relationship between variables. To analyze the collected data, the SPSS 26.0 was used. A two-step procedure was applied to analyze the mediation effect. Confirmatory factor analysis (CFA) was conducted to test the measurement model. Afterward, the Maximum Likelihood method was used for path analysis, and the Bias-corrected Bootstrap method was used to investigate determine the estimated value and confidence interval of the mediating effect. To analyze the mediation effect, the Mplus 7.0 was used. The results showed that FSC positively predicted individuals’ Internet wealth management systems. Furthermore, TU and TA played complete serial multiple mediating roles between FSC and IUIWM. The role of TA and TU have negative impact on intention to use. This study provides a theoretical basis in personality psychology that Internet financial product suppliers can use to improve the attractiveness of their products. Product managers can subdivide users according to these personality traits to provide customized products.

The association between intolerance of uncertainty and Internet addiction during the second wave of the coronavirus disease 2019 pandemic: A multiple mediation model considering depression and risk perception

Repeated outbreaks of coronavirus disease 2019 (COVID‐19) have forced people to shift most of their work and life activities from offline to online, leading to a growing problem of Internet dependence and even Internet addiction. However, the mechanism of the association between COVID‐19‐related intolerance of uncertainty (COVID‐19 IU) and Internet addiction during the second wave of COVID‐19 is still unclear. The current study explored the association between COVID‐19 IU and Internet addiction as mediated by depression and risk perception based on the Uncertainty‐Depression‐Perception‐Addiction model (UDPA). A total of 1,137 adult participants were recruited, and COVID‐19 IU, depression, risk perception, Internet addiction, and demographic variables were analyzed. The results showed that COVID‐19 IU was significantly and positively associated with Internet addiction and that this relationship was mediated in parallel by depression and risk perception. Our findings further extend the Interaction of Person‐Affect‐Cognition‐Execution (I‐PACE) model from the perspective of applicability in the unique context of COVID‐19. Furthermore, the study suggests that individuals could decrease their dependence on the Internet to prevent Internet addiction during the second wave of the pandemic through effective interventions that include lowering COVID‐19 IU, improving emotion regulation, and developing reasonable perceptions of risk.

Intolerance of uncertainty and distress in women with delayed IVF treatment due to the COVID-19 pandemic: The mediating role of situation appraisal and coping strategies

The COVID-19 pandemic has caused delays of numerous medical procedures, including IVF. This study investigates the relationship between Intolerance of Uncertainty (IU), situation appraisal-the perceived threat that COVID-19 poses for infertility treatment, coping strategies, and general distress among women with a delayed IVF procedure. SEM showed that situation appraisal is a partial mediator of the relationship between IU and avoidance, as well as the relationship between IU and general distress. The connection between situation appraisal and general distress is partially mediated by avoidance. In this challenging context for mental health, situation appraisal and coping strategies determine the level of distress, where IU, as a dispositional variable, represents the main determinant of the entire reaction.

The Shackles of Fear: A Moderated Mediation Model of How Fear of Aging May Increase Older Adults' Vulnerability to Fraud

Objectives: Older adults are disproportionately vulnerable to frauds of many kinds, and fear of aging has been conjectured to be a primary factor in older adults' vulnerability to fraud; however, no study has examined how and when fear of aging is associated with older adults' vulnerability to fraud.Methods: In this cross-sectional study, a sample of 251 Chinese older adults (M = 68.1, SD = 6.43) completed measures regarding fear of aging, intolerance of uncertainty, self-control, and vulnerability to fraud.Results: The results revealed that intolerance of uncertainty partially mediated the association between fear of aging and vulnerability to fraud. This indirect effect of fear of aging on vulnerability to fraud was only significant for older adults with lower levels of self-control.Conclusions: The association between fear of aging and older adults' vulnerability to fraud through intolerance of uncertainty varies as a function of self-control.Clinical implications: Clinicians may focus on reducing the fear of aging, decreasing intolerance of uncertainty, and enhancing self-control as promising pathways to develop effective interventions and outreach strategies aimed at protecting older adults from fraud.

COVID-19 and prejudice against migrants: the mediating roles of need for cognitive closure and binding moral foundations. A comparative study

What mitigates prejudice against migrants in situations of uncertainty? Addressing this question, we explored how individuals with greater COVID-19 concern perceive migrants as a greater threat and show prejudice against them, indirectly through the mechanism of need for cognitive closure and binding moral foundations.This study was conducted in two European countries: Malta and Italy. Six hundred and seventy-six individuals participated in this quantitative study (Malta: N = 204; Italy N = 472). Results from this study showed that the need for cognitive closure and binding moral foundations mediate the relationship between COVID-19 concern and prejudice against migrants in both countries. When testing the three binding moral foundations (loyalty, authority, and purity), the authority foundation seems to be the most consistent predictor.The implications of the findings contribute to theories about how situational uncertainty caused by COVID-19, together with the need for epistemic certainty and binding morality, contribute to increased prejudiced attitudes against migrants.

Intolerance of uncertainty and reactions to the COVID-19 pandemic

The COVID-19 pandemic has presented a threat to mental health worldwide. The current study aims to investigate the role of intolerance of uncertainty in cognitive, emotional and behavioral reactions to this pandemic and propose a path model of these reactions. In the first two months of the COVID-19 pandemic in Slovakia, participants in a general sample (n = 1,011) as well as an older adult sample (n = 655) completed measures regarding intolerance of uncertainty, mental health (anxiety, well-being, perceived stress) and adherence to preventive measures. Two rounds of data collection were carried out in the first sample. Intolerance of uncertainty was found to be related to mental health indicators and the structural equation model showed a direct and indirect effect on them as well as on the adherence to preventive measures. However, the comparison of data from different time points has brought inconsistent results. The findings highlight the role of intolerance of uncertainty in reaction to threat and indicate the potential of uncertainty reduction e.g., getting clear messages from authorities, as a way of decreasing mental health problems.

An Exploratory Pilot Study on Choking Episodes in Archery

The aim of our study is to test the fit of an explanatory model of the frequency of the phenomenon of choking under pressure in archers, focusing on both the individual components (anxiety, coping styles, and decentralization) and environmental components (perception of coach assistance). 115 competitive athletes including 72 males (62.6%) and 43 females (37.4%) participated in the study, with average age of 39 years (±15.47). Participants reported personal data and completed measures of self-consciousness, anxiety, coping styles, and decentering. The ruminative component of concern was found to be the factor directly influencing the frequency of choking episodes in performance. Two significant mediations of personal coping style were also identified on the effects of anxiety on brooding thinking and on the athlete's ability to decentralize. The latter personal self-regulative component has been shown to be able to strongly limit the frequency of choking under pressure. Finally, among the environmental components, a further facilitating influence for the athlete resulted in the perception of being supported by the coach. The results therefore suggest that the athlete in choking should not face alone the hard upcoming period, but should preferably be supported with an articulated program focused on the cognitive remodeling of disturbing thoughts, on the strengthening of the capacity of decentralization, on the enhancement of the relationship of support and trust with the coach.

Action Research Using a Chinese Career Model Based on the Wisdom of Classic of Changes and its Applications

To challenge the Taiwan Ministry of Education's (TMOE) dominant enforcement of a person-environment fit model, the Chinese Career Research Center incorporated yin-yang alternation principles from the Classic of Changes ( I Ching, Yi Jing or 易經) to develop the model of career development touching the sky yet grounded (TSG) and corresponding practice guidelines, a career website (CCN), and four career service projects. Using Lewin's (1946) cyclical-spiral process of action research, CCN and TSG service projects were promoted to complement the TMOE's fit model, and feedback was utilised to revise our TSG model and its applications. Yin-yang alternation principles and the four stages of chien (the creative) from the Classic of Changes were applied to develop social action strategies. Social change was indicated by counsellors’ and students’ changes in their career views, as well as the TMOE's direct financial support for TSG service projects. This progress is encouraging for whoever is interested in developing culture-inclusive indigenous psychology with practical outcomes.

Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety

Mindfulness-based interventions have gained extensive support for their application in the treatment of anxiety. However, their mechanisms remain largely unexplored. Excessive reactivity to uncertainty plays a central role in anxiety, and may represent a mechanism for the effect of mindfulness on anxiety, as mindfulness training fosters an open and accepting stance towards all aspects of experience. The present study sought to investigate both (i) self-reported intolerance of uncertainty (IU) as well as (ii) physiological and subjective responding to uncertain threat in a threat-of-shock paradigm, the NPU-threat test, as mediators for the relationship between mindfulness and anxiety in a cross-sectional study of healthy participants (N = 53). The results indicated that IU mediated the effect of mindfulness on some anxiety symptoms. In contrast, scores of physiological as well as subjective responses to uncertain threat from the NPU-threat test were largely unrelated to mindfulness, anxiety, or the IU self-report measure. The results provide initial evidence that reactions to uncertainty may play a role in the mindfulness-anxiety relationship and suggest that studies are needed to address how methodological variations of the NPU-threat test affect perceived levels of uncertainty and uncertainty-related anxiety.

Effects of intolerance of uncertainty on turnover intention in transplantation coordinators: the roles of burnout and grit

Background

Transplantation coordinators are essential professionals who play a wide range of roles in organ transplantation. Their burnout levels have been shown to be very high due to the significant uncertainty they experience at work. The taxing conditions that accompany their position can increase turnover, which can, in turn, lead to a decrease in the number of experts working in the field. This calls for an improved understanding of their turnover intentions.

Methods

We collected data of 80 transplantation coordinators and measured their intolerance of uncertainty, burnout, turnover intention, and grit. The data were analyzed using a multiple regression analysis.

Results

A mediation model was confirmed in which intolerance of uncertainty significantly increases burnout, which, in turn, increases turnover intention. The moderating effects of grit on the relationship between intolerance of uncertainty and turnover intentions were also found to be significant. When grit was low, overall turnover intention was high, regardless of intolerance of uncertainty. Conversely, when grit was high, the intention to leave was high only when the intolerance of uncertainty was also high.

Conclusions

There is a high level of uncertainty among transplantation coordinators due to the nature of the work; however, the degree to which the uncertainty is accepted varies individually. It is therefore necessary to seek ways to manage the uncertainty at an organizational and personal level. These efforts could contribute to improving transplantation coordinators’ long-term service and expertise.

Factors Associated with Psychological Distress and Physical Activity During the COVID-19 Pandemic

In Morocco, as in many countries, COVID-19 spread nationwide causing a public health emergency. Strict quarantine measures implemented as a result of the pandemic have disrupted many aspects of people's lives, triggering psychological distress. A total of 256 participants were recruited through a convenience sample. Data were collected through snowball sampling, an assessment of distress symptoms using the Brief Symptoms Inventory, and an assessment of leisure-time physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Bivariate and multivariate analyses were performed. Significant changes in paranoid ideation (z = -2.45, P = .01) and interpersonal sensitivity (z = -2.01, P = .04) dimensions were noted between those who were and those who were not authorized to leave their homes during quarantine. Similarly, for physical activity, significant changes in depression (z = -2.15, P = .03), anxiety (z = -2.13, P = .03), interpersonal sensitivity (z = -1.95, P = .05), and somatization (z = -2.11, P = .03) were reported among the insufficiently active group compared with the more physically active group. From multiple regression analysis, variables correlated with general distress were type of quarantine, gender, age, education level, chronic disease, and smoking (R² = .80). With some variables, leisure-time physical activity domains appeared to be associated only with interpersonal sensitivity and somatization. Having to leave one's home during the outbreak was linked to distress, especially symptoms like suspiciousness, hostility, fearful thoughts of losing autonomy, and feelings of inadequacy, uneasiness, and discomfort during interpersonal interactions. Individuals who were moderately or sufficiently active physically reported less psychological distress.

Illustrating Cancer Risk: Patient Risk Communication Preferences and Interest regarding a Novel BRCA1/2 Genetic Risk Modifier Test

INTRODUCTION

Genetic risk modifier testing (GRMT), an emerging form of genetic testing based on common single nucleotide polymorphisms and polygenic risk scores, has the potential to refine estimates of BRCA1/2 mutation carriers' breast cancer risks. However, for women to benefit from GRMT, effective approaches for communicating this novel risk information are needed.

OBJECTIVE

To evaluate patient preferences regarding risk communication materials for GRMT.

METHODS

We developed four separate presentations (panel of genes, icon array, verbal risk estimate, graphical risk estimate) of hypothetical GRMT results, each using varying risk communication strategies to convey different information elements including number of risk modifier variants present, variant prevalence among BRCA1/2 carriers, and implications and uncertainties of test results for cancer risk. Thirty BRCA1/2 carriers evaluated these materials (randomized to low, moderate, or high breast cancer risk versions). Qualitative and quantitative data were obtained through in-person interviews.

RESULTS

Across risk versions, participants preferred the presentation of the graphical risk estimate, often in combination with the verbal risk estimate. Interest in GRMT was high; 76.7% of participants wanted their own GRMT. Participants valued the potential for GRMT to clarify their cancer susceptibility and provide actionable information. Many (65.5%) anticipated that GRMT would make risk management decisions easier.

CONCLUSIONS

Women with BRCA1/2 mutations could be highly receptive to GRMT, and the minimal amount of necessary information to be included in result risk communication materials includes graphical and verbal estimates of future cancer risk. Findings will inform clinical translation of GRMT in a manner consistent with patients' preferences.

Intolerance of uncertainty, depression, and anxiety: Examining the indirect and moderating effects of worry

The present study sought to examine the indirect and moderating effects of worry between intolerance of uncertainty (IU) and symptoms of depression and anxiety. The study was a cross sectional study. Data were collected from 120 psychiatric patients, aged 22 to 37 years. A battery of self-report questionnaires was administered for tapping IU, worry, depression and anxiety symptoms. Results from indirect effects analyses revealed that even though IU, worry, depression, and anxiety symptoms correlated moderately with each other, worry carried a substantial proportion of variance in predicting symptoms of depression and anxiety. However, the relative effect was more pronounced for anxiety compared to depression symptoms. The results from hierarchical analyses supported the moderator role of worry. More specifically, a high level of worry enhanced the association between IU and symptoms of depression and anxiety. Given the potential for worry as a mechanism, and/or moderator between IU and symptoms of depression and anxiety, adults with a tendency to use this negative repetitive thought process (e.g. worry) may be at higher risk to develop psychological symptoms.

Symptom modelling can be influenced by psychiatric categories: choices for research domain criteria (RDoC)

Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria (RDoC). RDoC's importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric categories by directly investigating the causal basis of symptoms. The unique methodological approach of RDoC exploits the supposed lack of influence of psychiatric categories on symptom modelling, taking psychiatric symptoms as the same regardless of which psychiatric category is employed or if no psychiatric category is employed. But this supposition is not always true. I will show how psychiatric categories can influence symptom modelling, whereby identical behaviours can be considered as different symptoms based on an individual's psychiatric diagnosis. If the modelling of symptoms is influenced by psychiatric categories, then psychiatric categories will still play a role, a situation which RDoC researchers explicitly aim to avoid. I discuss four ways RDoC could address this issue. This issue also has important implications for factor analysis, cluster analysis, modifying psychiatric categories, and symptom based approaches.

Comparison of two individualized treatment regimens with ranibizumab for diabetic macular edema

PURPOSE

To compare outcomes between an as-needed and a treat-and-extend regimen in managing diabetic macular edema with intravitreal ranibizumab.

METHODS

This was a retrospective, single-centre, comparative case series on 46 treatment naive patients with diabetic macular edema. Twenty-two patients were treated following an optical coherence tomography guided treat-and-extend protocol (OCTER), and 24 patients were treated according to a visual acuity guided pro re nata regimen (VAPRN) at a tertiarry referral centre. The main outcome measures were best-corrected visual acuity, central retinal thickness, and the number of ranibizumab injections, as well as visits after 12 months of treatment.

RESULTS

After 12 months, the mean gain in best-corrected visual acuity (± standard deviation) was 8.3 ± 6.7 versus 9.3 ± 8.9 letters in the VAPRN and OCTER group, respectively (p = 0.3). The mean decrease in central retinal thickness was 68.1 ± 88.0 μm in the VAPRN group and 117.6 ± 114.4 μm in the OCTER group (p = 0.2). The mean number of ranibizumab injections was significantly different between the VAPRN (5.9 ± 1.8) and the OCTER protocol (8.9 ± 2.0) (p < 0.001).

CONCLUSION

The visual acuity driven retreatment regimen resulted in a similar visual acuity outcome like optical coherence tomography guided retreatment for diabetic macular edema. Although the number of visits was similar in both groups, patients in the VAPRN group received significantly fewer intravitreal injections than patients in the OCTER group.

What's in a name? Intolerance of uncertainty, other uncertainty-relevant constructs, and their differential relations to worry and generalized anxiety disorder

A number of studies have examined the association of intolerance of uncertainty (IU) to trait worry and generalized anxiety disorder (GAD). However, few studies have examined the extent of overlap between IU and other psychological constructs that bear conceptual resemblance to IU, despite the fact that IU-type constructs have been discussed and examined extensively within psychology and other disciplines. The present study investigated (1) the associations of IU, trait worry, and GAD status to a negative risk orientation, trait curiosity, indecisiveness, perceived constraints, self-oriented and socially prescribed perfectionism, intolerance of ambiguity, the need for predictability, and the need for order and structure and (2) whether IU is a unique correlate of trait worry and of the presence versus absence of Probable GAD, when overlap with other uncertainty-relevant constructs is accounted for. N = 255 adults completed self-report measures of the aforementioned constructs. Each of the constructs was significantly associated with IU. Only IU, and a subset of the other uncertainty-relevant constructs were correlated with trait worry or distinguished the Probable GAD group from the Non-GAD group. IU was the strongest unique correlate of trait worry and of the presence versus absence of Probable GAD. Indecisiveness, self-oriented perfectionism and the need for predictability were also unique correlates of trait worry or GAD status. Implications of the findings are discussed, in particular as they pertain to the definition, conceptualization, and cognitive-behavioral treatment of IU in GAD.

Attention Modulates Neural Responses to Unpredictable Emotional Faces in Dorsolateral Prefrontal Cortex

Unpredictability about upcoming emotional events disrupts our ability to prepare for them and ultimately results in anxiety. Here, we investigated how attention modulates the neural responses to unpredictable emotional events. Brain activity was recorded using functional magnetic resonance imaging (fMRI) while participants performed a variation of the emotional task. Behaviorally, we reported a fear-unpredictable effect and a happy-unpredictable effect. The fMRI results showed increased activity in the right dorsolateral prefrontal cortex (dlPFC) for unpredictable fear faces (Experiment 1) and decreased activity in the left dlPFC for unpredictable happy faces (Experiment 2) when these faces were unattended, probably reflecting that unpredictability amplifies the negative impact of fear faces and reduces the positive impact of happy faces. More importantly, it was found that the right dlPFC activity to unpredictable fear faces was diminished (Experiment 1) and the left dlPFC activity to unpredictable happy faces was enhanced (Experiment 2) when these faces were attended. These results suggest that attention may contribute to reducing the unpredictability about future emotional events.

Intolerance of Uncertainty: A Temporary Experimental Induction Procedure

Background and Objectives

Intolerance of uncertainty (IU) is a trans-diagnostic construct involved in anxiety and related disorders. Research focused on cross-sectional reporting, manipulating attitudes toward objective and impersonal events or on treatments designed to reduce IU in clinical populations. The current paper presents an experimental procedure for laboratory manipulations of IU and tests mediation hypotheses following the Intolerance of Uncertainty Model.

Methods

On pre-test, undergraduate volunteers (Study 1, n = 43;68% women. Study 2, n = 169;83.8% women) were asked to provide an idiosyncratic future negative life event. State-IU, Worry, Positive and Negative Affect were assessed after that a standardized procedure was used to identify event’s potential negative consequences. The same variables were assessed on post-test, after that participants were asked to read-through increasing and decreasing IU statements.

Results

Temporary changes on IU were consistently reproduced in both studies. Participants receiving increasing IU instructions reported greater state-IU, Worry and Negative Affect than those receiving decreasing IU instructions. However, this latter condition was not different from a control one (Study 2). Both studies revealed significant indirect effects of IU induction instructions on Worry and Negative Affect through state-IU.

Limitations

Both studies used undergraduate psychology students samples, younger than average population and predominantly female. Experimental manipulation and outcome measures belongs to the same semantic domain, uncertainty, potentially limiting generalizability.

Conclusions

Results supported the feasibility and efficacy of the proposed IU manipulation for non-clinical sample. Findings parallel clinical research showing that state-IU preceded Worry and Negative Affect states.

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

The current paper presents a future research agenda for intolerance of uncertainty (IU), which is a transdiagnostic risk and maintaining factor for emotional disorders. In light of the accumulating interest and promising research on IU, it is timely to emphasize the theoretical and therapeutic significance of IU, as well as to highlight what remains unknown about IU across areas such as development, assessment, behavior, threat and risk, and relationships to cognitive vulnerability factors and emotional disorders. The present paper was designed to provide a synthesis of what is known and unknown about IU, and, in doing so, proposes broad and novel directions for future research to address the remaining uncertainties in the literature.

Intolerance of uncertainty and attentional networks: Unique associations with alerting

The present study sought to extend our understanding as to how intolerance of uncertainty (IU) relates to information-processing by investigating associations between IU and attentional networks, including alerting, orienting, and executive attention. Based upon prior research, IU was expected to cluster with alerting. An unselected sample of college students (N=86; 79% women) completed self-report measures of IU and state anxiety, as well as the attention network test. Among the attentional networks, IU only shared a positive association with alerting and the association remained intact after statistically controlling for state anxiety. State anxiety did not moderate the association between IU and alerting. Although two IU dimensions (prospective and inhibitory) both shared a positive association with alerting, only prospective IU was associated with alerting after statistically controlling for state anxiety. The results provide evidence that IU relates to an overfunctioning of the alerting attentional network, which may suggest a role of hypervigilance and a greater influence of bottom-up processing in relation to IU. Implications for how these results advance our understanding of possible links between IU and anxiety disorders are discussed.

Enhancing the ecological validity of the Beads Task as a behavioral measure of intolerance of uncertainty

To broaden the measurement of intolerance of uncertainty (IU) beyond self-report methods, recent research has examined the Beads Task as a behavioral measure of IU. In the present study, we enhanced this task to increase its ecological validity by maximizing decisional uncertainty and the importance of a correct response. Undergraduate participants (n=102) completed the Beads Task with instructions that they would complete the Cold Pressor Task (CPT) if they answered incorrectly. As hypothesized, baseline CPT endurance time and self-reported pain level were weakly associated with later Beads Task distress during the decision-making process. Furthermore, in vivo Beads Task distress was associated with self-report inhibitory IU, which measures avoidance and paralysis in the face of uncertainty, but not with prospective IU, perfectionism, or general psychological distress after making statistical adjustments for multiple comparisons. Comparisons to previous work using the Beads Task, clinical implications, and avenues for future research are discussed.

Comparing the Roles of Ambiguity and Unpredictability in Intolerance of Uncertainty

One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increasing Threat Perception (TP). This process was examined by comparing two different definitions of uncertainty: ambiguity versus unpredictability. N = 104 participants were measured for IU and then made worry and TP estimates for four different scenario types: Ambiguous Scenarios (where an outcome could be interpreted as threatening), Unpredictable Positive Scenarios (where a surprising and positive outcome was anticipated), as well as Positive and Negative Scenarios (with certain outcome). Both Ambiguous and Unpredictable Positive Scenarios more strongly predicted the relationship between IU and worry scores than (certain) Positive or Negative Scenarios. The relationship between IU and ‘ambiguous worry’ was largely explained by TP estimates, whereas the relationship between IU and ‘Unpredictable Positive Worry’ was largely independent of TP. Results suggest ambiguity and unpredictability are differentially explained by TP such that they produce different types of response. The authors argue ambiguity and unpredictability are explanatory components within IU.

Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers

The cognitive avoidance model of worry assumes that worry has the adaptive function to keep under control the physiological arousal associated with anxiety. This study aimed to test this model by the use of a fear induction paradigm in both pathological and healthy individuals. Thirty-one pathological worriers and 36 healthy controls accepted to be exposed to a fear induction paradigm (white noise) during three experimental conditions: worry, distraction, and reappraisal. Skin conductance (SCR) and heart rate variability (HRV) were measured as indices of sympathetic and parasympathetic nervous system functioning. Worriers showed increased sympathetic and decreased parasympathetic activation during the worry condition compared to non-worriers. There were no differences between groups for the distraction and reappraisal conditions. SCRs to the white noises during worry were higher in worriers versus controls throughout the entire worry period. Intolerance of uncertainty - but not metacognitive beliefs about worry - was a significant moderator of the relationship between worry and LF/HF-HRV in pathological worriers. Results support the cognitive avoidance model in healthy controls, suggesting that worry is no longer a functional attitude when it becomes the default/automatic and pathological response.

Intolerance of uncertainty mediates reduced reward anticipation in major depressive disorder

BACKGROUND

Reduced reward sensitivity has long been considered a fundamental deficit of major depressive disorder (MDD). One way this deficit has been measured is by an asymmetry in electroencephalogram (EEG) activity between left and right frontal brain regions. MDD has been associated with a reduced frontal EEG asymmetry (i.e., decreased left relative to right) while anticipating reward. However, the mechanism (or mediator) of this association is unclear. The present study examined whether intolerance of uncertainty (IU) mediated the association between depression and reduced reward anticipation.

METHODS

Data were obtained from a prior study reporting reduced frontal EEG asymmetry while anticipating reward in early-onset MDD. Participants included 156 individuals with early-onset MDD-only, panic disorder-only, both (comorbids), or controls. Frontal EEG asymmetry was recorded during an uncertain reward anticipation task. Participants completed a self-report measure of IU.

RESULTS

All three psychopathology groups reported greater IU relative to controls. Across all participants, greater IU was associated with a reduced frontal EEG asymmetry. Furthermore, IU mediated the relationship between MDD and frontal EEG asymmetry and results remained significant after controlling for neuroticism, suggesting effects were not due to broad negative affectivity.

LIMITATIONS

MDD participants were limited to those with early-onset depression. Measures were collected cross-sectionally, precluding causal relationships.

CONCLUSIONS

IU mediated the relationship between MDD and reduced reward anticipation, independent of neuroticism. Explanations are provided regarding how IU may contribute to reduced reward anticipation in depression. Overall, IU appears to be an important mechanism for the association between depression and reduced reward anticipation.

Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to Internet searches for medical information

Individuals frequently use the Internet to search for medical information. However, for some individuals, searching for medical information on the Internet is associated with an exacerbation of health anxiety. Researchers have termed this phenomenon as cyberchondria. The present research sought to shed further light onto the phenomenology of cyberchondria. In particular, the moderating effect of intolerance of uncertainty (IU) on the relationship between the frequency of Internet searches for medical information and health anxiety was examined using a large sample of medically healthy community adults located in the United States (N=512). The purported moderating effect of IU was supported. More specifically, the relationship between the frequency of Internet searches for medical information and health anxiety grew increasingly stronger as IU increased. This moderating effect of IU was not attributable to general distress. These results suggest that IU is important for better understanding the exacerbation of health anxiety in response to Internet searches for medical information. Conceptual and therapeutic implications of these results are discussed.

Confirmatory factor analysis of the Dutch Intolerance of Uncertainty Scale: Comparison of the full and short version

BACKGROUND AND OBJECTIVES

The Intolerance of Uncertainty Scale (IUS) was developed for assessing reactions to ambiguous situations, uncertainty, and future events. The IUS has been validated in different languages, but equivocal factor structures, in combination with highly interrelated items and factors, resulted in a redundancy of the items of the English version. In the current study, the psychometric properties of the Dutch version of the IUS were examined, and compared with the shortened 12-item version (IUS-12).

METHODS

Confirmatory factor analyses were used to investigate different factor structures of both the full and short version of the IUS.

RESULTS

Results indicated that the IUS-12 model with two factors (Prospective Anxiety and Inhibitory Anxiety) provides the best fit. The reduced measure has equally good internal consistency, and is highly correlated with the full version.

LIMITATIONS

Future research could investigate whether the current findings generalize to clinical populations.

CONCLUSION

To summarize, the usage of the short 12-item version of the IUS should be encouraged in future research concerning intolerance of uncertainty.

The Relationship of Meta-Worry and Intolerance of Uncertainty With Pathological Worry, Anxiety, and Depression

This study explored how meta-worry and intolerance of uncertainty relate to pathological worry, generalised anxiety, obsessive–compulsive disorder, social phobia, and depression. University students (n = 253)completed a questionnaire battery. A series of regression analyses were conducted. The results indicated that meta-worry was associated with GAD, social phobia, obsessive–compulsive, and depressive symptoms. Intolerance of uncertainty was related to GAD, social phobia, and obsessive–compulsive symptoms, but not depressive symptoms. The importance of meta-worry and intolerance of uncertainty as predictors of pathological worry, GAD, social phobia, obsessive–compulsive and depressive symptoms was also examined. Even though both factors significantly predicted the aforementioned symptoms, meta-worry emerged as a stronger predictor of GAD and obsessive compulsive symptoms than did intolerance of uncertainty. Intolerance of uncertainty, compared with meta-worry, appeared as a stronger predictor of social phobia symptoms. Findings emphasise the importance of addressing meta-worry and/or intolerance of uncertainty not only for the assessment and treatment of generalised anxiety disorder (GAD), but also obsessive–compulsive disorder, social phobia, and depression.