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Sang Z, Chen HF, Yeung JWK, Xu L. The Association Between Intolerance of Uncertainty and Mobile Phone Addiction Among Overseas Chinese Students During COVID-19: The Mediating Roles of Perceived Stress and Rumination. Psychol Res Behav Manag 2024; 17:2573-2585. [PMID: 38973974 PMCID: PMC11227860 DOI: 10.2147/prbm.s463399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/23/2024] [Indexed: 07/09/2024] Open
Abstract
Purpose This study investigated the mechanism underlying the association between intolerance of uncertainty and mobile phone addiction among Chinese overseas students during the COVID-19 pandemic by examining the mediating roles of perceived stress and rumination. Patients and Methods An online questionnaire survey was distributed via social media platforms popular in mainland China. The items collected demographic information and assessed intolerance of uncertainty, perceived stress, rumination, and mobile phone addiction. A total of 249 respondents completed the questionnaire. Results The findings suggest a considerably high risk of mobile phone addiction in the study period among overseas Chinese students, as three-fourths of the participants may have been susceptible to mobile phone addiction according to the suggested cut-off point of the Chinese version of the Smartphone Addiction Scale-Short Form. Intolerance of uncertainty showed a significant positive direct effect on mobile phone addiction. The mediation analyses suggest that intolerance of uncertainty affected mobile phone addiction mainly through three pathways: the mediating effect of perceived stress, the mediating effect of rumination, and the chain mediating effect of perceived stress and rumination. Conclusion This study enhances understanding of mobile phone addiction among Chinese overseas students and suggests the mediating roles of rumination and perceived stress in the relationship between intolerance of uncertainty and mobile phone addiction. The study also provides suggestions for interventions among Chinese students overseas.
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Affiliation(s)
- Ziyang Sang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region
| | - Hui-Fang Chen
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region
| | - Jerf W K Yeung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region
| | - Leilei Xu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region
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Xu J, Ironside ML, Broos HC, Johnson SL, Timpano KR. Urged to feel certain again: The role of emotion-related impulsivity on the relationships between intolerance of uncertainty and OCD symptom severity. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:258-272. [PMID: 38351642 PMCID: PMC11104491 DOI: 10.1111/bjc.12456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/19/2023] [Accepted: 01/22/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Obsessive-compulsive disorder (OCD) is a debilitating mental disorder characterized by persistent and intrusive thoughts accompanied by repetitive mental or physical acts. While both intolerance of uncertainty and emotion-related impulsivity have been consistently evidenced as cognitive risk factors of OCD, no studies have considered their joint effects. The current study examined the interaction between intolerance of uncertainty and two forms of emotion-related impulsivity-including both a behavioural and cognitive form-in predicting OCD symptoms. DESIGN Cross-sectional data were collected online from community-based adult participants. METHODS Participants (N = 673) completed a battery of self-report measures of OCD symptom severity, intolerance of uncertainty, and emotion-related impulsivity. RESULTS The behavioural form of emotion-related impulsivity positively moderated the relationship between intolerance of uncertainty and OCD symptoms. Elevated levels of both factors predicted the most severe symptoms, particularly checking, washing, and obsessing. This interaction effect was not found for the cognitive form of emotion-related impulsivity, which still emerged as a unique predictor of OCD symptom severity, specifically obsessing symptoms. CONCLUSIONS Current findings furthered the understanding of the link between intolerance of uncertainty and OCD symptoms by highlighting the role of emotion-related impulsivity. When uncertainty triggers distress in individuals with high intolerance of uncertainty, the urge to behaviourally alleviate this distress could promote the use of maladaptive obsessions and compulsions, leading to greater OCD symptoms. Results also indicated the potentially differential effects from the behavioural versus cognitive forms of emotion-related impulsivity on different symptom domains, and the mechanistic link here is worthy of further investigation.
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Affiliation(s)
- Junjia Xu
- Obsessive Compulsive Disorder Institute, McLean Hospital
- University of California, Berkeley
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Broos HC, Dev AS, Llabre MM, Saab PG, Timpano KR. Trait and situation-specific intolerance of uncertainty predict affective symptoms during the COVID-19 pandemic. J Affect Disord 2024; 352:115-124. [PMID: 38350541 PMCID: PMC11167600 DOI: 10.1016/j.jad.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
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.
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Affiliation(s)
- Hannah C Broos
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America.
| | - Amelia S Dev
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Maria M Llabre
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Patrice G Saab
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Kiara R Timpano
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
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Morse JL, Luong G, Prince MA, Steger MF. Disentangling trait and daily experiences of uncertainty and meaning in life: implications for daily anxiety, negative affect, and somatic symptoms. ANXIETY, STRESS, AND COPING 2024; 37:127-142. [PMID: 37068102 PMCID: PMC10579451 DOI: 10.1080/10615806.2023.2201000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Although there is growing evidence supporting the association between intolerance of uncertainty (IU) and psychopathology, little is known about the covariation of IU and psychological distress day-to-day. The purpose of this ecological momentary assessment (EMA) study was to examine negative emotional and somatic correlates of trait IU and daily uncertainty, while investigating how a source of stability, meaning in life (MIL), might buffer against deleterious effects of IU and uncertainty. DESIGN AND METHODS Adult community members (n = 62) from a mid-size town in the Rocky Mountain region completed baseline measures of IU and MIL and ecological momentary assessments (EMA) of meaning, uncertainty, affect, and somatic symptoms over the course of one week. RESULTS Results indicate individuals high in trait IU experience more uncertainty day-to-day and greater distress when they feel uncertain compared to individuals lower in trait IU; however, MIL plays a stronger protective role for high IU compared to low IU individuals. CONCLUSIONS These findings support and extend previous research showing IU is associated with psychological distress and that MIL may be a critical resource to cultivate. Interventions promoting meaning day-to-day may reduce the effects of uncertainty on the well-being of those highly intolerant of uncertainty.
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Affiliation(s)
- Jessica L Morse
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Gloria Luong
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Michael F Steger
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
- Center for Meaning and Purpose, Colorado State University, Fort Collins, CO, USA
- North-West University, Vanderbijlpark, South Africa
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Jacoby RJ, Szkutak A, Shin J, Lerner J, Wilhelm S. Feeling uncertain despite knowing the risk: Patients with OCD (but not controls) experience known and unknown probabilistic decisions as similarly distressing and uncertain. J Obsessive Compuls Relat Disord 2023; 39:100842. [PMID: 38249753 PMCID: PMC10795542 DOI: 10.1016/j.jocrd.2023.100842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Patients with obsessive compulsive disorder (OCD) present as risk-averse and avoidant of feared stimuli, yet the literature examining risk aversion in OCD is conflicting. One possible explanation is that patients may exhibit aversion only on ambiguous tasks where the likelihood of possible outcomes is unknown. To test this idea, the current study assigned 30 patients with OCD versus 30 non-psychiatric controls (NPC) to conditions of known versus unknown risk (i.e., probabilities) on the Beads Task. Importantly, the task involved real financial stakes. We also examined self-reported intolerance of uncertainty (IU) as a mechanism. Results revealed a significant risk information x group interaction for certainty about the decision. Specifically, while NPCs felt significantly less certain on the unknown risk (versus known risk) task, the OCD group felt uncertain regardless of risk information. Results also revealed a significant main effect of group for distress after deciding, such that the OCD group was more distressed across all task versions compared to NPCs. Elevated trait IU was associated with higher task-related distress. Results indicate that even when patients with OCD are given information about likelihoods, they still feel uncertain and experience distress. Findings have clinical implications for addressing risk aversion and ambiguity/uncertainty in treatment.
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Affiliation(s)
- Ryan J. Jacoby
- Massachusetts General Hospital/Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA
| | - Abigail Szkutak
- Teachers College, Columbia University, 422F Thompson Hall, 525 W 120th Street, New York, NY, 10027, USA
| | - Jin Shin
- Washington University in St. Louis, CB 1125, One Brookings Drive, St. Louis, MO, 63130-4899, USA
| | - Jennifer Lerner
- Harvard Kennedy School,, 79 John F. Kennedy Street, Cambridge, MA 02138, USA
| | - Sabine Wilhelm
- Massachusetts General Hospital/Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA
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Jones D, McCalla M, Beverly EA. Measuring grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation osteopathic medical students. BMC MEDICAL EDUCATION 2023; 23:190. [PMID: 36978030 PMCID: PMC10043857 DOI: 10.1186/s12909-023-04181-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Medical school is a challenging time, with many medical students reporting symptoms of burnout, depression, anxiety, suicidal ideation, and psychological distress during pre-clinical and clinical years. First-generation college and first-generation medical students may be two groups of students at increased risk for the negative psychosocial effects of medical school. Importantly, grit, self-efficacy, and curiosity are protective factors against the negative psychosocial effects of medical school, whereas intolerance of uncertainty is a risk factor. Thus, research examining the associations among grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation medical students is needed. METHODS We conducted a cross-sectional, descriptive study to assess medical students' grit, self-efficacy, curiosity, and intolerance of uncertainty. We conducted independent samples t-tests and regression analyses using SPSS statistical software version 28.0. RESULTS A total of 420 students participated in the study for a response rate of 51.5%. One-fifth of participants (21.2%, n = 89) identified as first-generation students, 38.6% (n = 162) participants reporting having a physician relative, and 16.2% (n = 68) reported having a physician parent. Grit, self-efficacy, and curiosity and exploration scores did not differ by first-generation college status, physician relative(s), or physician parent(s). However, total intolerance of uncertainty scores differed by physician relative(s) (t= -2.830, p = 0.005), but not by first-generation status, or physician parent(s). Further, subscale scores for prospective intolerance of uncertainty differed by physician relative(s) (t= -3.379, p = 0.001) and physician parent(s) (t= -2.077, p = 0.038), but not by first-generation college student status. In the hierarchical regression models, first-generation college student status and first-generation medical student status were not predictive of grit, self-efficacy, curiosity and exploration, or intolerance of uncertainty, although statistical trends were observed with students with physician relative(s) predicting lower intolerance of uncertainty scores (B= -2.171, t= -2138, p = 0.033) and lower prospective intolerance of uncertainty (B= -1.666, t= -2.689, p = 0.007). CONCLUSIONS These findings suggest that first-generation college students did not differ by grit, self-efficacy, curiosity, or intolerance of uncertainty. Similarly, first-generation medical students did not differ by grit, self-efficacy, or curiosity; however, first-generation medical students showed statistical trends in higher total intolerance of uncertainty and higher prospective intolerance of uncertainty. Additional research needs to confirm these findings in first-generation medical students.
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Affiliation(s)
- DeWitt Jones
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
| | - Monet McCalla
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
| | - Elizabeth A Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA.
- The Diabetes Institute, Ohio University, Athens, OH, 45701, USA.
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7
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Sorid SD, Yap DL, Bravo AJ, Behar E. The Moderating Role of Intolerance of Uncertainty in the Relationship Between Health Anxiety and Pandemic-Related Stress. COGNITIVE THERAPY AND RESEARCH 2023; 47:340-349. [PMID: 37168694 PMCID: PMC10025784 DOI: 10.1007/s10608-023-10365-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 05/13/2023]
Abstract
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.
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Affiliation(s)
- Samantha D. Sorid
- William & Mary, Williamsburg, United States
- Department of Psychology, Temple University, Philadelphia, United States
| | - David L. Yap
- Hunter College, City University of New York, New York, United States
- The Graduate Center, City University of New York, New York, United States
| | | | - Evelyn Behar
- Hunter College, City University of New York, New York, United States
- The Graduate Center, City University of New York, New York, United States
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Radoman M, Gorka SM. Intolerance of uncertainty and functional connectivity of the anterior insula during anticipation of unpredictable reward. Int J Psychophysiol 2023; 183:1-8. [PMID: 36122824 PMCID: PMC11062179 DOI: 10.1016/j.ijpsycho.2022.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 09/04/2022] [Accepted: 09/11/2022] [Indexed: 01/04/2023]
Abstract
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.
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Affiliation(s)
- Milena Radoman
- Department of Psychiatry, University of Illinois at Chicago, 1601 W Taylor Street, Chicago, IL 60612, USA; Department of Anatomy and Cell Biology, University of Illinois at Chicago, 840 S Wood Street, Chicago, IL 60612, USA; The Graduate Program in Neuroscience, University of Illinois at Chicago, 840 S Wood Street, Chicago, IL 60612, USA.
| | - Stephanie M Gorka
- Department of Psychiatry and Behavioral Health, Ohio State University, 1670 Upham Drive, Columbus, OH 43205, USA
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Shams M, Pardini S, Del Bianco P, Calabrese C, De Salvo GL, Novara C. The predictive role of intolerance of uncertainty and trait of worry in breast cancer patients: A prospective, observational, single-center clinical study. Front Psychol 2023; 14:1092060. [PMID: 37138973 PMCID: PMC10149753 DOI: 10.3389/fpsyg.2023.1092060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Background Breast cancer diagnosis and treatment compromise well-being in a pervasive way, and negative consequences may remain after recovery. The psychological side of breast cancer has been extensively investigated; however, the role of intrusive thoughts and intolerance of uncertainty have been studied less systematically. Objectives The present study aimed to prospectively evaluate worry content, depression, anxiety, and post-traumatic stress symptoms and to define the role of the trait of worry and intolerance of uncertainty (IU) related to breast cancer. Methods Patients with their first breast cancer diagnosis were enrolled in a single-center, prospective observational trial. The trait of worry and IU were assessed using the Penn State Worry Questionnaire (PSWQ) and the Intolerance of Uncertainty Scale-Revised (IUS-R). The psychological aspects were evaluated using the Worry Domains Questionnaire (WDQ), the Beck Anxiety (BAI), Beck Depression Inventory-II (BDI-II), and the Impact of Event Scale-Revised (IES-R). Questionnaires were administered in a randomized sequence at diagnosis (T0), 3 months post-diagnosis (T1), and 12 months post-diagnosis (T2). Results One hundred and fifty eligible patients were enrolled in the study and provided the T0 assessment. Further compliance rates were 57% at T1 and 64% at T2. All patients showed a significant and continuous increase in the IES-R scale (p < 0.0001) from diagnosis to the end of the study, while no significant changes were observed for the WDQ, BAI, and BDI-II scales. The clinical PSWQ levels and/or high levels of the IUS-R score were the only variables that aided the distinction between patients who maintain high levels of depression, anxiety, and post-traumatic disorders and those who did not. Conclusion An early assessment of the components of the trait of worry and intolerance of uncertainty could be critical in identifying patients with a higher psychopathological risk. Furthermore, if future studies confirm the present findings, support and monitoring throughout the prognosis may present crucial benefits, and possibly affect the course of treatment.
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Affiliation(s)
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Padua, Italy
- *Correspondence: Susanna Pardini,
| | | | | | | | - Caterina Novara
- Department of General Psychology, University of Padova, Padua, Italy
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Perez TM, Glue P, Adhia DB, Navid MS, Zeng J, Dillingham P, Smith M, Niazi IK, Young CK, De Ridder D. Infraslow closed-loop brain training for anxiety and depression (ISAD): a protocol for a randomized, double-blind, sham-controlled pilot trial in adult females with internalizing disorders. Trials 2022; 23:949. [PMID: 36397122 PMCID: PMC9670077 DOI: 10.1186/s13063-022-06863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/22/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The core intrinsic connectivity networks (core-ICNs), encompassing the default-mode network (DMN), salience network (SN) and central executive network (CEN), have been shown to be dysfunctional in individuals with internalizing disorders (IDs, e.g. major depressive disorder, MDD; generalized anxiety disorder, GAD; social anxiety disorder, SOC). As such, source-localized, closed-loop brain training of electrophysiological signals, also known as standardized low-resolution electromagnetic tomography (sLORETA) neurofeedback (NFB), targeting key cortical nodes within these networks has the potential to reduce symptoms associated with IDs and restore normal core ICN function. We intend to conduct a randomized, double-blind (participant and assessor), sham-controlled, parallel-group (3-arm) trial of sLORETA infraslow (<0.1 Hz) fluctuation neurofeedback (sLORETA ISF-NFB) 3 times per week over 4 weeks in participants (n=60) with IDs. Our primary objectives will be to examine patient-reported outcomes (PROs) and neurophysiological measures to (1) compare the potential effects of sham ISF-NFB to either genuine 1-region ISF-NFB or genuine 2-region ISF-NFB, and (2) assess for potential associations between changes in PRO scores and modifications of electroencephalographic (EEG) activity/connectivity within/between the trained regions of interest (ROIs). As part of an exploratory analysis, we will investigate the effects of additional training sessions and the potential for the potentiation of the effects over time. METHODS We will randomly assign participants who meet the criteria for MDD, GAD, and/or SOC per the MINI (Mini International Neuropsychiatric Interview for DSM-5) to one of three groups: (1) 12 sessions of posterior cingulate cortex (PCC) ISF-NFB up-training (n=15), (2) 12 sessions of concurrent PCC ISF up-training and dorsal anterior cingulate cortex (dACC) ISF-NFB down-training (n=15), or (3) 6 sessions of yoked-sham training followed by 6 sessions genuine ISF-NFB (n=30). Transdiagnostic PROs (Hospital Anxiety and Depression Scale, HADS; Inventory of Depression and Anxiety Symptoms - Second Version, IDAS-II; Multidimensional Emotional Disorder Inventory, MEDI; Intolerance of Uncertainty Scale - Short Form, IUS-12; Repetitive Thinking Questionnaire, RTQ-10) as well as resting-state neurophysiological measures (full-band EEG and ECG) will be collected from all subjects during two baseline sessions (approximately 1 week apart) then at post 6 sessions, post 12 sessions, and follow-up (1 month later). We will employ Bayesian methods in R and advanced source-localisation software (i.e. exact low-resolution brain electromagnetic tomography; eLORETA) in our analysis. DISCUSSION This protocol will outline the rationale and research methodology for a clinical pilot trial of sLORETA ISF-NFB targeting key nodes within the core-ICNs in a female ID population with the primary aims being to assess its potential efficacy via transdiagnostic PROs and relevant neurophysiological measures. TRIAL REGISTRATION Our study was prospectively registered with the Australia New Zealand Clinical Trials Registry (ANZCTR; Trial ID: ACTRN12619001428156). Registered on October 15, 2019.
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Affiliation(s)
- Tyson M Perez
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
| | - Paul Glue
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Divya B Adhia
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Muhammad S Navid
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
- Donders Institute for Brain, Cognition and Behaviour, Radbout University Medical Center, Nijmegen, The Netherlands
| | - Jiaxu Zeng
- Department of Preventative & Social Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Peter Dillingham
- Coastal People Southern Skies Centre of Research Excellence, Department of Mathematics & Statistics, University of Otago, Dunedin, New Zealand
| | - Mark Smith
- Neurofeedback Therapy Services of New York, New York, USA
| | - Imran K Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
| | - Calvin K Young
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Dirk De Ridder
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
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Oral M, Karakurt N. The impact of psychological hardiness on intolerance of uncertainty in university students during the COVID-19 pandemic. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3574-3589. [PMID: 35415919 PMCID: PMC9088253 DOI: 10.1002/jcop.22856] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
The purpose of the study was to measure the impact of psychological hardiness on the intolerance of uncertainty (IOU) among university students during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional correlational research design was used in the study, where participants were selected by convenience sampling. The data was collected from 1217 undergraduate students from a university in Turkey through web-based questionnaires. The Intolerance of Uncertainty Scale assessed data, including intolerance of uncertainty. In addition, the Personal Views Survey III-R was used to measure students' psychological hardiness. The results indicated that Turkish undergraduate students overall had high IOU and above-average psychological hardiness. Psychological hardiness was negatively correlated with IOU. Students losing a loved one because of COVID-19 had increased intolerance to uncertainty and lower psychological hardiness. Psychological hardiness was a powerful predictor of IOU. These findings show the need to implement hardiness-training programs for undergraduate students to increase their tolerance to uncertainty and reduce the effect of grief.
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Affiliation(s)
- Meltem Oral
- Department of Elderly Care Services, Vocational College of Health ServicesAtaturk UniversityErzurumTurkey
| | - Nurgül Karakurt
- Department of Nursing, Faculty of Health SciencesErzurum Technical UniversityErzurumTurkey
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Beatty CC, Ferry RA, Nelson BD. Intolerance of uncertainty and psychophysiological reactivity in anticipation of unpredictable threat in youth. Int J Psychophysiol 2022; 179:110-118. [PMID: 35787438 DOI: 10.1016/j.ijpsycho.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Intolerance of uncertainty (IU) is a key transdiagnostic feature of internalizing psychopathology. An increasing body of research suggests that IU is associated with increased psychophysiological reactivity in anticipation of unpredictable threat. However, most studies examining the psychophysiological correlates of IU have been conducted in adults. There is a critical need to understand the relationship between IU and psychophysiological reactivity in anticipation of unpredictable threat during adolescence, a key developmental period associated with increased exploration of situations with uncertain outcomes. Thus, the present study examined the association between (1) youth IU and (2) parental IU (as an indicator of risk) in relation to youth defensive motivation (startle reflex) and attention (startle probe N100 and P300) in anticipation of unpredictable threat. METHODS The sample included 193 13 to 22-year-old (M = 17.33, SD = 1.97) females and a biological parent. Participants and their parent completed a self-report measure of prospective and inhibitory IU. Youth startle potentiation, probe N100 enhancement, and probe P300 suppression (indicating increased attention to threat) were measured in anticipation of predictable and unpredictable threat. RESULTS Youth prospective IU and inhibitory IU were not related to youth psychophysiological reactivity to predictable or unpredictable threat. Greater parental prospective IU was associated with greater youth startle potentiation and probe N100 enhancement in anticipation of unpredictable threat. CONCLUSION The present study suggests that parental IU, but not concurrent IU, is associated with heightened defensive motivation and attentional engagement in anticipation of unpredictable threat in youth.
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Affiliation(s)
- Clare C Beatty
- Department of Psychology, Stony Brook University, United States of America.
| | - Rachel A Ferry
- Department of Psychology, Stony Brook University, United States of America
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, United States of America
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Vadivel B, Azadfar Z, Talib MA, Mutlak DA, Suksatan W, Abbood AAA, Sultan MQ, Allen KA, Patra I, Hammid AT, Abdollahi A, Chupradit S. Intolerance of Uncertainty Scale-12: Psychometric Properties of This Construct Among Iranian Undergraduate Students. Front Psychol 2022; 13:894316. [PMID: 35756321 PMCID: PMC9216185 DOI: 10.3389/fpsyg.2022.894316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Uncertainty intolerance (IU), the tendency to think or react negatively toward uncertain events may have implication on individuals' mental health and psychological wellbeing. The Intolerance of Uncertainty Scale-12 (IU-12) is commonly used across the globe to measure IU, however, its' psychometric properties are yet to be evaluated in Iran with a Persian-speaking population. Therefore, the purpose of this research was to translate and validate the IU-12 among Iranian undergraduate students. Materials and Methods The multi-stage cluster random sampling was employed to recruit 410 Iranian undergraduate students (260 females) from the Azad University to complete the IU-12, the Depression Anxiety Stress Scale-2, and the Penn State Worry Questionnaire in a cross-sectional design. In this study, face validity, content validity, construct validity, and concurrent validity were measured and Construct Reliability (CR) and Cronbach's alpha were used to measure reliability. Results The impact score of the translated IU-12 indicated acceptable face validity (value of impact score was greater than 1.5). The value of Content Validity Index (CVI) and the value of Content Validity Ratio (CVR) were above 0.7 and 0.78, respectively. The values of CVI and CVR indicated the items had acceptable content validity and were deemed essential to the measure. The measurement model analysis showed the measure with two subscales had good fit indices (CMIN/df = 2.75, p < 0.01, RMSEA = 0.07, TLI = 0.94, CFI = 0.95, GFI = 0.94). A Confirmatory Factor Analysis (CFA) indicated the scale was composed of the two subscales found in the English-version of the scale (prospective anxiety and inhibitory anxiety), and no items were removed from the scale. The values of CR (0.86) and Cronbach's alphas (0.89) showed the measure had appropriate internal consistency. Conclusion The findings support the psychometric properties of the Persian version of the IU-12. This scale could be used to reliably and accurately measure uncertainty intolerance among undergraduate students in Iran.
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Affiliation(s)
| | - Zahra Azadfar
- Department of Psychology, Faculty of Educational Sciences and Psychology, Alzahra University, Tehran, Iran
| | - Mansor Abu Talib
- Department of Psychology, Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
| | | | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Abbas Abd Ali Abbood
- Department of Business Administration, Al-Mustaqbal University College, Hillah, Iraq
| | | | - Kelly A. Allen
- Educational Psychology and Inclusive Education, Faculty of Education, Monash University, Clayton, VIC, Australia
| | | | - Ali Thaeer Hammid
- Computer Engineering Department, Imam Ja’afar Al-Sadiq University, Baghdad, Iraq
| | - Abbas Abdollahi
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Supat Chupradit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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14
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An experimental investigation of intolerance of uncertainty and its impact on sub-clinical psychopathology. J Behav Ther Exp Psychiatry 2022; 75:101718. [PMID: 35081482 DOI: 10.1016/j.jbtep.2021.101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/22/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intolerance of Uncertainty (IU) is a transdiagnostic construct that is implicated in psychological difficulties, including Major Depressive Disorder (MDD), Generalised Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), and eating disorders (ED). However, most studies exploring IU have been correlational in nature. This study examined (1) whether a linguistic manipulation of the Intolerance of Uncertainty Scale (IUS) would successfully manipulate IU in an undergraduate sample, (2) whether experimentally increased or decreased levels of IU affect symptoms of MDD, GAD, OCD and ED, and (3) whether increased baseline symptom severity influences the magnitude of change in symptom severity post-manipulation. METHODS A linguistic manipulation of the IUS was used to manipulate participants' beliefs about their ability to tolerate uncertainty. N = 106 undergraduate participants were randomised to one of two conditions: high IU (HIU; n = 54) or low IU (LIU; n = 52), and completed measures on symptom severity at baseline and one-week follow-up. RESULTS The manipulation successfully reduced IU in LIU. Participants in this group did not experience significant changes in symptom severity post-manipulation. However, individuals with higher baseline OCD in LIU demonstrated greater decreases in post-manipulation OCD symptoms, compared with individuals in HIU. LIMITATIONS Only the LIU manipulation was effective, limiting the findings from the HIU. The one-week follow-up and relatively small sample size of predominantly female undergraduate students may dilute and limit the generalisability of results. CONCLUSION Findings support the utility of this manipulation in reducing IU, and the significance of different levels of IU in OCD.
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15
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Champion SM, Grisham JR. Excessive reassurance seeking versus compulsive checking in OCD: Comparing implicit motivators and mechanisms. J Behav Ther Exp Psychiatry 2022; 75:101720. [PMID: 34922212 DOI: 10.1016/j.jbtep.2021.101720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/29/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Excessive reassurance seeking (ERS) in OCD increases following scenarios with high threat and personal responsibility, but the mechanism via which ERS addresses these concerns is unclear. We investigated whether reassurance following OCD-related threats facilitated temporary threat re-appraisal and/or transferred responsibility to others. We also examined the 'checking by proxy' theory of OCD ERS by comparing the functional mechanisms of reassurance and checking behaviour. METHODS Community participants (N = 398) were recruited through MTurk and randomised to one of four conditions: ambiguous object-derived (checking) information, ambiguous person-derived (reassurance) information, unambiguous object-derived information and unambiguous person-derived information. Participants read scenarios that conveyed a risk of harm or contamination before imagining receiving reassurance or checking information as per their condition. Ratings of personal and external responsibility, threat likelihood and uncertainty were made before and after receiving the information. RESULTS In support of a checking by proxy hypothesis of ERS, participants in the unambiguous information conditions reported decreased uncertainty, decreased estimated threat likelihood and increased responsibility of others, regardless of whether they imagined checking or receiving reassurance. Those in the ambiguous conditions reported no changes in threat estimation or responsibility beliefs. OCD symptom level moderated responses to ambiguity: unlike low OCD, high OCD participants did not respond differentially to ambiguous versus unambiguous reassurance. LIMITATIONS The study was performed online due to Covid-19 restrictions and utilised non-clinical participants. CONCLUSIONS Like checking, reassurance facilitates short-term threat re-appraisal and diffuses responsibility following obsessive threats. Differentiated responses to reassurance ambiguity disappear as OC symptoms increase.
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16
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Khosravani V, Samimi Ardestani SM, Sharifi Bastan F, McKay D, Asmundson GJG. The associations of obsessive-compulsive symptom dimensions and general severity with suicidal ideation in patients with obsessive-compulsive disorder: The role of specific stress responses to COVID-19. Clin Psychol Psychother 2021; 28:1391-1402. [PMID: 33881790 PMCID: PMC8250844 DOI: 10.1002/cpp.2602] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Abstract
Suicidal ideation is prevalent in patients with obsessive-compulsive disorder (OCD); but, during COVID-19, it may be increased. The present study aimed to examine the effects of obsessive-compulsive (OC) symptom dimensions and OCD severity on suicidal ideation by considering the role of stress responses in reaction to COVID-19 in a clinical sample of patients with OCD. In a cross-sectional study, 304 patients with OCD completed measures of OC symptom dimensions, OCD severity, general mental health (depression and anxiety), and COVID-19-related stress. Results showed that after controlling for depression, anxiety, comorbidity, and lifetime suicide attempts, the OC symptom dimensions of responsibility for harm and unacceptable obsessional thoughts as well as general severity had indirect effects on suicidal ideation through the specific stress responses to COVID-19, including traumatic stress and compulsive checking. The study shows that OCD patients with specific OC symptom dimensions and severe OCD are more likely to have suicidal ideation during the pandemic. Further, the specific stress responses to COVID-19 may be an underlying mechanism. Clinicians should carefully assess suicidal ideation in patients with OCD who experience responsibility for harm and unacceptable thoughts, particularly during the pandemic.
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Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Seyed Mehdi Samimi Ardestani
- Department of Psychiatry, Behavioral Sciences Research Center, Imam Hossein HospitalShahid Beheshti University of Medical SciencesTehranIran
| | | | - Dean McKay
- Department of PsychologyFordham UniversityNew YorkUSA
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17
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YIĞMAN F, FİDAN S. Transdiagnostik Faktör Olarak Belirsizliğe Tahammülsüzlük. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2021. [DOI: 10.18863/pgy.827416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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18
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Kumar S, Saini R, Jain R, Sakshi. Confirmatory factor analysis of the Intolerance of Uncertainty Scale (short form) in India. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1969321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sanjay Kumar
- Department of Psychology, D.A.V. College, Muzaffarnagar, UP, India
| | - Reena Saini
- Department of Psychology, D.A.V. College, Muzaffarnagar, UP, India
| | - Ranjeeta Jain
- Department of Psychology, D.A.V. College, Muzaffarnagar, UP, India
| | - Sakshi
- Department of Psychology, D.A.V. College, Muzaffarnagar, UP, India
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19
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Badawi A, Steel Z, Harb M, Mahoney C, Berle D. Changes in intolerance of uncertainty over the course of treatment predict posttraumatic stress disorder symptoms in an inpatient sample. Clin Psychol Psychother 2021; 29:230-239. [PMID: 34110076 PMCID: PMC9292517 DOI: 10.1002/cpp.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022]
Abstract
Intolerance of uncertainty (IU) is the inability to tolerate distress that arises in response to the absence of important information. The level of IU has been investigated across various psychological disorders; however, few studies have examined IU in trauma‐affected samples. We aimed to investigate the relationship between IU and posttraumatic stress disorder (PTSD) across the course of treatment. Participants (n = 106) had a diagnosis of PTSD and were from first responder, military, and occupational injury backgrounds. Participants completed self‐report questionnaires pre‐ and post‐engagement in an inpatient group trauma‐informed psychoeducation and skills (TIPS) intervention. Regression analyses indicated that decreases in overall and inhibitory IU were associated with decreases in PTSD severity overall and at the symptom cluster level. However, prospective IU was only associated with changes in the re‐experiencing, avoidance, and arousal PTSD symptom clusters. Our findings are congruent with the nascent literature indicating that IU may be a maintaining factor for PTSD, suggesting clinical relevance for attendance to IU within the course of treatment.
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Affiliation(s)
- Amalia Badawi
- Discipline of Clinical Psychology, University of Technology, Sydney, Australia
| | - Zachary Steel
- School of Psychiatry, University of New South Wales, Sydney, Australia.,St John of God Healthcare, Richmond Hospital, Sydney, Australia.,Black Dog Institute, Randwick, Australia
| | | | | | - David Berle
- Discipline of Clinical Psychology, University of Technology, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
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20
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Pinciotti CM, Riemann BC, Abramowitz JS. Intolerance of uncertainty and obsessive-compulsive disorder dimensions. J Anxiety Disord 2021; 81:102417. [PMID: 33991818 DOI: 10.1016/j.janxdis.2021.102417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/23/2021] [Accepted: 05/04/2021] [Indexed: 01/23/2023]
Abstract
Intolerance of uncertainty (IU), which can include prospective (i.e., desire for predictability) and inhibitory (i.e., uncertainty paralysis) IU, is widely understood to be a central underlying component of obsessive-compulsive disorder (OCD). IU has several treatment implications, yet research on the differences in IU underlying OCD dimensions is limited and does not account for covarying effects of overlapping symptoms, shared variance in IU, demographic variables, and comorbid psychiatric conditions like generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). A sample of 974 patients with diagnosed OCD enrolled in residential, partial hospitalization, and intensive outpatient treatment programs for OCD and anxiety completed self-report measures of OCD symptoms and IU at admission. Structural equation modeling included prospective. inhibitory IU, and common IU and covariates (i.e., race, ethnicity, level of care, and comorbid GAD and PTSD) as predictors of four common OCD dimensions found that contamination and unacceptable thoughts symptoms evidenced a unique relationship with IU. Specifically, whereas a common IU factor predicted all four OCD symptom dimensions, inhibitory IU uniquely predicted contamination and unacceptable thoughts symptoms over and above covarying effects. Individuals with contamination and unacceptable thoughts symptoms may be more likely to feel "paralyzed" by uncertainty due to overreliance on overt immediate rituals, outright avoidance, rumination, or difficulties with emotion regulation, and may benefit from additional psychoeducation, problem-solving, and accountability. Broadly, individuals with OCD may benefit from explicit discussions about IU-related expectancies and disconfirmation of fears.
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Affiliation(s)
| | - Bradley C Riemann
- Rogers Behavioral Health, 34700 Valley Rd., Oconomowoc, WI, 53066, USA
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, 235 E. Cameron Ave, Chapel Hill, NC, 27514, USA
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21
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Smith N, Thomas SJ. Doomsday Prepping During the COVID-19 Pandemic. Front Psychol 2021; 12:659925. [PMID: 33935919 PMCID: PMC8079789 DOI: 10.3389/fpsyg.2021.659925] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/22/2021] [Indexed: 01/16/2023] Open
Abstract
“Doomsday prepping” is a phenomenon which involves preparing for feared societal collapse by stockpiling resources and readying for self-sufficiency. While doomsday prepping has traditionally been reported in the context of extremists, during the COVID-19 pandemic, excessive stockpiling leading to supply shortages has been reported globally. It is unclear what psychological or demographic factors are associated with this stockpiling. This study investigated doomsday prepping beliefs and behaviors in relation to COVID-19 proximity, demographics, coping strategies, psychopathology, intolerance of uncertainty (IU), and personality in 384 participants (249 female) in an online study. Participants completed a number of questionnaires including the Post-Apocalyptic and Doomsday Prepping Beliefs Scale and a scale designed for the current study to measure prepping in the context of COVID-19. These were analyzed using ANOVAs, correlational, and mediation analyses to examine relationships between psychometric variables and stockpiling. Prepping beliefs and behaviors were higher in males than females and positively associated with anxiety, obsessive-compulsive symptoms, IU, and traditional masculinity traits. Older age, male gender, obsessive-compulsive symptoms, and traditional masculinity predicted unique variance in prepping. The relationship between gender and stockpiling was mediated by social learning (witnessing other people panic buying) and the perceived threat of COVID-19 (doomsday interpretations) while proximity and personal vulnerability to COVID-19 were non-significant. Results indicate that panic buying was influenced more by witnessing others stockpiling, personality, and catastrophic thinking rather than by proximity to danger. Education could target these factors in ongoing waves of the pandemic or future catastrophes.
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Affiliation(s)
- Nina Smith
- Faculty of Social Sciences, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Susan Jennifer Thomas
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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22
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Wilson EJ, Stapinski L, Dueber DM, Rapee RM, Burton AL, Abbott MJ. Psychometric properties of the Intolerance of Uncertainty Scale-12 in generalized anxiety disorder: Assessment of factor structure, measurement properties and clinical utility. J Anxiety Disord 2020; 76:102309. [PMID: 33002756 DOI: 10.1016/j.janxdis.2020.102309] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/16/2020] [Accepted: 09/08/2020] [Indexed: 01/04/2023]
Abstract
Intolerance of uncertainty is a psychological vulnerability implicated in the development and maintenance of generalized anxiety disorder (GAD). The Intolerance of Uncertainty Scale-12 (IUS-12) is a widely used measure, however no studies have thoroughly tested the psychometric properties in a clinically diagnosed GAD sample. This study aimed to evaluate the factor structure, measurement properties and clinical utility of the IUS-12 in clinical and non-clinical samples. Participants were screened using the Anxiety Disorders Interview Schedule for DSM-IV to ascertain clinical (n = 136: principal diagnosis of GAD) or non-clinical status (n = 76). Confirmatory factor analysis determined that the bifactor type (two-factor testlet) model demonstrated significantly better fit in comparison to the unidimensional model for the clinical sample. The IUS-12 exhibited limited multidimensionality indicating that only the total score provides meaningful interpretation. The IUS-12 demonstrated good construct validity (with DASS-21, MCQ-30, and PSWQ), good internal consistency, as well as good test-retest reliability over 12-weeks. The IUS-12 demonstrated responsivity to treatment following cognitive behavioral therapy and mindfulness based psychological interventions. Receiver operating characteristic curve analysis indicated an optimal cut-off score of 28 for distinguishing individuals with GAD from non-clinical cases. Overall, the IUS-12 is a valid, reliable and clinically useful instrument for individuals with GAD.
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Affiliation(s)
- Emily J Wilson
- School of Psychology, The University of Sydney, Australia
| | - Lexine Stapinski
- Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - David M Dueber
- Department of Educational, School and Counseling Psychology, The University of Kentucky, United States
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - Amy L Burton
- School of Psychology, The University of Sydney, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Australia.
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23
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Groves D, Clark LH, Clark GI. The relationship between worry and intolerance of uncertainty subtypes. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- David Groves
- School of Behavioural, Cognitive & Social Sciences, University of New England, Armidale, New South Wales, Australia,
| | - Laura H. Clark
- School of Behavioural, Cognitive & Social Sciences, University of New England, Armidale, New South Wales, Australia,
| | - Gavin I. Clark
- School of Behavioural, Cognitive & Social Sciences, University of New England, Armidale, New South Wales, Australia,
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24
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What is the internal structure of intolerance of uncertainty? A network analysis approach. J Anxiety Disord 2020; 75:102293. [PMID: 32827868 DOI: 10.1016/j.janxdis.2020.102293] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 08/01/2020] [Accepted: 08/10/2020] [Indexed: 12/29/2022]
Abstract
Intolerance of uncertainty (IU) is a transdiagnostic vulnerability factor spanning psychological disorders. Although IU has been extensively studied, its internal structure is still not fully understood. In the current study, we applied network analysis to investigate IU - as measured by the Intolerance of Uncertainty Scale-Revised (IUS-R) - in two large non-clinical samples, consisting of undergraduates (N = 1172) and community individuals (N = 1759). Network analysis revealed that feeling a general internal uncertainty aversion and the belief that things have to be planned in advance are the most central nodes in both samples. Moreover, the community analysis revealed that, in both samples, the network of IU consists of three communities referring to negative beliefs about uncertainty, behavioral reactions to uncertainty, and emotional reactions to uncertainty. Lastly, the network was highly similar in undergraduates and community individuals in terms of network similarity, global connectivity, and structure and items mean levels; only minimal-to-negligible differences were found. The way current findings expand our knowledge of the internal structure of IU, along with theoretical and clinical implications, are discussed.
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25
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Katz DE, Laposa JM, Rector NA. Excessive reassurance seeking in depression versus obsessive-compulsive disorder: Cross-sectional and cognitive behavioural therapy treatment comparisons. J Anxiety Disord 2020; 75:102280. [PMID: 32805518 DOI: 10.1016/j.janxdis.2020.102280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 07/06/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
UNLABELLED 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.
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Affiliation(s)
- Danielle E Katz
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
| | - Judith M Laposa
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada; Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Neil A Rector
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada.
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26
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McKay D, Minaya C, Storch EA. Conducting exposure and response prevention treatment for contamination fears during COVID-19: The behavioral immune system impact on clinician approaches to treatment. J Anxiety Disord 2020; 74:102270. [PMID: 32650220 PMCID: PMC7328595 DOI: 10.1016/j.janxdis.2020.102270] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/02/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic sparked significant anxiety regarding viral rates and means of transmission. Heightened concerns about contamination have prompted new hygienic strategies to vigilantly guard against infection, including hand washing immediately after touching foreign objects or suspected contaminants. This has presented a critical challenge for the delivery of exposure and response prevention (ERP) therapy to individuals with contamination fears due to Obsessive Compulsive Disorder (OCD), as providers must manage not only their clients' attitudes and reactions but their own as well. In this investigation, self-identified anxiety and OCD treatment specialists (N = 139) provided demographic information, including their anxiety and OCD caseloads, and completed measures related to intolerance of uncertainty (IUS-SF; Carlton et al., 2007), beliefs about exposure therapy (TBES; Deacon et al., 2013), and emotional reactions to physical sensations (The Chills; Maruskin et al., 2012). We tested the hypothesis that intolerance of uncertainty and activation of the behavioral immune system (BIS; Schaller & Park, 2011), a mechanism theoretically activated by the prominent emergence of pathogens to protect against illness would predict attitudes toward exposure. The Chills Scale was used to assess BIS activation, a broad assessment of vasoconstriction responses associated with different emotional reactions, and includes a subscale (coldness) that evaluates vasoconstriction associated with defense against pathogens. Both coldness and OCD caseload, but not anxiety caseload or subscales of intolerance of uncertainty, emerged as significant predictors of clinicians' beliefs about exposure; increases in OCD caseload were also related to decreases in negative beliefs about exposure. Findings are useful in determining methods for aiding clinicians in developing effective approaches to contamination fears during and post-pandemic that include addressing their own BIS-related concerns and mapping out means for social behavioral norms associated with engaging in exposure treatment.
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27
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Lucas Casanova M, Pacheco LS, Costa P, Lawthom R, Coimbra JL. Factorial validity and measurement invariance of the uncertainty response scale. PSICOLOGIA-REFLEXAO E CRITICA 2019; 32:23. [PMID: 32027003 PMCID: PMC6967211 DOI: 10.1186/s41155-019-0135-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/10/2019] [Indexed: 12/30/2022] Open
Abstract
This study presents the adaptation of the Uncertainty Response Scale (Greco & Roger, Pers. Individ. Differ, 31:519-534, 2001) to Portuguese. This instrument was administered to a non-clinical community sample composed of 1596 students and professionals, allowing a thorough validity and invariance analysis by randomly dividing participants into three subsamples to perform: an exploratory factor analysis (sample one: N = 512); a preliminary confirmatory factor analysis to identify the final solution for the scale (sample two: N = 543); and the confirmatory factor analysis (sample three: N = 541). Samples two and three were also used for multi-group analysis to assess measurement invariance, invariance across gender, sociocultural levels, and students versus active professionals. Results showed the scale reflects the original factorial structure, as well as good internal consistency and overall good psychometric qualities. Invariance results across groups reached structural invariance which provides a confident invariance measurement for this scale, while invariance across gender and sociocultural levels reached metric invariance. Accordingly, differences between these groups were explored, by comparing means with multi-group analysis to establish the scale's sensitivity toward social vulnerability, by demonstrating the existence of statistically significant differences regarding gender and sociocultural levels on how individuals cope with uncertainty, specifically in terms of emotional strategies, as a self-defeating strategy. Thus, females scored higher on emotional uncertainty, as well as low sociocultural levels, compared with higher ones. Therefore, it is proposed that this scale could be a sound alternative to explore strategies for coping with uncertainty, when considering social, economic, or other environmental circumstances that may affect them.
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Affiliation(s)
- Mariana Lucas Casanova
- Universidade do Porto, Faculdade de Psicologia e de Ciências da Educação, Porto, Portugal.
| | - Lara S Pacheco
- Universidade do Porto, Faculdade de Psicologia e de Ciências da Educação, Porto, Portugal
| | - Patrício Costa
- Universidade do Porto, Faculdade de Psicologia e de Ciências da Educação, Porto, Portugal
| | - Rebecca Lawthom
- Universidade do Porto, Faculdade de Psicologia e de Ciências da Educação, Porto, Portugal
| | - Joaquim L Coimbra
- Universidade do Porto, Faculdade de Psicologia e de Ciências da Educação, Porto, Portugal
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Reiser SJ, Wright KD. Fetal health anxiety: development and psychometric properties of the fetal health anxiety inventory. J Psychosom Obstet Gynaecol 2019; 40:264-273. [PMID: 30089227 DOI: 10.1080/0167482x.2018.1490722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objective: To develop a measure to assess fetal health anxiety and examine its factor structure, convergent and divergent validity. Methods: In Study 1, the Short Health Anxiety Inventory-14 item version (SHAI) (Salkovskis et al., Psychol Med. 2002;32:843-853) was adapted for use with pregnant women to examine fetal health anxiety named the Fetal Health Anxiety Inventory (FHAI). Four pregnant women and three subject matter experts (SMEs) reviewed the FHAI. In Study 2, 100 pregnant women completed the FHAI and related self-report measures. Results: In Study 1, both reviewer groups provided feedback directing minor changes to the FHAI. In Study 2, a revised version was used. The revised FHAI demonstrated excellent internal consistency (α = 0.91). Results from an EFA suggested that the FHAI may be conceptualized as a one- or two-factor scale. Convergent (pregnancy-related anxiety [r = 0.56, p = .0001], parental health anxiety [r = 0.53, p = .0001], anxiety [r = 0.57, p = .0001], anxiety sensitivity [r = 0.28, p = .004] and intolerance of uncertainty [r = 0.29, p = .003]) and divergent (parental depression [r = 0.16, p = .12]) validity was evidenced with additional measures of interest. Conclusion: Preliminary findings suggest that the FHAI represents a psychometrically sound instrument to measure the construct of fetal health anxiety. Practical and theoretical implications of the present results are discussed.
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Affiliation(s)
- Sarah J Reiser
- Department of Psychology, University of Regina , Regina , SK , Canada
| | - Kristi D Wright
- Department of Psychology, University of Regina , Regina , SK , Canada
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Neither wrong nor right: Theta and delta power increase during performance monitoring under conditions of uncertainty. Int J Psychophysiol 2019; 146:225-239. [DOI: 10.1016/j.ijpsycho.2019.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 12/21/2022]
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The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clin Psychol Rev 2019; 73:101778. [PMID: 31678816 DOI: 10.1016/j.cpr.2019.101778] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/04/2019] [Accepted: 08/20/2019] [Indexed: 01/12/2023]
Abstract
Intolerance of uncertainty is a dispositional trait associated with a range of psychological disorders, but the influence of methodological factors on theses associations remains unknown. The first aim of this meta-analysis was to quantify the strengths of the association between IU and symptoms of generalised anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive compulsive disorder, depression, and eating disorders. The second aim was to assess the influence of methodological factors on these relationships, including clinical (vs. non-clinical) status, age group, sex, IU measure, and symptom measure. We extracted 181 studies (N participants = 52,402) reporting 335 independent effect sizes (Pearson's r). Overall, there was a moderate association between IU and symptoms (r = 0.51, 95% CI = 0.50-0.52), although heterogeneity was high (I2 = 83.50, p < .001). Some small but significant moderator effects emerged between and within disorders. Effect sizes were not impacted by sample size. The results indicate that IU has robust, moderate associations with a range of disorder symptoms, providing definitive evidence for the transdiagnostic nature of IU.
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Hellberg SN, Buchholz JL, Twohig MP, Abramowitz JS. Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions. Clin Psychol Psychother 2019; 27:69-78. [PMID: 31657499 DOI: 10.1002/cpp.2409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/17/2019] [Accepted: 10/17/2019] [Indexed: 11/08/2022]
Abstract
Cognitive fusion (CF) involves the tendency to "buy in" to thoughts and feelings and consists of three empirically established domains: somatic concerns, emotion regulation, and negative evaluation. CF is hypothesized to play a role in obsessive-compulsive disorder (OCD). The present study examined how well the CF domains, relative to traditional cognitive-behavioural constructs (i.e., obsessive beliefs such as inflated responsibility), predict OCD symptoms. Fifty-two treatment-seeking adults with OCD completed self-report measures of CF, obsessive beliefs, OCD symptoms, and general distress. Domains of CF were differentially associated with the responsibility for harm, symmetry, and unacceptable thoughts of OCD dimensions; yet after accounting for obsessive beliefs, only the negative evaluation domain of CF significantly predicted symmetry OCD symptoms. Obsessive beliefs significantly predicted all OCD dimensions except for contamination. These findings provide additional support for existing cognitive-behavioural models of OCD across symptom dimensions, with the exception of contamination symptoms, and suggest that the believability of thoughts and feelings about negative evaluation adds to the explanation of symmetry symptoms. Conceptual and treatment implications, study limitations, and future directions are discussed.
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Affiliation(s)
- Samantha N Hellberg
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer L Buchholz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Jacoby RJ, Abramowitz JS, Blakey SM, Reuman L. Is the hierarchy necessary? Gradual versus variable exposure intensity in the treatment of unacceptable obsessional thoughts. J Behav Ther Exp Psychiatry 2019; 64:54-63. [PMID: 30851653 DOI: 10.1016/j.jbtep.2019.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 01/24/2019] [Accepted: 02/20/2019] [Indexed: 11/29/2022]
Abstract
Although research suggests that introducing varying levels of fear during exposure enhances outcomes for some anxiety-related problems, this has not been examined in the context of obsessions. The current preliminary study tested the hypothesis that introducing variability in exposure intensity would improve long-term outcomes relative to traditional gradual (hierarchical) exposure METHODS: Adults (N = 40) with a moderately distressing unacceptable obsessional thought were randomly assigned in parallel to four twice-weekly sessions of: (a) gradual exposure (EXP-G; n = 19) emphasizing hierarchical exposure completion, or (b) variable exposure (EXP-V; n = 21) emphasizing variability in exposure intensity RESULTS: There were no significant differences in pre to post changes between groups using self-report, interview, or behavioral outcomes (as evaluated by an independent assessor blind to treatment condition). Group comparisons at 3-month follow-up did not reach statistical significance but were moderate in magnitude. Specifically, as measured by clinical interview (the Yale-Brown Obsessive-Compulsive Scale; primary outcome) and self-report, individuals in the EXP-G group maintained gains at 3-month follow-up, while the EXP-V group continued to improve. Treatment expectancies and satisfaction were comparable for both groups. Five participants withdrew from the EXP-G condition, and none withdrew from the EXP-V condition. In contrast to previous studies, variability in subjective and physiological fear during exposure did not predict outcomes LIMITATIONS: The study employed an analogue sample with moderate unacceptable obsessions, and results should be replicated in clinical samples CONCLUSIONS: Variable exposure warrants future study to understand the mechanisms, moderators, and implications of this novel approach.
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Affiliation(s)
- Ryan J Jacoby
- University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC, 27599, United States; Massachusetts General Hospital / Harvard Medical School, 185 Cambridge St, Boston, MA, 02114, United States.
| | - Jonathan S Abramowitz
- University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC, 27599, United States.
| | - Shannon M Blakey
- University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC, 27599, United States.
| | - Lillian Reuman
- University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC, 27599, United States.
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Kothari R, Barker C, Pistrang N, Rozental A, Egan S, Wade T, Allcott-Watson H, Andersson G, Shafran R. A randomised controlled trial of guided internet-based cognitive behavioural therapy for perfectionism: Effects on psychopathology and transdiagnostic processes. J Behav Ther Exp Psychiatry 2019; 64:113-122. [PMID: 30981162 DOI: 10.1016/j.jbtep.2019.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/19/2019] [Accepted: 03/26/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Perfectionism is a transdiagnostic process that has been associated with a range of psychopathology and also with other transdiagnostic processes. We have previously shown that guided internet-based cognitive behavioural therapy (ICBT) can reduce symptoms of dysfunctional perfectionism, however, no impact was observed on symptoms of depression and anxiety. Here we explore the impact of guided ICBT for perfectionism on symptoms of other associated psychopathology, specifically obsessive-compulsive disorder (OCD) and eating disorders, and also on other associated transdiagnostic processes (self-esteem, intolerance of uncertainty, and self-compassion). METHODS Participants who presented with clinical levels of perfectionism were randomised to an experimental group that received the intervention (n = 62), or a wait list control group (n = 58). Questionnaires assessing symptoms of OCD, eating disorders, self-esteem, intolerance of uncertainty, and fear of self-compassion were completed pre-intervention, post-intervention (12 weeks), and at follow-up (24 weeks). Between group effect sizes are reported. RESULTS The intervention led to significant decreases in symptoms of OCD (d = -0.9; CI: -1.4, -0.4) and eating disorders (d = -0.6; CI: -1.0, -0.1), and had an impact on other transdiagnostic processes resulting in increased self-esteem (d = 0.7; CI: 0.2, 1.2), decreases in intolerance of uncertainty (d = -0.9; CI: -1.4, -0.4), and fear of self-compassion (d = -0.8; CI: -1.3, -0.3). At follow-up changes were maintained in symptoms of OCD (d = -1.3; CI: -1.8, -0.8), disordered eating (d = -0.7; CI: -1.2, -0.2), intolerance of uncertainty (d = -0.8; CI: -1.2, -0.3), and fear of self-compassion (d = -1.0; CI: -1.5, -0.5). CONCLUSIONS Guided ICBT for perfectionism improves associated psychopathology and transdiagnostic processes. ClinicalTrials.gov registration no. NCT02756871.
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Affiliation(s)
- Radha Kothari
- Division of Psychology and Language Sciences, University College London, London, 1 - 19 Torrington Place, London, WC1E 7HB, United Kingdom; Institute of Child Health Population, Policy and Practice Programme, University College London, 30 Guilford Street, London, WC1N 1EH, United Kingdom.
| | - Chris Barker
- Division of Psychology and Language Sciences, University College London, London, 1 - 19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Nancy Pistrang
- Division of Psychology and Language Sciences, University College London, London, 1 - 19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Alexander Rozental
- Institute of Child Health Population, Policy and Practice Programme, University College London, 30 Guilford Street, London, WC1N 1EH, United Kingdom; Department of Clinical Neuroscience, Karolinska Institutet, Norra Stationsgatan 69, 113 64, Stockholm, Sweden.
| | - Sarah Egan
- School of Psychology, Faculty of Health Sciences, Curtin University, Kent St, Bentley, WA 6102, Perth, Australia.
| | - Tracey Wade
- School of Psychology, Flinders University, Adelaide, Sturt Rd, Bedford Park, SA, 5042, Australia.
| | - Hannah Allcott-Watson
- Institute of Child Health Population, Policy and Practice Programme, University College London, 30 Guilford Street, London, WC1N 1EH, United Kingdom.
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linkoping University, 581 83, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Solnavägen 1, 171 77 Solna, Stockholm, Sweden.
| | - Roz Shafran
- Institute of Child Health Population, Policy and Practice Programme, University College London, 30 Guilford Street, London, WC1N 1EH, United Kingdom.
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Bottesi G, Noventa S, Freeston MH, Ghisi M. Seeking certainty about Intolerance of Uncertainty: Addressing old and new issues through the Intolerance of Uncertainty Scale-Revised. PLoS One 2019; 14:e0211929. [PMID: 30742694 PMCID: PMC6370219 DOI: 10.1371/journal.pone.0211929] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 01/24/2019] [Indexed: 01/30/2023] Open
Abstract
Intolerance of Uncertainty is a trans-diagnostic process that spans a range of emotional disorders and it is usually measured through the Intolerance of Uncertainty Scale-12. The current study aims at investigating some issues in the assessment of Intolerance of Uncertainty (IU) through the Italian Intolerance of Uncertainty Scale-Revised, a measure adapted from the Intolerance of Uncertainty Scale-12 to assess IU across the lifespan. In particular we address the factor structure among a large community sample, measurement invariance across gender, age, and over time, together with reliability and validity of the overall scale and its subscales. The questionnaire was administered to community (N = 761; mean age = 35.86 ± 14.01 years) and undergraduate (N = 163; mean age = 21.16 ± 2.64 years) participants, together with other self-report measures assessing constructs theoretically related to IU. The application of a bifactor model shows that the Italian Intolerance of Uncertainty Scale-Revised possesses a robust general factor, thus supporting the use of the unit-weighted total score of the questionnaire as a measure of the construct. Furthermore, measurement invariance across gender, age, and over time is supported. Finally, the Italian Intolerance of Uncertainty Scale-Revised appears to possess adequate reliability and validity. These findings support the unidimensionality of the measure, a conceptually reasonable result in line with the trans-diagnostic nature of Intolerance of Uncertainty. In addition, this study and comparison with published factor structures of the Intolerance of Uncertainty Scale-12 and of the Intolerance of Uncertainty Scale-Revised identify some issues for the internal structure of the measure. In particular, concern is expressed for the Prospective IU subscale. In light of the promising psychometric properties, the use of the Italian Intolerance of Uncertainty Scale-Revised as a univocal measure is encouraged in both research and clinical practice.
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Affiliation(s)
- Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Mark H. Freeston
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padova, Italy
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Knowles KA, Olatunji BO. Enhancing Inhibitory Learning: The Utility of Variability in Exposure. COGNITIVE AND BEHAVIORAL PRACTICE 2019; 26:186-200. [PMID: 31787834 PMCID: PMC6884337 DOI: 10.1016/j.cbpra.2017.12.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Exposure therapy has strong empirical support as a treatment for anxiety and related disorders, yet not all participants see clinically meaningful reduction in symptoms, and some experience return of fear. In this review, we examine the theoretical models of exposure therapy, from early precursors to the contemporary inhibitory learning model. The inhibitory learning model is applied to examine one potential method of improving outcomes in exposure therapy: increasing variability in the progression of the exposure hierarchy. We explore mechanisms that support the use of variability in exposure, including the violation of expectancies to enhance learning. In addition, the role of intolerance of uncertainty in anxiety is examined; variable exposure therapy could target this transdiagnostic mechanism in anxiety and related disorders. Suggestions for future research are then offered.
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Gorka SM, Phan KL, Hosseini B, Chen EY, McCloskey MS. Ventrolateral prefrontal cortex activation during social exclusion mediates the relation between intolerance of uncertainty and trait aggression. Clin Psychol Sci 2018; 6:810-821. [PMID: 30643671 DOI: 10.1177/2167702618776947] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intolerance of uncertainty (IU) is an important individual difference factor that may contribute to trait-like aggression. Deficient engagement of the ventrolateral PFC (vlPFC) during social situations may also be a mechanism that links these two constructs. The aim of the current study was to test a proposed mediation model whereby IU is associated with trait aggression through neural activation of the vlPFC during a social exclusion task. Fifty-three adults with a range of impulsive-aggressive traits completed validated assessments of IU and trait aggression, and the 'Cyberball' social exclusion task during functional magnetic resonance imaging (fMRI). Results supported the mediation model such that greater levels of IU were associated with greater trait aggression through hypoactivation of the vlPFC during social exclusion. This study is the first to provide evidence suggesting that individuals higher in IU have difficulties engaging regulatory neural processes, which in-turn may increase the propensity for aggression.
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Affiliation(s)
- Stephanie M Gorka
- University of Illinois-Chicago; Department of Psychiatry, 1747 West Roosevelt Road Chicago, IL 60608
| | - K Luan Phan
- University of Illinois-Chicago; Department of Psychiatry, 1747 West Roosevelt Road Chicago, IL 60608.,Jesse Brown VA Medical Center; Mental Health Service Line, 820 S. Damen Avenue Chicago, IL 60612.,University of Illinois-Chicago; Department of Anatomy and Cell Biology, & the Graduate Program in Neuroscience, 808 S. Wood Street Chicago, IL 60612
| | - Bobak Hosseini
- University of Illinois-Chicago; Department of Psychiatry, 1747 West Roosevelt Road Chicago, IL 60608
| | - Eunice Y Chen
- Temple University; Department of Psychology, 1701 North 13 Street Philadelphia, PA 19122
| | - Michael S McCloskey
- Temple University; Department of Psychology, 1701 North 13 Street Philadelphia, PA 19122
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Reuman L, Buchholz J, Abramowitz JS. Obsessive beliefs, experiential avoidance, and cognitive fusion as predictors of obsessive-compulsive disorder symptom dimensions. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gillett CB, Bilek EL, Hanna GL, Fitzgerald KD. Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment. Clin Psychol Rev 2018; 60:100-108. [DOI: 10.1016/j.cpr.2018.01.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/12/2017] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
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Lewis MA, Stine A, Paquin RS, Mansfield C, Wood D, Rini C, Roche MI, Powell CM, Berg JS, Bailey DB. Parental preferences toward genomic sequencing for non-medically actionable conditions in children: a discrete-choice experiment. Genet Med 2018; 20:181-189. [PMID: 28771249 PMCID: PMC5868968 DOI: 10.1038/gim.2017.93] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/16/2017] [Indexed: 01/12/2023] Open
Abstract
PurposeApplication of whole-exome and whole-genome sequencing is likely to increase in clinical practice, public health contexts, and research. We investigated how parental preference for acquiring information from genome-scale testing is influenced by the characteristics of non-medically actionable genetic disorders in children, as well as whether the preferences differed by gender and between African-American and white respondents.MethodsWe conducted a Web-based discrete-choice experiment with 1,289 parents of young children. Participants completed "choice tasks" based on pairs of profiles describing sequencing results for hypothetical genetic disorders, selected the profile in each pair that they believed represented the information that would be more important to know, and answered questions that measured their level of distress.ResultsKnowing the likelihood that the disorder would develop given a true-positive test result was most important to parents. Parents showed greater interest in learning sequencing results for disease profiles with more severe manifestations. This was associated with greater distress. Differences by gender and race reflected small differences in magnitude, but not direction.ConclusionParents preferred to learn results about genetic disorders with more severe manifestations, even when this knowledge was associated with increased distress. These results may help clinicians support parental decision making by revealing which types of sequencing results parents are interested in learning.
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Affiliation(s)
- Megan A Lewis
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Alex Stine
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Ryan S Paquin
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Carol Mansfield
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Dallas Wood
- RTI International, Research Triangle Park, Durham, North Carolina, USA
| | - Christine Rini
- Department of Health Behavior and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Myra I Roche
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Cynthia M Powell
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jonathan S Berg
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Donald B Bailey
- RTI International, Research Triangle Park, Durham, North Carolina, USA
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Pain anxiety differentially mediates the association of pain intensity with function depending on level of intolerance of uncertainty. J Psychiatr Res 2018; 97:30-37. [PMID: 29175295 DOI: 10.1016/j.jpsychires.2017.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/13/2017] [Accepted: 11/10/2017] [Indexed: 01/13/2023]
Abstract
Uncertainty about symptom duration, cause, prognosis and treatment is common in patients who seek medical care, yet individual ability to manage this uncertainty varies. Intolerance of uncertainty is considered an important factor in the etiology and persistence of negative emotions- in particular, depression and anxiety. We explored the contribution of intolerance of uncertainty to anxiety due to pain and physical function in patients seeking care at an orthopedic medical practice. Participants (N = 105, mean age of 51 ± 17, 63% male) were administered PROMIS Physical Function v1.2 Upper Extremity CAT, Numerical Rating Scale (NRS), Pain Anxiety Symptoms Scale-short form (PASS-20), and the Intolerance of Uncertainty Scale-short version (IUS-12). Results showed that the mediating role of pain anxiety is contingent upon the level of intolerance of uncertainty. Specifically, a minimum level of intolerance of uncertainty is required for the development of pain anxiety and its effect on function, and as intolerance of uncertainty rises from low to medium to high levels, the effect of pain on function goes from being independent of the anxiety to being more and more carried by and through anxiety about pain. These findings support the contention that intolerance of uncertainty plays a crucial role in the relationship between pain, pain anxiety, and physical function. Intolerance of uncertainty appears to be a trans-diagnostic target for coping skills training.
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Katz D, Rector NA, Laposa JM. The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder. Cogn Behav Ther 2017. [DOI: 10.1080/16506073.2017.1334087] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Danielle Katz
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Neil A. Rector
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Judith M. Laposa
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Bottesi G, Ghisi M, Sica C, Freeston MH. Intolerance of uncertainty, not just right experiences, and compulsive checking: Test of a moderated mediation model on a non-clinical sample. Compr Psychiatry 2017; 73:111-119. [PMID: 27939647 DOI: 10.1016/j.comppsych.2016.11.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Intolerance of uncertainty (IU) and not just right experiences (NJREs) have been claimed putative vulnerability factors for obsessive-compulsive disorder (OCD). The aim of the present study was to test whether IU could represent a trans-diagnostic construct accountable for OC checking behaviors and whether NJREs could embody an OCD-specific criterion through which IU operates. METHOD One hundred and eighty-eight Italian community individuals completed self-report measures of IU, NJREs, OC symptoms, worry, anxiety, and depression. Mediation and moderated mediation models were tested using a bootstrapping approach, wherein IU was included as the independent variable as well as the moderator; checking behaviors were entered as the dependent variable; and NJRE severity was included as a mediator. RESULTS The main findings highlighted that NJREs were a mediator of the relationship between IU and checking behaviors; nonetheless, in connection with medium levels of IU, NJREs no longer mediated the path. Furthermore, IU did not emerge to moderate the mediation. CONCLUSION Despite their preliminary nature, the present results might be a hint for future research, as theoretical integration may represent a way to go for better understanding OCD etiology and phenomenology.
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Affiliation(s)
- Gioia Bottesi
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
| | - Marta Ghisi
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
| | - Claudio Sica
- Department of Health Sciences, University of Firenze, via di San Salvi 12, Complesso di San Salvi Padiglione 26, 50135 Firenze, Italy.
| | - Mark H Freeston
- Institute of Neuroscience, (Ridley Building, 4th Floor), Faculty of Medical Sciences, University of Newcastle, Newcastle upon Tyne, Tyne and Wear NE1 7RU, United Kingdom.
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Uncertain and Fused: Cognitive Fusion, Thought-Action Fusion, and the Intolerance of Uncertainty as Predictors of Obsessive-Compulsive Symptom Dimensions. J Cogn Psychother 2017; 31:191-203. [DOI: 10.1891/0889-8391.31.3.191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive-behavioral models of obsessions, although widely accepted, do not entirely explain obsessive-compulsive (OC) symptoms. Constructs from relational frame theory (RFT; e.g., cognitive fusion—the tendency for behavior to be overly regulated and influenced by cognition) may improve our understanding of OC symptoms above and beyond cognitive-behavioral constructs (e.g., intolerance of uncertainty [IU]). This study examined the extent to which cognitive fusion accounts for unique variability in four OC symptom dimensions: contamination, responsibility for harm, unacceptable thoughts, and order/symmetry. Participants completed measures of cognitive fusion, general distress, thought action fusion, IU, and OC symptoms. Regression analyses showed that IU and thought-action fusion (TAF) were significant predictors across the OC symptom dimensions; however, cognitive fusion was only a unique predictor of the unacceptable thoughts symptom dimension. Results support the notion that RFT may best relate to the unacceptable thoughts domain of OCD. Study findings, limitations, and future directions are discussed.
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44
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Roma VG, Hope DA. Are we certain about which measure of intolerance of uncertainty to use yet? Cogn Behav Ther 2016; 46:327-338. [PMID: 27876443 DOI: 10.1080/16506073.2016.1252792] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Intolerance of Uncertainty (IU) has been understood as a dispositional tendency to view the presence of negative events as unacceptable and threatening, regardless of the likelihood of those events occurring. The preference over the 12-item vs. 27-item of the IUS has been central to debate. The goals of the present study were to evaluate two competing models of measuring IU with model-fitting analyses and explore model invariance of gender (e.g. men vs. women). A sample of 980 individuals completed an online IUS survey. Results indicated that the two-factor short-form model provided better fit to the data compared to the full-length two-factor model proposed by. Results also indicated that the short-form IUS is gender invariant, suggesting acceptable use among men and women. These findings provide further support of a two-factor structure and suggest that the IUS is appropriate for men and women.
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Affiliation(s)
- Vincenzo G Roma
- a Psychology , University of Nebraska-Lincoln , 238 Burnett Hall, 1400 R St, Lincoln , NE 68588 , USA
| | - Debra A Hope
- a Psychology , University of Nebraska-Lincoln , 238 Burnett Hall, 1400 R St, Lincoln , NE 68588 , USA
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45
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Vander Haegen M, Etienne AM. Cognitive processes across anxiety disorders related to intolerance of uncertainty: Clinical review. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1215773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Marie Vander Haegen
- Unit of Health Psychology, Université de Liège, Quartier Village 2, Rue de l’Aunaie 30, Liège 4000, Belgium
| | - Anne-Marie Etienne
- Unit of Health Psychology, Université de Liège, Quartier Village 2, Rue de l’Aunaie 30, Liège 4000, Belgium
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46
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Intolerance of uncertainty and insula activation during uncertain reward. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2016; 16:929-39. [DOI: 10.3758/s13415-016-0443-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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47
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Fergus TA, Carleton RN. Intolerance of uncertainty and attentional networks: Unique associations with alerting. J Anxiety Disord 2016; 41:59-64. [PMID: 27068067 DOI: 10.1016/j.janxdis.2016.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/14/2016] [Accepted: 03/21/2016] [Indexed: 12/31/2022]
Abstract
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.
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48
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Carleton RN, Duranceau S, Shulman EP, Zerff M, Gonzales J, Mishra S. Self-reported intolerance of uncertainty and behavioural decisions. J Behav Ther Exp Psychiatry 2016; 51:58-65. [PMID: 26788617 DOI: 10.1016/j.jbtep.2015.12.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/04/2015] [Accepted: 12/21/2015] [Indexed: 11/24/2022]
Abstract
Intolerance of Uncertainty (IU) appears to be a robust transdiagnostic risk factor related to anxiety and depression. Most transdiagnostic IU research has used the self-report Intolerance of Uncertainty Scale-Short Form; however, there is comparatively little research exploring presumed behavioral correlates of IU. The current study was designed to assess relationships between self-reported IU and decisions in uncertainty-based behavioral tasks (specifically, the Wisconsin Card Sorting Task, the Risky Gains Task, and the Modified Iowa Gambling Task). Participants comprised compensated community members (n = 108; 69% women) and undergraduates (n = 98; 78% women). Community member compensation was not contingent on performance, but undergraduate compensation was partially contingent on performance. Results replicated prior research, with both samples producing small (r = .19) to moderate (r = -.29) correlations (ps < .05) between self-reported IU and outcome variables from each of the behavioral tasks. The relationships were larger in the undergraduate sample, likely due to the compensation incentive. In general, the results suggest that increasing IU is associated with increasingly risk adverse behaviors; however, the relationship appears complex and in need of substantial additional research to understand how clinically-significant IU would impact pathology-related behaviours.
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Affiliation(s)
- R Nicholas Carleton
- The Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, SK, Canada.
| | - Sophie Duranceau
- The Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, SK, Canada.
| | | | - Marissa Zerff
- The Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, SK, Canada.
| | - Josh Gonzales
- Risk and Gambling Behaviour Laboratory, University of Regina, Regina, SK, Canada.
| | - Sandeep Mishra
- Risk and Gambling Behaviour Laboratory, University of Regina, Regina, SK, Canada.
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49
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Carleton RN. Fear of the unknown: One fear to rule them all? J Anxiety Disord 2016; 41:5-21. [PMID: 27067453 DOI: 10.1016/j.janxdis.2016.03.011] [Citation(s) in RCA: 260] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 03/26/2016] [Accepted: 03/26/2016] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada.
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50
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Enhancing the ecological validity of the Beads Task as a behavioral measure of intolerance of uncertainty. J Anxiety Disord 2016; 41:43-9. [PMID: 26896872 DOI: 10.1016/j.janxdis.2016.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/28/2016] [Accepted: 02/02/2016] [Indexed: 11/23/2022]
Abstract
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.
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