The Intolerance of Uncertainty Scale: psychometric properties of the English version

Research is now suggesting that intolerance of uncertainty may be very important in understanding worry and may play a key role in the etiology and maintenance of worry. The present study attempted to further our understanding of intolerance of uncertainty by examining the psychometric properties of the English version of the Intolerance of Uncertainty Scale (IUS), which has already been validated in French. Factor analysis indicated that the IUS has a four-factor structure that represents the idea that uncertainty is stressful and upsetting, uncertainty leads to the inability to act, uncertain events are negative and should be avoided, and being uncertain is unfair. The IUS has excellent internal consistency, good test-retest reliability over a five-week period, and convergent and divergent validity when assessed with symptom measures of worry, depression, and anxiety. Overall, this study suggests that the IUS is a sound measure of intolerance of uncertainty and supports the idea that intolerance of uncertainty is an important construct involved in worry.     

The Prediction of Worry in Non-Clinical Individuals: The Role of Intolerance of Uncertainty,Meta-Worry,and Neuroticism

The present study investigated the relation between intolerance of uncertainty (IU), meta-worry, and neuroticism on the one hand, and worry on the other hand, in a sample of 105 university students. Two different operationalizations of worry were used: trait worry and idiosyncratic worry. Results showed that IU, meta-worry, and neuroticism correlated significantly with trait worry. Further, IU and meta-worry were strongly related but made a unique and independent contribution to trait worry. Finally, IU and meta-worry could be considered as partial mediators of the relation between neuroticism and trait-like worry. Relations of IU, meta-worry, and neuroticism with idiosyncratic worry were weak or even absent, although neuroticism was associated with idiosyncratic worry when the stressful event was more imminent. In conclusion, not IU and meta-worry, but the general vulnerability factor of neuroticism appeared to possess the most declarative value in relation to both trait and idiosyncratic worry.     

Distress and Avoidance in Generalized Anxiety Disorder: Exploring the Relationships with Intolerance of Uncertainty and Worry

Theory and research suggest that treatments targeting experiential avoidance may enhance outcomes for patients with generalized anxiety disorder (GAD). The present study examined the role of experiential avoidance and distress about emotions in a treatment-seeking sample with a principal diagnosis of GAD compared with demographically matched nonanxious controls and sought to explore their shared relationship with two putative psychopathological processes in GAD: intolerance of uncertainty and worry. Patients with GAD reported significantly higher levels of experiential avoidance and distress about emotions compared with nonclinical controls while controlling for depressive symptoms, and measures of these constructs significantly predicted GAD status. Additionally, experiential avoidance and distress about anxious, positive, and angry emotions shared unique variance with intolerance of uncertainty when negative affect was partialed out, whereas only experiential avoidance and distress about anxious emotions shared unique variance with worry. Discussion focuses on implications for treatment as well as future directions for research.     

Relationships Among Perceived Racial Stress, Intolerance of Uncertainty, and Worry in a Black Sample

The purpose of this study was to explore the relationships among chronic worry, perceived racial stress, and intolerance of uncertainty in a sample of adults who racially identify as Black. Intolerance of uncertainty has been associated with worry and generalized anxiety disorder in predominantly White samples. Given that racial stress is likely to increase worry, perhaps through the mechanism of intolerance of uncertainty, intolerance of uncertainty was hypothesized to mediate the relationship between perceived racial stress and chronic worry. A nonclinical sample of 77 Black undergraduate students at an urban university completed a series of questionnaires assessing the constructs of interest. Both perceived racial stress and intolerance of uncertainty were significantly correlated with chronic worry in this sample. Moreover, intolerance of uncertainty fully mediated the relationship between perceived racial stress and worry for these Black individuals. These findings are discussed in terms of directions for future research and implications for clinical interventions for Black individuals who are both exposed to racial stress and suffer from chronic worry.     

Intolerance of uncertainty,causal uncertainty,causal importance,self-concept clarity and their relations to generalized anxiety disorder

Although numerous studies have provided support for the notion that intolerance of uncertainty plays a key role in pathological worry (the hallmark feature of generalized anxiety disorder (GAD)), other uncertainty-related constructs may also have relevance for the understanding of individuals who engage in pathological worry. Three constructs from the social cognition literature, causal uncertainty, causal importance, and self-concept clarity, were examined in the present study to assess the degree to which these explain unique variance in GAD, over and above intolerance of uncertainty. N = 235 participants completed self-report measures of trait worry, GAD symptoms, and uncertainty-relevant constructs. A subgroup was subsequently classified as low in GAD symptoms (n = 69) or high in GAD symptoms (n = 54) based on validated cut scores on measures of trait worry and GAD symptoms. In logistic regressions, only elevated intolerance of uncertainty and lower self-concept clarity emerged as unique correlates of high (vs. low) GAD symptoms. The possible role of self-concept uncertainty in GAD and the utility of integrating social cognition theories and constructs into clinical research on intolerance of uncertainty are discussed.     

Intolerance of Uncertainty Mediates the Relation Between Generalized Anxiety Disorder Symptoms and Anger

Previous research has shown that individuals with generalized anxiety disorder (GAD) report elevated anger compared with nonanxious individuals; however, the pathways linking GAD and anger are currently unknown. We hypothesized that negative beliefs about uncertainty, negative beliefs about worry and perfectionism dimensions mediate the relationship between GAD symptoms and anger variables. We employed multiple mediation with bootstrapping on cross-sectional data from a student sample (N = 233) to test four models assessing potential mediators of the association of GAD symptoms to inward anger expression, outward anger expression, trait anger and hostility, respectively. The belief that uncertainty has negative personal and behavioural implications uniquely mediated the association of GAD symptoms to inward anger expression (confidence interval [CI] = .0034, .1845, P_M = .5444), and the belief that uncertainty is unfair and spoils everything uniquely mediated the association of GAD symptoms to outward anger expression (CI = .0052, .1936, P_M = .4861) and hostility (CI = .0269, .2427, P_M = .3487). Neither negative beliefs about worry nor perfectionism dimensions uniquely mediated the relation of GAD symptoms to anger constructs. We conclude that intolerance of uncertainty may help to explain the positive connection between GAD symptoms and anger, and these findings give impetus to future longitudinal investigations of the role of anger in GAD.     

The relationship between negative urgency and generalized anxiety disorder symptoms: the role of intolerance of negative emotions and intolerance of uncertainty

Background and Objectives: GAD symptoms are associated with greater negative urgency, a dimension of impulsivity defined as the tendency to act rashly when distressed. This study examined the degree to which intolerance of negative emotional states and intolerance of uncertainty account for the association between negative urgency and GAD symptoms. Design: An analysis of indirect effects evaluated whether intolerance of negative emotions and intolerance of uncertainty uniquely account for the association between negative urgency and GAD symptom severity. Methods: Undergraduate students (N?=?308) completed measures of GAD symptoms, trait anxiety, negative urgency, distress tolerance, and intolerance of uncertainty. Results: Greater symptoms of GAD, intolerance of negative emotional states, and intolerance of uncertainty were associated with greater negative urgency. There was an indirect relationship between negative urgency and GAD symptoms through intolerance of negative emotional states and intolerance of uncertainty even when controlling for trait anxiety. Intolerance of negative emotional states and intolerance of uncertainty each had an indirect relationship with GAD severity through negative urgency, suggesting possible bi-directional relations. Conclusions: Future studies should examine the role of intolerance of negative emotional states and intolerance of uncertainty in the impulsive behavior of individuals with GAD, and whether impulsive behavior reinforces these processes.     

无法忍受不确定性与担忧：对记忆偏差与解释偏差的检验

旨在是探索记忆偏差与解释偏差在无法忍受不确定性(IU)与个体担忧之间的机制作用。实验1采用伴随学习任务范式,计算被试对中性词语和不确定词的回忆量。结果发现,IU对记忆偏差的预测不显著,记忆偏差在IU与担忧倾向之间的中介作用不显著。实验2采用情境评估任务范式收集被试在不确定情境下的担忧评分和解释倾向。结果发现,IU可以正向预测被试在不确定情境下的担忧评分,被试对情境的解释倾向在IU与担忧评分的关系中起到中介作用。概言之,高IU个体存在一定的信息加工偏差     

Intolerance of Uncertainty, Fear of Anxiety, and Adolescent Worry

A 5 year, ten wave longitudinal study of 338 adolescents assessed the association between two forms of cognitive vulnerability (intolerance of uncertainty and fear of anxiety) and worry. Multilevel mediational analyses revealed a bidirectional and reciprocal relation between intolerance of uncertainty and worry in which change in one variable partially explained change in the other. Fear of anxiety and worry also showed evidence of a bidirectional relation, although change in fear of anxiety had a much weaker mediational effect on change in worry than vice versa. The findings show that relative to fear of anxiety, intolerance of uncertainty may play a greater role in the etiology of worry in adolescents.     

Age and gender differences in adolescent worry

The purpose of the present study was to explore gender and age differences in adolescent worry. High school students filled out measures of worry, negative problem orientation, intolerance of uncertainty, and general mental health. Girls and boys of different ages were then compared and the relationships between gender, beliefs about worry, intolerance of uncertainty, negative problem orientation and mental health were also examined. Boys reported greater negative problem orientation and intolerance of uncertainty while girls reported more positive beliefs about worry. Findings also revealed certain age trends, indicating that the variables under study may be under the influence of developmental tasks. Regression analysis was performed and positive beliefs about worry emerged as a significant predictor of worry in both sexes. Positive beliefs about worry and negative problem orientation appear to be the key processes in adolescent anxiety and depression.     

Understanding adolescent worry: the application of a cognitive model

The relationship between worry and 4 cognitive variables, intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance, was examined in an adolescent sample of 528 boys and girls aged 14–18. The participants completed questionnaires assessing worry, somatic anxiety symptoms, and the variables mentioned above. The results show that (a) intolerance of uncertainty, positive beliefs about worry, and negative problem orientation each account for a significant amount of variance in adolescent worry scores in the multiple regression, and (b) the discriminant function derived from the 4 variables is effective in classifying moderate and high worriers into their respective groups (72.8% correct classification). Furthermore, analyses demonstrate that intolerance of uncertainty has the strongest association with worry scores and is the most important variable in discriminating between moderate and high adolescent worriers. These results suggest that intolerance of uncertainty plays a key role in our understanding of adolescent worry.     

Intolerance of uncertainty and emotional distress following the death of a loved one

Abstract

Research has shown that intolerance of uncertainty (IU) – the tendency to react negatively to situations that are uncertain – is involved in worry and generalized anxiety disorder, as well as in other anxiety symptoms and disorders. To our knowledge, no studies have yet examined the association between IU and emotional distress connected with the death of a loved one. Yet, it seems plausible that those who have more difficulties to tolerate the uncertainties that oftentimes occur following such a loss experience more intense distress. The current study examined this assumption, using self-reported data from 134 bereaved individuals. Findings showed that IU was positively and significantly correlated with symptom levels of complicated grief and posttraumatic stress disorder (PTSD), even when controlling for time since loss (the single demographic/loss-related variable associated with symptom levels), and for neuroticism and worry, which are both correlates of IU. Furthermore, IU was specifically related with worry and symptom levels of PTSD, but not complicated grief, when controlling the shared variance between worry, complicated grief severity, and PTSD-severity. The present findings complement prior research that has shown that IU is a cognitive vulnerability factor for worry, and indicate that it may also be involved in emotional distress following loss.     

An Examination of Distress Intolerance in Undergraduate Students High in Symptoms of Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD) engage in maladaptive coping strategies to reduce or avoid distress. Evidence suggests that uncertainty and negative emotions are triggers for distress in people with GAD; however, there may also be other triggers. Recent conceptualizations have highlighted six types of experiences that people report having difficulty withstanding: uncertainty, negative emotions, ambiguity, frustration, physical discomfort, and the perceived consequences of anxious arousal. The present study examined the extent to which individuals high in symptoms of GAD are intolerant of these distress triggers, compared to individuals high in depressive symptoms, and individuals who are low in GAD and depressive symptoms. Undergraduate students (N = 217) completed self-report measures of GAD symptoms, depressive symptoms, and distress intolerance. Individuals high in GAD symptoms reported greater intolerance of all of the distress triggers compared to people low in symptoms of GAD and depression. Individuals high in GAD symptoms reported greater intolerance of physical discomfort compared to those high in depressive symptoms. Furthermore, intolerance of physical discomfort was the best unique correlate of GAD status, suggesting that it may be specific to GAD (versus depression). These findings support continued investigation of the transdiagnosticity and specificity of distress intolerance.     

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

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

Age-related differences in affective and cognitive empathy: self-report and performance-based evidence

The correlation between age and empathy is not clear, with prior findings yielding mixed and inconsistent results. Here, we distinguished between two aspects of empathy and respectively investigated the effects of age on the affective and cognitive facets of empathy using a self-report measure (interpersonal reactivity index, IRI) and performance-based tasks (viewing films). The results showed that older adults manifested age-related deficits in both trait and state cognitive empathy, with the latter being positively associated with memory. Otherwise, the overall affective empathy increased in the elderly, but the age-related differences in affective empathy may be qualified by the valence of the film clips. Specifically, older participants showed more empathic concern (EC) and less personal distress (PD) to other people’s emotions than the younger participants for the distress film. Interestingly, for the amusing film, older participants demonstrated more EC and PD. Overall, the two aspects of empathy have different development trajectories.     

Rethinking the Role of Worry in Generalized Anxiety Disorder: Evidence Supporting a Model of Emotional Contrast Avoidance

The Contrast Avoidance model (Newman & Llera, 2011) proposes that individuals with generalized anxiety disorder (GAD) are hypersensitive to sharp upward shifts in negative emotion that typically accompany negative events, and use worry to maintain sustained intrapersonal negativity in an attempt to avoid these shifts. Although research shows that worry increases negative emotionality and mutes further emotional reactivity to a stressor when compared to the worry period (e.g., Llera & Newman, 2010), no study has tracked changes in negative emotionality from baseline to worry inductions followed by a range of emotional exposures. Further, no study has yet assessed participants’ subjective appraisals of prior worry on helping to cope with such exposures. The present study tested the main tenets of the Contrast Avoidance model by randomly assigning participants with GAD (n = 48) and nonanxious controls (n = 47) to experience worry, relaxation, and neutral inductions prior to sequential exposure to fearful, sad, and humorous film clips. Both physiological (nonspecific skin conductance responses [NS-SCRs]) and self-reported emotional changes were observed. Results indicated that worry boosted negative emotionality from baseline, which was sustained across negative exposures, whereas low negative emotionality during relaxation and neutral inductions allowed for sharp increases in response to exposures. Furthermore, GAD participants found worry to be more helpful than other conditions in coping with exposures, whereas control participants reported the opposite pattern. Results provide preliminary support for the Contrast Avoidance model. This suggests that treatment should focus on underlying avoidance patterns before attempting to reduce worry behavior.     

Metacognitions,intolerance of uncertainty and worry: An investigation in adolescents

BackgroundCognitive models of Generalized Anxiety Disorder have mainly been tested in adult samples to date. Studies investigating whether the concepts are also applicable to worry in adolescents are largely lacking. The goal of the present study was to test the relationship between worry and key cognitive variables (positive and negative metacognitions; intolerance of uncertainty) in adolescents.MethodSecondary school students (N = 521) completed self-report measures of worry frequency, metacognitions, intolerance of uncertainty, and depression.ResultsResults showed a significant association between metacognitions, intolerance of uncertainty and worry, even after controlling for depression. In regression analyses, a substantial proportion of the variance of worry could be accounted for by the cognitive variables of interest.ConclusionsThe findings support the relevance of metacognitions and intolerance of uncertainty for understanding cognitive mechanisms underlying worry in adolescents. It appears useful to combine them into a more comprehensive integrated model.     

A Taxometric Investigation of the Latent Structure of Worry: Dimensionality and Associations With Depression, Anxiety, and Stress

Worry has been described as a core feature of several disorders, particularly generalized anxiety disorder (GAD). The present study examined the latent structure of worry by applying 3 taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from 2 large samples. Worry in the first sample (Study 1) of community participants (n = 1,355) was operationalized by worry engagement, absence of worry, and the worry feature of trait anxiety. Worry in the second sample (Study 2) of undergraduate participants (n = 1,171) was operationalized by the tendency to experience worry, intolerance of uncertainty, beliefs about worry, and symptoms of GAD. Results across both samples provided converging evidence that worry is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Findings from Study 2 also indicated that the latent dimension of worry generally has an equal association with symptoms of depression, anxiety, and stress across the entire continuum. These findings are discussed in relation to the conceptualization and assessment of worry in GAD and related disorders.     

Effects of worry on physiological and subjective reactivity to emotional stimuli in generalized anxiety disorder and nonanxious control participants

The present study examined the effect of worry versus relaxation and neutral thought activity on both physiological and subjective responding to positive and negative emotional stimuli. Thirty-eight participants with generalized anxiety disorder (GAD) and 35 nonanxious control participants were randomly assigned to engage in worry, relaxation, or neutral inductions prior to sequential exposure to each of four emotion-inducing film clips. The clips were designed to elicit fear, sadness, happiness, and calm emotions. Self reported negative and positive affect was assessed following each induction and exposure, and vagal activity was measured throughout. Results indicate that worry (vs. relaxation) led to reduced vagal tone for the GAD group, as well as higher negative affect levels for both groups. Additionally, prior worry resulted in less physiological and subjective responding to the fearful film clip, and reduced negative affect in response to the sad clip. This suggests that worry may facilitate avoidance of processing negative emotions by way of preventing a negative emotional contrast. Implications for the role of worry in emotion avoidance are discussed.     

Relationships Among the Sport Competition Anxiety Test,the Sport Anxiety Scale,and the Collegiate Hockey Worry Scale

This study examined the degree to which the Sport Competition Anxiety Test (SCAT; Martens, 1977) and the Sport Anxiety Scale (SAS; Smith, Smoll, & Schutz, 1990) shared variance with the four subscales of the Collegiate Hockey Worry Scale (CHWS; Dunn, 1999)a sport-specific measure of athletes' dispositional tendencies to worry about performance failure, negative social evaluation, physical danger, and situational uncertainty. Participants were 178 male intercollegiate ice hockey players. Correlation and regression analyses reinforced the links between worries about failure and negative social evaluation to competitive trait anxiety (CTA). However, neither the SCAT nor the SAS shared more than 5.8% of the variance surrounding athletes' worries pertaining to physical danger and situational uncertainty. Findings are discussed in the context of Martens, Vealey, and Burtons' (1990) recommendation to develop instruments with separate subscales measuring different situational components of CTA.