Cognitive content-specificity in future expectancies: Role of hopelessness and intolerance of uncertainty in depression and GAD symptoms

Examining illness perceptions over time: an exploratory prospective analysis of causal attributions in individuals with depressive symptoms

BACKGROUND

According to the Common-Sense Model of Illness Representations, illness beliefs, such as causal attributions, can influence the way people assess and cope with their illness and vice versa. To date, causal attributions in people with depressive symptoms have been studied mainly cross-sectionally, quantitatively and independently. The purpose of this study is to examine the causal attributions of people with depressive symptoms in terms of their stability over time, dependence on treatment experience, and differentiation of causal concepts.

METHODS

In a population-based prospective sample, people with at least mild depressive symptoms (PHQ-9 Score ≥ 5) were interviewed via telephone at T0 and twelve months later (T1). Causal attributions were assessed using the Brief Illness Perception Questionnaire. After the open responses were qualitatively analysed using a deductive-inductive approach, stability over time was assessed for causal attributions and concepts by comparing answers between the two time points. Subsequent exploratory quantitative analyses were conducted using chi-square tests, t-tests, and logistic regression analyses.

RESULTS

A total of 471 individuals (age M = 53.9, 53.6% female) with a mean PHQ-9 Score of 8.4 were included in the analyses. Causal attributions related to participants' social environment, workplace, and past are the most stable over time. However, individuals with and without a time-stable causal concept showed no differences in terms of sociodemographic characteristics, severity of depressive symptoms, risk of comorbidity, and treatment experiences. Overall, the causal concepts of people with depressive symptoms appear to be very diverse. Those with treatment experience (M = 2.21, SD = 0.80) named significantly more causal attributions compared to people without treatment experience (M = 1.98, SD = 0.81, t(471) = -3.060, p < 0.01). In addition, logistic regression analyses revealed that treatment-experienced respondents were more likely to attribute "childhood/youth/parental home" and "predisposition".

CONCLUSIONS

Our study reveals that people with treatment experience tend to report treatment-congruent causal attributions, such as childhood and family environment, as well as predisposition, more frequently. Understanding how causal attributions and concepts are formed and change can be helpful for addressing causal attributions in treatment. Future studies should take into account the benefits of employing qualitative survey methods for exploring causal attributions.

The Future-oriented Repetitive Thought (FoRT) scale: Validation in Chinese samples and application in the schizophrenia spectrum

BACKGROUND

Repetitive thoughts are usually associated with psychopathology. The Future-oriented Repetitive Thought (FoRT) Scale is a measure designed to capture frequency of repetitive thought about positive and negative future events. However, the validity of the scale in Chinese population and its application in the schizophrenia spectrum have not been examined.

METHODS

The current study aimed to examine the psychometric properties of the Chinese version of the FoRT scale and to apply it to the schizophrenia spectrum. In Study 1, three samples (total N = 1875) of university students were recruited for exploratory factor analysis, confirmatory factor analysis, and validity test, respectively. In Study 2, we identified subsamples with high schizotypal traits (N = 89) and low schizotypal traits (N = 89), and recruited 36 inpatients with schizophrenia and 41 matched healthy controls.

RESULTS

The three-factor (pessimistic repetitive future thinking, repetitive thinking about future goals, and positive indulging about the future) structure of the FoRT scale with one item deleted, fitted the Chinese samples. And the scale could distinguish patients with schizophrenia and individuals with high schizotypal traits from controls.

CONCLUSION

These findings support that the Chinese version of the FoRT scale is a valid tool and provide evidence for the potential applications in the schizophrenia spectrum.

Intolerance of uncertainty and negative emotions among high school art students during COVID-19 pandemic: a moderated mediation analysis

Objectives

A number of high school art students experience negative emotions during their preparation for the art college entrance examination, characterized by worries and fear of uncertainty. Therefore, how individual difference factors, such as intolerance of uncertainty, affect the negative emotions of students needs to be examined. Inspired by the integrative model of uncertainty tolerance, the current study seeks to explain the association between intolerance of uncertainty and negative emotions by testing the potential mediating role of psychological capital and the moderating role of family functioning.

Patients and methods

A total of 919 Chinese high school art students (Mage = 18.50 years, range = 16-22) participated from November 2022 to December 2022. Convenience sampling strategies were used. The participants were asked to complete the measures of intolerance of uncertainty scale, psychological capital questionnaire, depression anxiety stress scale, and family adaptability and cohesion evaluation scale. The data were analyzed using Pearson's r correlations and moderated mediation analysis.

Results

Results showed that intolerance of uncertainty was positively associated with negative emotions but negatively associated with psychological capital, which in turn, was negatively associated with negative emotions. Psychological capital mediated the indirect link of intolerance of uncertainty with negative emotions. Family functioning buffered the impact of psychological capital on negative emotions.

Conclusion

This study can enhance our understanding of the intolerance of uncertainty on negative emotions and provide insights on interventions for high school art students' negative emotions for educators. The interventions targeting intolerance of uncertainty, psychological capital and family functioning may be beneficial in reducing the effect of intolerance of uncertainty on negative emotions faced by high school art students.

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.

Measurement of event-related potentials from electroencephalography to evaluate emotional processing in Fibromyalgia Syndrome: A systematic review and meta-analysis

OBJECTIVE

The present systematic review and meta-analysis intended to: 1) determine the extent of abnormalities in emotional processing linked to emotional event-related potentials (ERPs) in Fibromyalgia Syndrome (FMS) and 2) integrate data from similar emotional tasks into a meta-analysis to clearly demonstrate the scientific and clinical value of measuring emotional ERPs by electroencephalography (EEG) in FMS.

METHODS

A systematic review and meta-analysis of studies comparing emotional processing indicated by ERPs in FMS patients and healthy controls was conducted. Fifteen articles were included in the systematic review after applying the eligibility criteria.

RESULTS

Nine articles demonstrated disturbances in emotional processing in FMS. These emotional disturbances were distributed over the whole range of ERP latencies, mainly over central, parietal, temporal and occipital areas. Despite of this, quantitative analysis revealed only significant differences in N250 and LPP/LPC between FMS patients and healthy controls, with smaller LPP/LPC and greater N250 seen in FMS.

DISCUSSION

N250 and LPP/LPC seem to be the ERPs with the greatest potential to determine emotional alterations in FMS. These ERPs are related to complex cognitive processes such as decoding features relevant to affect recognition (N250) as well differentiation between emotions, persistent engagement, conflict resolution or evaluation of emotional intensity (LPC/LPP). However, differences in task setup had an important impact on the variation of ERP outcomes. Systematization of protocols and tasks is indispensable for future studies.

Self- and observer ratings of capacity limitations in patients with neurological conditions

OBJECTIVE

The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients' ability to participate in work and social life and improving collaborative patient-clinician relationships.

METHOD

The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S).

RESULTS

Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings.

CONCLUSIONS

The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.

A randomized controlled trial to evaluate the efficacy of metacognitive training for older adults with depression (MCT-Silver) in Portugal: study protocol

Introduction

Depression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver).

Methods

This is a study protocol of an observer-blind, parallel-group, randomized controlled trial to compare the efficacy of MCT-Silver with a treatment as usual (TAU) control group among older adults (age 65 years and older) with depressive symptoms according to the Montgomery-Asberg Depression Scale. Participants will be tested at three assessment time points (baseline, immediately following the intervention [8 weeks], and 3 months after the intervention). The primary outcome is change in self-rated depression symptoms assessed by the Beck Depression Inventory (BDI-II). Secondary outcomes include clinician-rated depression, self-esteem, dysfunctional beliefs, metacognitive beliefs, ruminations, attitudes toward aging and quality of life. A self-designed subjective appraisal rating scale consisting of 21-items will be used to assess participant acceptance of MCT-Silver.

Discussion

MCT-Silver is an innovative intervention, which aims to reduce dysfunctional thoughts as well as depression-related behaviors and coping strategies through the metacognitive perspective. Until now, the training has only been tested in Germany. It is expected that after 8 weeks of treatment and 3 months later, the experimental group will demonstrate significant reductions in depressive symptoms, metacognitive beliefs, dysfunctional attitudes and ruminative responses compared to the TAU group. Moreover, quality of life, self-esteem, and attitudes towards aging will be significantly improved in MCT-Silver compared to the TAU group.

Clinical trial registration

ClinicalTrials.gov, NCT05640492.

Future self-continuity and depression among college students: The role of presence of meaning and perceived social support

INTRODUCTION

Future self-continuity has been shown to have a protective effect against depression. This study aims to investigate the longitudinal relationship between future self-continuity and depression among college students, and to explore the mediating role of the presence of meaning and the moderating role of perceived social support.

METHODS

We conducted two studies in China in 2022 and 2023. Study 1 was a longitudinal cross-lagged study that examined the relationship between future self-continuity and depression among 173 participants (49.13% females, Mage  = 19.39, SD = 1.63). Study 2 was a cross-sectional study that explored the mediating role of the presence of meaning and the moderating role of perceived social support among 426 participants (48.59% females, Mage  = 19.30, SD = 1.60).

RESULTS

Study 1 showed that future self-continuity (T1) could significantly predict depression (T2), but depression (T1) could not predict future self-continuity (T2). Study 2 showed that after controlling for gender, the presence of meaning mediated the relationship between future self-continuity and depression, whereas perceived social support moderated the first half of the mediated model's pathway and the direct pathway.

CONCLUSIONS

These findings suggest that enhancing the future self-continuity of college students and increasing the level of presence of meaning are effective measures for alleviating depression. Meanwhile, educators and families are called upon to provide more social support to college students.

Future-oriented repetitive thought, depressive symptoms, and suicide ideation severity: Role of future-event fluency and depressive predictive certainty

BACKGROUND

Knowing how future-oriented repetitive thought - i.e., repeated consideration of whether positive or negative outcomes will happen in one's future - leads to hopelessness-related cognitions may elucidate the role of anticipating the future in depressive symptoms and suicide ideation. This study examined future-event fluency and depressive predictive certainty - i.e., the tendency to make pessimistic future-event predictions with certainty - as mechanisms explaining the relation between future-oriented repetitive thought, depressive symptoms, and suicide ideation.

METHODS

Young adults (N = 354), oversampled for suicide ideation or attempt history, completed baseline measures of pessimistic future-oriented repetitive thought (i.e., the degree to which people consider whether negative outcomes will happen or positive outcomes will not happen in their futures), future-event fluency, depressive predictive certainty, depressive symptoms, and suicide ideation severity and were followed up 6 months later (N = 324).

RESULTS

Pessimistic future-oriented repetitive thought predicted depressive predictive certainty at 6-months, partially mediated by lower positive but not increased negative future-event fluency. There was an indirect relationship between pessimistic future-oriented repetitive thought and 6-month suicide ideation severity via 6-month depressive predictive certainty through 6-month depressive symptoms, and also via 6-month depressive symptoms (but not depressive predictive certainty) alone.

LIMITATIONS

Lack of an experimental design limits inferences about causality, and a predominantly female sample may limit generalizability by sex.

CONCLUSION

Clinical interventions should address pessimistic future-oriented repetitive thought - and its impact on how easily people can think about positive future outcomes - as one potential way to reduce depressive symptoms and, indirectly, suicide ideation.

Clarifying the Factor structure of the Intolerance of Uncertainty Inventory: Measurement Invariance and Validity in Predicting Clinical Outcomes

The Intolerance of Uncertainty Inventory (IUI) is a two-part inventory assessing the general unacceptability of uncertainty in terms of generalized maladaptive beliefs (IUI-A) and specific individuals’ reactions to uncertainty, such as avoidance, doubt, overestimation of threat, worry, control of uncertainty, and seeking reassurance (IUI-B). Previous research has examined the factor structure of both parts with mixed results, especially for IUI-A. The present study took advantage of the Farsi-language version to clarify the IUI factor structure, assess measurement invariance between clinical and nonclinical samples, and examine the criterion-related and incremental validity of IUI-A and IUI-B. We administered the IUI to a mixed psychiatric sample of patients who met DSM-IV criteria for affective disorders (N = 198) and community participants in relatively good health (N = 427). Exploratory structural equation modeling analyses were used to test alternative factor models and determine whether IUI factors predicted depression and anxiety symptoms. A bifactor model was found to be the best fit for IUI-A and IUI-B, and reliability analyses supported the use of the total scores for both parts. The IUI-A and IUI-B were scalar invariant. The general factors of each part and the IUI-B worry factor were higher in patients with affective disorders than in community participants. Validity analyses showed that the two general factors tapped into the same variance in depression and anxiety symptoms as the competing instruments, although not superior in predictive performance to the Intolerance of Uncertainty scale (IUS-12) and the Disorder Specific Intolerance of Uncertainty (DSIU) scale. The present study clarified the factorial structure of the IUI and provided evidence that IUI total scores are reliable and valid for assessing the Intolerance of Uncertainty construct and predicting clinical outcomes.

Negative cognitive beliefs, positive metacognitive beliefs, and rumination as mediators of metacognitive training for depression in older adults (MCT-Silver)

Background

Metacognitive Training for Depression in older adults (MCT-Silver; www.uke.de/mct-silver) is a cognitive-behavioral based group intervention that aims at reducing depression by targeting (meta)cognitive beliefs and rumination. In the present study, it was examined whether negative cognitive beliefs, positive metacognitive beliefs and/or rumination may be implicated as mediators of MCT-Silver's effects on depression.

Materials and methods

We conducted a secondary analysis of a randomized controlled trial comparing MCT-Silver to an active control intervention (cognitive remediation) including 66 older adults (60 years and older) with complete baseline data. Clinician-rated (Hamilton Depression Rating Scale) and self-reported (Beck Depression Inventory-II) depression, negative cognitive beliefs (Dysfunctional Attitudes Scale-18B), positive metacognitive beliefs (positive beliefs subscale; Metacognition Questionnaire-30) and rumination (10-item Ruminative Response Scale) were assessed before (pre) and after 8 weeks of treatment (post), as well as 3 months later (follow-up). It was examined whether change in depression (pre- to follow-up) was mediated by change in negative cognitive beliefs, positive metacognitive beliefs and/or rumination (pre- to post-assessment).

Results

Mediation results differed for self-reported vs. clinician-rated depression. The effect of MCT-Silver on reduction in clinician-rated depression was mediated by a reduction in self-reported rumination, whereas reduction in self-reported depression was mediated by a reduction in negative cognitive beliefs. Positive metacognitive beliefs were not a significant mediator for either outcome.

Conclusion

The current study provides initial evidence for the roles of negative cognitive beliefs and rumination in the treatment of depression in later life with MCT-Silver. Given the divergence of findings and lack of causal precedence, mechanisms of change for MCT-Silver cannot yet be equivocally identified.

Psychological well-being, risk factors, and coping strategies with social isolation and new challenges in times of adversity caused by the COVID-19 pandemic

Objective

COVID-19 triggers anxiety and fear due to several reasons, and thus, dealing with it requires prolonged coping mechanisms. When the number of infections soared, to slow the spread, many governments decided to close universities and dormitories and move teaching to online platforms. The majority of the university students decided to move back home to their parents changing their social lives. Here, we aimed to point to risk, as well as protective factors, and understand the influence of these factors on both physical and psychological indicators of well-being. Further, to discover how university students cope with maintaining their social lives during the COVID-19 pandemic.

Method

We collected online survey data from multiple university sources. Participants (N = 605) completed measures of emotion regulation strategies, knowledge on the disease, contamination fear, perceived social support, worrying and intolerance of uncertainty, quality of sleep, well-being, emotional stability, anxiety, and depression.

Results

Our results showed that the most prominent risk and protective factors that were most strongly associated with the indicators of well-being were rumination, catastrophizing, positive refocusing, and social support from family; respectively.

Conclusion

These results have implications for professionals working with and helping (e.g., as counselors) people during the challenges of an emergency.

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.

[Belief updating and mood congruence in depressive disorder]

Depressive disorder is characterized by a polymorphic symptomatology associating emotional, cognitive and behavioral disturbances. One of the most specific symptoms is negative beliefs, called congruent to mood. Despite the importance of these beliefs in the development, the maintenance, and the recurrence of depressive episodes, little is known about the processes underlying the generation of depressive beliefs. In this paper, we detail the link between belief updating mechanisms and the genesis of depressive beliefs. We show how depression alters information processing, generating cognitive immunization when processing positive information, affective updating bias related to the valence of belief and prediction error, and difficultie to disengage from negative information. We suggest that disruption of belief-updating mechanisms forms the basis of belief-mood congruence in depression.

Assessment of intolerance of uncertainty: Validation of a modified anagram task

BACKGROUND AND OBJECTIVES

Intolerance of uncertainty (IU) is an individual difference factor that reflects difficulty tolerating emotional distress in the context of uncertainty and is a robust transdiagnostic risk factor for emotional disorders. A limitation of prior research on IU is the heavy reliance on self-report measures to assess this construct. The aim of the present study was to examine the validity of a brief, computerized anagram task modified to assess IU (the PACT Anagram Task; PAT).

METHODS

Participants were 221 unselected undergraduate students (71% female; M_age = 19; 89% Caucasian) who completed the PAT and a series of self-report measures of convergent, discriminant, and incremental validity, and measures of anxiety and depression symptoms online for course credit.

RESULTS

Greater PAT-Distress was positively correlated measures of convergent validity and demonstrated incremental validity in relation to self-reported IU above and beyond attentional control. None of the PAT indicators were associated with compassion or empathic concern, evidencing discriminant validity. PAT-Distress and PAT-Answers were each associated with greater worry above and beyond self-reported IU.

LIMITATIONS

Study limitations include the cross-sectional design and lack of diversity in terms of sample demographics. Furthermore, we did not examine convergence between this task and other behavioral measures of IU.

CONCLUSION

Subjective distress following completion of the PAT may serve as one indicator of IU. Further research is needed in order to replicate these results and validate the use of the PAT in clinical samples.

Being certain that negative events will happen or that positive events will not happen: Depressive predictive certainty and change in suicide ideation over time

INTRODUCTION

Relatively little research has examined the precise components of hopelessness that increase vulnerability to suicidal thinking. We examined whether certainty about an absence of positive future outcomes (Certainty-AP) would more strongly predict suicide ideation over time than certainty about negative future outcomes (Certainty-N).

METHOD

Young adults (N = 208), ages 18-34 (M = 19.08, SD = 2.22), with either recent suicide ideation, suicide attempt history, or past-year psychiatric diagnosis were assessed four times over 18 months.

RESULTS

We used multilevel modeling to assess within-participant differences in suicide ideation over time. Both Certainty-AP and Certainty-N predicted later suicide ideation above and beyond generalized hopelessness and depressive symptoms, when examined in separate models. However, Certainty-AP emerged as a stronger predictor of suicide ideation than Certainty-N when examined in the same model.

DISCUSSION

These findings suggest that certainty about an absence of positive future outcomes may have a more unique prospective relationship to SI than certainty about the presence of negative future outcomes. We discuss clinical and theoretical implications of these findings.

Intolerance of Uncertainty, Anxiety and Depression in the Context of Covid-19 in Indonesia

"This Covid-19 pandemic brings uncertainty and may lead to mental problems. Yet, in this context, no study has examined the relationship between intolerance of uncertainty (IU) and either anxiety or depression during pandemic among Indonesians. This study investigated the pathway between IU, anxiety and depression serially mediated by cognitive appraisals (perceived severity, controllability, and knowledge) and emotional and behavioural responses to COVID-19. Online psychological measures were administered to 406 participants, including the IUS-12, the DASS-21, cognitive appraisal scales, and emotional and behavioural response scale. An indirect pathway was found between IU and depression, and the effect was serially mediated by perceived of severity and emotional and behavioural responses to COVID-19. Perceived knowledge and perceived controllability of COVID-19 did not significantly contribute to the model. A similar pathway was found for IU predicting anxiety. As conclusion, IU represents a risk factor for heightened emotional and behavioural difficulties that eventually, could lead to either anxiety or depression during COVID-19."

Somatic symptoms of helplessness and hopelessness

Helplessness and hopelessness are transdiagnostic and aggravating factors of mental ill health, but their relation with somatization is not well documented. The main objectives were to identify somatic symptoms that are particularly associated with helplessness, referred to as somatic symptoms of helplessness (SS-He), and hopelessness, referred to as somatic symptoms of hopelessness (SS-Ho), determine increased risk of helplessness and hopelessness if having these symptoms and a certain number of these symptoms, and determine sensitivity and specificity in identifying helplessness and hopelessness based on number of these symptoms in a general Swedish sample. Population-based data from validated questionnaire instruments were used from 3,210 participants who constituted case groups of helplessness and hopelessness, and corresponding reference groups. Among 15 common somatic symptoms, five SS-He (e.g., feeling tired/having low energy) and five SS-Ho (e.g., dizziness) were identified, showing increased risk of helplessness and hopelessness that ranged from the factor 1.73 to 2.58 and from 1.44 to 1.92, respectively, which decreased considerably when controlled for depression and anxiety. The risk of helplessness increased by the factor 1.49 for each additional SS-He, and by 1.38 for each SS-Ho. A cutoff of two/three or more SS-He showed a sensitivity of 81.7/63.7% and a specificity of 40.6/61.4% in identifying helplessness, and 77.4/54.6% and 40.4/66.1%, respectively, in identifying hopelessness based on two/three or more SS-Ho. Primary care clinicians may consider further investigation of helplessness and hopelessness as well as depression and anxiety if presenting with these symptoms.

Behavioral Inhibition/Activation Systems and Depression Among Females With Substance Use Disorder: The Mediating Role of Intolerance of Uncertainty and Anhedonia

Previous studies have shown that the behavioral inhibition/activation systems (BIS/BAS) have substantial effects on substance use disorder and emotional disorders, and substance use disorder and emotional disorders often occur; in particular, females with substance use disorder are more likely to also have serious emotional disorders including depression than their male counterparts. However, the associations between the BIS/BAS and depression in females with substance use disorder have received little attention. Furthermore, the underlying mechanisms of these relations are largely unknown. The present study examines the mediating roles of intolerance of uncertainty and anhedonia in the associations between the BIS/BAS and depression among females with substance use disorder from the Research Domain Criteria (RDoC) framework. A total of 303 females with substance use disorder from a compulsory substance abuse detention center were tested using a cross-sectional survey involving BIS/BAS Scales, Intolerance of Uncertainty Scale, Snaith-Hamilton Pleasure Scale, and Center for Epidemiologic Studies Depression Scale. The path analysis model revealed that both the BIS and BAS had a direct effect on depression, that the BIS had an indirect effect on depression through intolerance of uncertainty, and that the BAS had an indirect effect on depression via anhedonia. These findings contribute to a more thorough understanding of how the BIS/BAS influence depression among females with substance use disorder and suggest that the utility of targeting these associations in treatments would help reduce depression in females with substance use disorder.

Threat appraisal and negative affect under ambiguity in generalised anxiety disorder

Generalised anxiety disorder (GAD) is one of the most common anxiety disorders, yet its mechanisms remain poorly understood. In the current study, we assessed threat processing and negative affect under conditions of uncertainty and ambiguity in a sample of treatment-seeking individuals with GAD (n = 34) and in community controls (n = 34). Participants completed a laboratory aversive learning task based on that used by Grupe and Nitschke (2011). A bias in threat expectancy was observed in GAD participants relative to controls for an ambiguous cue that had not been mentioned in the instructions. GAD participants also overestimated the number of times this ambiguous cue had been followed by an aversive outcome, relative to an instructed uncertain cue (50 %). This covariation bias was not observed in controls. GAD participants also reported significantly stronger negative affect towards the ambiguous cue than the uncertain cue, a pattern that was not observed in controls, although the group interaction did not reach significance. These results provide preliminary evidence that ambiguity - rather than uncertainty per se - may be a particularly powerful trigger for biased threat appraisal and negative affect in GAD.

Relationships between Trait Emotional Intelligence, mood states, and future orientation among female Italian victims of Intimate Partner Violence

Objective

Trait Emotional Intelligence (EI) has been associated with psychological outcomes in many conditions; however, it has received little attention in the field of Intimate Partner Violence (IPV). We explored the relationship between trait EI, mood states, and future orientation in a sample of Italian women victims of IPV.

Method

We recruited 409 help-seeking women who were victims of IPV. They completed the Trait Emotional Intelligence Questionnaire, Positive Affect-Negative Affect Schedule, Long-Term Personal Direction Scale, and Achievability of Future Goals Scale.

Results

The results showed that trait EI was associated with the future orientation of IPV victims both directly and indirectly through the mood states.

Conclusions

Our findings suggest potential paths for developing future psychoeducation methodologies designed at improving the quality of life of women IPV victims.

Making friends with uncertainty: experiences of developing a transdiagnostic group intervention targeting intolerance of uncertainty in IAPT. Feasibility, acceptability and implications

Co-morbid mental health diagnoses present challenges for services structured to provide disorder-specific models of treatment, such as those structured around Improving Access to Psychological Therapies (IAPT). Intolerance of uncertainty (IU) has been identified as both disorder specific and transdiagnostic, although little research explores transdiagnostic approaches to treatment of IU alone. A cognitive behavioural therapy treatment targeting IU previously established for individual therapy was adapted for a group within an IAPT primary care service: the ‘Making Friends with Uncertainty’ (MFWU) group. Twenty patients presenting with symptoms of a range of disorders including generalised anxiety disorder, obsessive compulsive disorder and depression completed the intervention in three groups. Measures of IU, anxiety and depression administered in the first and final sessions of the group have been analysed as well as examining common themes in participant feedback and facilitators’ own reflections. The results showed that nine participants (45%) showed reliable change in IU following the group and 16 (80%) showed reliable change on a measure of depression or anxiety. A thematic analysis identified universality, tolerance and acceptance and the manifestation of IU in the group process as key. The results suggest that the MFWU group provides an effective and feasible option for individuals presenting to IAPT services, including those reporting co-morbid difficulties. Implications for future practice are discussed as iteration and evaluation of the framework and content will continue.

Key learning aims

(1)

Excessive reassurance seeking in depression versus obsessive-compulsive disorder: Cross-sectional and cognitive behavioural therapy treatment comparisons

Excessive reassurance seeking (ERS) has been hypothesized as an important maintenance factor in depression and obsessive compulsive disorder (OCD). The present study examined the types of ERS in depression and OCD, the effects of CBT on ERS, predictors of ERS reduction, and the relation between ERS reduction and symptom change.

METHOD

Treatment-seeking participants diagnosed with a depressive disorder (N = 361) or OCD (N = 156) completed the Reassurance Seeking Scale (RSS) and symptom measures before and following CBT treatment. Measures of intolerance of uncertainty and distress tolerance were completed pre-treatment as potential predictors of ERS change.

RESULTS

Individuals with depression demonstrated higher pre-treatment ERS related to social attachment compared to those with OCD. ERS significantly decreased over treatment in both groups and change in ERS predicted symptom change among both OCD and depression groups. Higher pre-treatment intolerance of uncertainty significantly predicted less ERS change regardless of diagnosis. Distress tolerance was not associated with ERS changes.

CONCLUSION

ERS is significantly related to symptom severity cross-sectionally as well as over treatment in depression and OCD, though types of ERS may differ. Higher intolerance of uncertainty may impede the reduction of ERS in CBT.

Predicting Mental Health and Psychological Wellbeing in Mothers of Children with Autism Spectrum Disorder: Roles of Intolerance of Uncertainty and Coping

Research has consistently shown that parents of children with autism spectrum disorder (ASD) are more likely to report chronic stress and symptoms of psychopathology when compared to parents of typically developing children and children with other psychological or physical conditions. Certain individual characteristics might either put parents at risk or allow them to cope more effectively under the strenuous conditions of raising children with neurodevelopmental conditions. Previous research has suggested that higher levels of intolerance of uncertainty and certain coping styles are associated with higher parental levels of anxiety and depression. The aim of this study is to characterize the way in which intolerance of uncertainty and coping (avoidant and problem-focused coping) predict mental health and psychological wellbeing in parents of children with ASD. Only mothers participated in this study. Fifty mothers (M_age = 44.28 years, SD_age = 6.58) of children with ASD completed questionnaires assessing anxiety and depression, psychological wellbeing, intolerance of uncertainty, and avoidant and problem-focused coping. The results from this study provide preliminary evidence that higher use of problem-focused coping but not avoidant coping and intolerance of uncertainty predicts psychological wellbeing. Furthermore, our observation of greater intolerance of uncertainty and higher use of avoidant coping predicting anxiety and depression supports previous research. The findings from this study have implications for the development of intervention programs to help improve the mental health and psychological wellbeing of parents. LAY SUMMARY: This research studied the factors that impact the mental health of parents of children on the autism spectrum. We found that mothers, who are not comfortable with uncertainty, use more avoidant coping, and less problem-focused coping have poorer mental health. Identifying these factors is a crucial first step in developing intervention programs to help improve the mental health of parents. Autism Res 2020, 13: 1797-1801. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Facilitating Episodic Simulation in Anxiety: Role of Sensory Scaffolding and Scenario Modality

Cognitive bias modification of interpretation style (CBM-I) is a family of cognitive training programs that seek to reduce anxious thinking by training people to assign relatively more positive meanings to ambiguous situations. CBM-I’s effects may be enhanced by encouraging more vivid imagery-based episodic simulation of events and by increasing engagement with the training materials. This study investigated the role of sensory scaffolding (whether pictures, or pictures + sound were added) and verbal scenario modality (whether scenarios were delivered visually or aurally) on episodic simulation (Vivid; Plausible; Changing Perspective ratings) and user engagement (Relatable, Comprehensible, Enjoyable ratings). Amazon Mechanical Turk workers (N = 187) with varied anxiety symptom severity read or listened to brief scenarios that varied by sensory scaffolding and verbal scenario modality. Results were somewhat mixed. Generally, picture scaffolding tended to facilitate both episodic simulation and user engagement (relative to no scaffolding), irrespective of scenario modality and anxiety level.

Distorted Cognitive Processes in Major Depression: A Predictive Processing Perspective

The cognitive model of depression has significantly influenced the understanding of distorted cognitive processes in major depression; however, this model's conception of cognition has recently been criticized as possibly too broad and unspecific. In this review, we connect insights from cognitive neuroscience and psychiatry to suggest that the traditional cognitive model may benefit from a reformulation that takes current Bayesian models of the brain into account. Appealing to a predictive processing account, we explain that healthy human learning is normally based on making predictions and experiencing discrepancies between predicted and actual events or experiences. We present evidence suggesting that this learning mechanism is distorted in depression: current research indicates that people with depression tend to negatively reappraise or disregard positive information that disconfirms negative expectations, thus resulting in sustained negative predictions and biased learning. We also review the neurophysiological correlates of such deficits in processing prediction errors in people with depression. Synthesizing these findings, we propose a novel mechanistic model of depression suggesting that people with depression have the tendency to predominantly expect negative events or experiences, which they subjectively feel confirmed due to reappraisal of disconfirming evidence, thus creating a self-reinforcing negative feedback loop. Computationally, we consider too much precision afforded to negative prior beliefs as the main candidate of pathology, accompanied by an attenuation of positive prediction errors. We conclude by outlining some directions for future research into the understanding of the behavioral and neurophysiological underpinnings of this model and point to clinical implications of it.

Intolerance of Uncertainty and Mindfulness as Determinants of Anxiety and Depression in Female Students

Bearing in mind the characteristics of an academic setting, as well as the developmental tasks young people inevitably face, there is a need to identify and study the factors that play an important role in the development and maintenance of psychological distress among college students. One factor that has emerged as crucial for the development of both anxiety and depression is the intolerance of uncertainty. On the other hand, there appears to be mounting evidence that mindfulness is an important factor that can be beneficial for the psychological health of college students. Taking this into consideration, the purpose of the current study was to determine the contribution of the intolerance of uncertainty and mindfulness in explaining the symptoms of depression and anxiety in a sample of female college students (n = 282) whose average age was 21. The results indicated that students had moderate levels of anxiety and depression. Additionally, they were, on average, intolerant of uncertainty and mindfulness. Two hierarchical regression analyses revealed that the intolerance of uncertainty and mindfulness significantly predict both anxiety and depression in female students, and that mindfulness partially mediates the relationship between the intolerance of uncertainty and anxiety/depression. The results are discussed in the light of previous studies, and its clinical implications.

A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety

The development and conceptual relationship of the constructs of threat appraisal (TA) and intolerance of uncertainty (IU) are explored in the context of anxiety disorders. A narrative review tracking the development of these constructs and their relationship is undertaken. There is some evidence to suggest that the interaction between the components of threat appraisal (probability × cost) may partially account for or provide a theoretical framework which explains presenting levels of anxiety. Furthermore, research suggested that IU is a construct which contributes to a broad range of anxiety disorders. It was concluded that distinctive cognitive biases linked with IU – such as interpreting ambiguous and uncertain (both positive and negative) information as highly concerning – suggests that IU is interpreted negatively independent of threat appraisal. These findings mean a number of issues remain unclear, including whether IU in anxiety-provoking situations is sufficient in itself – independent of threat appraisal – in eliciting high levels of anxiety. Additionally, it is unclear whether threat appraisal and IU act as independent constructs, or more in an interactive manner in anxiety. To achieve further clarity on these issues, methodological recommendations for future research are made.

Key learning aims

(1)

The role of outcome expectancy in therapeutic change across psychotherapy versus pharmacotherapy for depression

BACKGROUND

Patient outcome expectancy - the belief that treatment will lead to an improvement in symptoms - is linked to favourable therapeutic outcomes in major depressive disorder (MDD). The present study extends this literature by investigating the temporal dynamics of expectancy, and by exploring whether expectancy during treatment is linked to differential outcomes across treatment modalities, for both optimistic versus pessimistic expectancy.

METHODS

A total of 104 patients with MDD were randomized to receive either cognitive behavioral therapy (CBT) or pharmacotherapy for 16 weeks. Outcome expectancy was measured throughout treatment using the Depression Change Expectancy Scale (DCES). Depression severity was measured using both the Hamilton Depression Rating Scale and Beck Depression Inventory-II.

RESULTS

Latent growth curve models supported improvement in expectancy across both treatments. Cross-lagged panel models revealed that both higher optimistic and lower pessimistic expectancy at mid-treatment predicted greater treatment response in pharmacotherapy. For CBT, the associative patterns between expectancy and depression differed as a function of expectancy type; higher optimistic expectancy at pre-treatment and lower pessimistic expectancy at mid-treatment predicted greater treatment response.

LIMITATIONS

The sample size limited statistical power and the complexity of models that could be explored.

CONCLUSIONS

Results suggest that outcome expectancy improved during treatment for depression. Whether outcome expectancy represents a specific mechanism for the reduction of depression warrants further investigation.

Worry and anxiety account for unique variance in the relationship between intolerance of uncertainty and depression

The evidence supporting the relationship between intolerance of uncertainty (IU), a cognitive construct well established in the anxiety literature, and depression is mixed. Some research has demonstrated a direct association between IU and depression, whereas other studies suggest that IU is either unrelated or indirectly related to depression through other pathways, including anxiety. The present study aimed to further elucidate the relationship between IU and depression in an undergraduate sample (N = 221). We posited a model in which worry and anxiety account for unique variance in the association between IU and depression. Results supported this hypothesis. Worry and trait anxiety significantly accounted for unique variance in the relationship between IU and depression. Furthermore, the model that best fit the data included two additional direct paths, from IU to anxiety and from worry to depression, and excluded the direct path from IU to depression. Our findings support the notion that IU and depression are indirectly related through worry and anxiety. Limitations and future directions are discussed.

The Intolerance of Uncertainty Inventory: Validity and Comparison of Scoring Methods to Assess Individuals Screening Positive for Anxiety and Depression

Intolerance of Uncertainty is a fundamental transdiagnostic personality construct hierarchically organized with a core general factor underlying diverse clinical manifestations. The current study evaluated the construct validity of the Intolerance of Uncertainty Inventory, a two-part scale separately assessing a unitary Intolerance of Uncertainty disposition to consider uncertainties to be unacceptable and threatening (Part A) and the consequences of such disposition, regarding experiential avoidance, chronic doubt, overestimation of threat, worrying, control of uncertain situations, and seeking reassurance (Part B). Community members (N = 1046; Mean age = 36.69 ± 12.31 years; 61% females) completed the Intolerance of Uncertainty Inventory with the Beck Depression Inventory-II and the State-Trait Anxiety Inventory. Part A demonstrated a robust unidimensional structure and an excellent convergent validity with Part B. A bifactor model was the best fitting model for Part B. Based on these results, we compared the hierarchical factor scores with summated ratings clinical proxy groups reporting anxiety and depression symptoms. Summated rating scores were associated with both depression and anxiety and proportionally increased with the co-occurrence of depressive and anxious symptoms. By contrast, hierarchical scores were useful to detect which facets mostly separated between for depression and anxiety groups. In sum, Part A was a reliable and valid transdiagnostic measure of Intolerance of Uncertainty. The Part B was arguably more useful for assessing clinical manifestations of Intolerance of Uncertainty for specific disorders, provided that hierarchical scores are used. Overall, our study suggest that clinical assessments might need to shift toward hierarchical factor scores.

PTSD and depression in adult survivors of flood fury in Kashmir: The payoffs of social support

Exposure to disasters such as floods predisposes individuals for psychological distress such as posttraumatic stress disorder (PTSD), depression, and anxiety. Researchers exploring the association between flood-exposure and psychopathology attempt to understand the conditions and mechanisms through which potential benefits may occur. One such potential factor that may contribute to resilience in the face of disaster is social support system. However, there is scarcity of researches concerning the protective effects of social support following floods, in adult samples. Thus, the present study examined the moderating and indirect effects of perceived social support from family and friends in the association between flood-exposure and symptoms of PTSD and depression. The study was a cross sectional in nature. Survey data were collected from 87 adult survivors of flood fury in Kashmir valley, aged 30-40. High level of family and friends' support reduced the association between flood-exposure and symptoms of PTSD and depression whereas a low level of such support enhanced this association. Results also suggested that family support carried a significant proportion of variance in predicting depression. Given the potential for negative mental health outcomes following natural disasters, efforts to enhance adults' social support may be especially important.

Lower-order anxiety sensitivity and intolerance of uncertainty dimensions operate as specific vulnerabilities for social anxiety and depression within a hierarchical model

Within a hierarchical framework for depressive and anxiety disorders, negative affect (NA) is posited to be indirectly related to social anxiety and depression through cognitive vulnerabilities, including intolerance of uncertainty (IU) and anxiety sensitivity (AS). However, few prior studies have considered whether the lower-order dimensions of IU (i.e., prospective and inhibitory IU) and AS (i.e., physical, cognitive, and social concerns) better explain the indirect relation between NA and social anxiety and depression. The indirect relations between NA and social anxiety and depression through these cognitive vulnerabilities were examined using structural equation modeling in a clinical sample (N=298). NA and social anxiety symptoms were indirectly related through AS social concerns and inhibitory IU, although a direct effect of NA was also found. Only AS social concerns explained the relation between NA and a social anxiety disorder diagnosis. AS cognitive concerns was the only cognitive vulnerability factor to indirectly explain the relation between NA and depressive symptoms, although a direct effect of NA was also found. These findings suggest that the lower-order dimensions of AS and IU demonstrate more specific and less transdiagnostic associations with social anxiety and depression.

Focusing on situation-specific expectations in major depression as basis for behavioural experiments - Development of the Depressive Expectations Scale

OBJECTIVES

Dysfunctional expectations are considered to be core features of various mental disorders. The aim of the study was to develop the Depressive Expectations Scale (DES) as a depression-specific measure for the assessment of dysfunctional expectations. Whereas previous research primarily focused on general cognitions and attitudes, the DES assesses 25 future-directed expectations (originally 75 items) which are situation-specific and falsifiable.

DESIGN AND METHODS

To evaluate the psychometric properties of the DES, the scale was completed by 175 participants with and without severe depressive symptoms in an online survey. Participants additionally completed the Patient Health Questionnaire modules for depression (PHQ-9) and anxiety (GAD-7). People experiencing depressive symptoms were informed about the study with the help of self-help organizations.

RESULTS

Reliability analyses indicated excellent internal consistency of the scale. An exploratory factor analyses revealed four factors: social rejection, social support, mood regulation, and ability to perform. The DES sum score strongly correlated with the severity of depressive symptoms. The DES sum score also significantly correlated with symptoms of generalized anxiety.

CONCLUSION

The DES was shown to have excellent reliability; validity analyses were promising. As the DES items are situation-specific and falsifiable, they can be tested by the individual using behavioural experiments and may therefore facilitate cognitive restructuring. Thus, a structured assessment of patients' expectation with help of the DES can provide a basis for interventions within cognitive-behavioural treatment of depression.

PRACTITIONER POINTS

Assessing situation-specific expectations in patients experiencing depressive symptoms can provide a basis for the conduction of behavioural experiments to test patients' expectations. For the use of behavioural experiments, therapists should choose those dysfunctional expectations which a patient strongly agrees on. To modify patients' expectations, they should be exposed to situations where the discrepancy between patients' expectations and actual situational outcomes can be maximized. The Depressive Expectations Scale can be completed repeatedly to monitor a patient's progress within cognitive-behavioural treatment.

Intolerance of Uncertainty in eating disorders: An update on the field

Pathological fear and anxiety regarding food, eating, weight and body shape are at the core of eating disorder (ED) psychopathology. To manage anxiety, patients develop complicated repertoires of ritualistic and repetitive behaviours, which can lead to total functional impairment. Yet the cognitive processes underlying anxiety, fear, and anxiety-driven behaviours in EDs remain poorly understood. Intolerance of Uncertainty (IU) is defined as a tendency to react negatively on an emotional, cognitive, and behavioural level to uncertain situations and events. There is substantial evidence that IU is a transdiagnostic process that contributes to the maintenance of anxiety disorders; however, IU may also be relevant to the understanding and treatment of EDs. The current review summarises the growing literature examining IU in relation to ED symptoms, including restriction, bingeing, purging, ritualised behaviours, reassurance-seeking and body checking. Extending from the obsessive-compulsive disorder (OCD) and anxiety disorder literature, we propose that IU provides a novel theoretical and clinical framework from which to understand the anxiety, fixation with rules and rituals, and the cognitively rigid profile that is characteristic of ED presentations. We conclude with suggestions for future research, and discuss IU as a potential treatment target for core features of EDs and comorbid symptoms.

Positive future-oriented fantasies and depressive symptoms: Indirect relationship through brooding

Although a positive future outlook is generally associated with psychological well-being, indulging in positive fantasies about the future has been found to exacerbate negative mood-related outcomes such as depressive symptoms. We examined rumination as a cognitive mechanism in this relationship, using an objectively coded measure of future-oriented fantasies, among 261 young adults assessed twice. Engaging in a positive fantasy about the future was associated with the brooding subtype of rumination but not with reflection at baseline. There was an indirect relationship between fantasies at baseline and depressive symptoms at six-week follow-up through brooding at average and high levels of fantasy positivity when fantasizing was consistent or increased over time but not when it decreased. Engaging in fantasies was indirectly associated with perceived difficulty anticipating likely positive future outcomes through brooding. These findings extend previous research on positive fantasies by suggesting brooding as a mechanism to explain when they are maladaptive.

The future-oriented repetitive thought (FoRT) scale: A measure of repetitive thinking about the future

BACKGROUND AND OBJECTIVES

Repetitive thinking about the future has been suggested as one way in which individuals may become hopeless about the future. We report on a new scale assessing future-oriented repetitive thinking, termed the Future-Oriented Repetitive Thought (FoRT) Scale.

METHODS

In Study 1, an exploratory factor analysis was conducted with data from 1071 individuals who completed the scale. Study 2 describes a confirmatory factor analysis with a revised version of the scale on a sample of 612 individuals, a subsample of whom (N=99) also completed measures of repetitive thought (rumination, worry), hopelessness-related cognitions, and symptoms of depression and generalized anxiety disorder in order to examine evidence for the measure's convergent, discriminant, and concurrent validity. Study 3 examined the scale's concurrent validity in distinguishing between individuals with and without a history of suicidal ideation and attempts.

RESULTS

A three-factor solution emerged in Study 1, and this solution was confirmed in Study 2. In addition, the FoRT scale demonstrated moderate associations with other measures of repetitive thought (rumination, worry), with hopelessness-related cognitions, and with symptoms of depression and generalized anxiety. Finally, the FoRT scale distinguished between individuals with and without a history of suicidal ideation and attempts.

LIMITATIONS

Cross-sectional data limit conclusions that can be drawn about directionality.

CONCLUSIONS

These findings suggest that the newly developed FoRT scale is a reliable and valid measure of future-oriented repetitive thought.

Clarifying the unique associations among intolerance of uncertainty, anxiety, and depression

Increasing evidence suggests that intolerance of uncertainty (IU) may be a transdiagnostic factor across the anxiety disorders, and to a lesser extent, unipolar depression. Whereas anxiety inherently involves uncertainty regarding threat, depression has traditionally been associated with certainty (e.g. the hopelessness theory of depression). Some theorists posit that the observed relationship between depression and IU may be due to the relationship between depression and anxiety and the relationship between anxiety and IU. The present study sought to elucidate the unique relationships among trait anxiety, depression, and IU in undergraduate (N = 554) and clinical (generalized anxiety disorder; N = 43) samples. Findings suggest that IU may play a larger role in anxiety than depression, although some evidence indicates that inhibitory IU and depression may have a modest but independent relationship.

Using Emotion as Information in Future-Oriented Cognition: Individual Differences in the Context of State Negative Affect

Predictions about the future are susceptible to mood-congruent influences of emotional state. However, recent work suggests individuals also differ in the degree to which they incorporate emotion into cognition. This study examined the role of such individual differences in the context of state negative emotion. We examined whether trait tendencies to use negative or positive emotion as information affect individuals' predictions of what will happen in the future (likelihood estimation) and how events will feel (affective forecasting), and whether trait influences depend on emotional state. Participants (N=119) reported on tendencies to use emotion as information ("following feelings"), underwent an emotion induction (negative versus neutral), and made likelihood estimates and affective forecasts for future events. Views of the future were predicted by both emotional state and individual differences in following feelings. Whereas following negative feelings affected most future-oriented cognition across emotional states, following positive feelings specifically buffered individuals' views of the future in the negative emotion condition, and specifically for positive future events, a category of future-event prediction especially important in psychological health. Individual differences may confer predisposition toward optimistic or pessimistic expectations of the future in the context of acute negative emotion, with implications for adaptive and maladaptive functioning.

Fear of the unknown: One fear to rule them all?

The current review and synthesis was designed to provocatively develop and evaluate the proposition that "fear of the unknown may be a, or possibly the, fundamental fear" (Carleton, 2016) underlying anxiety and therein neuroticism. Identifying fundamental transdiagnostic elements is a priority for clinical theory and practice. Historical criteria for identifying fundamental components of anxiety are described and revised criteria are offered. The revised criteria are based on logical rhetorical arguments using a constituent reductionist postpositivist approach supported by the available empirical data. The revised criteria are then used to assess several fears posited as fundamental, including fear of the unknown. The review and synthesis concludes with brief recommendations for future theoretical discourse as well as clinical and non-clinical research.

The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty

The search for universal processes associated with symptom change across emotional disorders and different forms of psychotherapy offers hope of increased theoretical parsimony and treatment efficiencies. This study investigated whether intolerance of uncertainty (IU) is a universal process by examining whether changes in IU were associated with changes in symptoms across three different cognitive behavior therapy protocols for depression (n=106), social anxiety disorder (n=88), or generalized anxiety disorder (n=62) in a community mental health clinic. IU was associated with reductions in repetitive negative thinking in all treatments, which is consistent with IU being a transdiagnostic and 'trans-therapy' process of change. Changes in IU were also associated with symptom relief in the social anxiety disorder and generalized anxiety disorder groups, but not in the depression group. Implications of these findings are discussed within the broader literature of transdiagnostic approaches to emotional disorders.

Into the unknown: A review and synthesis of contemporary models involving uncertainty

The current review and synthesis serves to define and contextualize fear of the unknown relative to related constructs, such as intolerance of uncertainty, and contemporary models of emotion, attachment, and neuroticism. The contemporary models appear to share a common core in underscoring the importance of responses to unknowns. A recent surge in published research has explored the transdiagnostic impact of not knowing on anxiety and related pathologies; as such, there appears to be mounting evidence for fear of the unknown as an important core transdiagnostic construct. The result is a robust foundation for transdiagnostic theoretical and empirical explorations into fearing the unknown and intolerance of uncertainty.