The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder

Distress tolerance (DT) and intolerance of uncertainty (IU) have been identified as transdiagnostic processes that predict symptom severity across a range of distinct anxiety disorders. However, the joint effect of these two variables on therapeutic outcome has not yet been examined. It is possible that DT and IU may both impact on treatment response to cognitive-behavioural therapy (CBT) in clients with anxiety, as clients with weak DT and strong IU may be less likely to engage in exposure and cognitive restructuring tasks across treatment due to their associated distress. The purpose of this study was to examine the interaction of DT and IU as predictors of post-treatment symptom severity and treatment response to group CBT in participants with primary DSM-IV-TR diagnosed social anxiety disorder (SAD). Participants (N = 95) with SAD completed 12 weeks of manualized group CBT. Results of multilevel longitudinal analysis demonstrated an interaction effect, such that lower DT and higher IU predicted higher SAD symptom severity across the course of therapy. The findings are discussed in terms of clinical implications for the disorder-specific and transdiagnostic treatment of anxiety disorders.     

The Central Role of Group-Based Hatred as an Emotional Antecedent of Political Intolerance: Evidence from Israel

In recent years, political scientists have shifted the focus of explaining political phenomena from the purely cognitive perspective to an integrated emotion-cognition one. Yet most studies which examine antecedents of political intolerance ignore the potential role played by "gut feelings" or group-based negative emotions in endorsing those attitudes. Moreover, even the few studies that deal with emotions and intolerance concentrate exclusively on the role of groups of emotions (positive vs. negative, dispositional vs. surveillance) or on basic emotions (anger or fear) and ignore the potential influence of more complex discrete emotions like hatred on political intolerance. Hence, the main goal of this study was to create a deeper understanding regarding the role of discrete negative emotions in increasing political intolerance among different groups of individuals in different contexts. In order to do so, the relations between political intolerance and three group-based negative emotions (hatred, anger, and fear) were tested by means of four large-scale nationwide surveys. Within the surveys, various intolerance measurement methods were used in various contexts (wartime vs. no-war/routine periods) and among individuals with different levels of political sophistication. Results, obtained via multiple regression analysis and structural equation modeling, show that: (1) Group-based hatred is the most important antecedent of political intolerance even when controlling for important intolerance inducers such as perceived threat. (2) Other group-based negative emotions like anger or fear influence political intolerance wholly through the mediation of hatred or perceived threat. (3) The role of group-based hatred in inducing political intolerance is more substantial in the face of heightened existential threat and among unsophisticated individuals than among sophisticated ones.     

Behavioral Experiments for Intolerance of Uncertainty: Challenging the Unknown in the Treatment of Generalized Anxiety Disorder

Intolerance of uncertainty (IU) is implicated in the development and maintenance of generalized anxiety disorder (GAD). Although an efficacious cognitive-behavioral treatment (CBT) targeting IU and associated factors has been established, approximately 20–30% of participants do not achieve full remission by posttreatment. IU remains elevated in these individuals. In addition, GAD treatments need greater parsimony and efficiency. To that end, we developed a novel, focused CBT protocol exclusively targeting IU via behavioral experiments. Treatment consists of three modules applied over 12 sessions: (a) psychoeducation and uncertainty awareness training, (b) behavioral experiments targeting IU, and (c) relapse prevention. The present article describes each treatment component, as well as additional considerations for therapists. We conducted a preliminary investigation of efficacy with seven (N = 7) participants with a primary diagnosis of GAD. Results indicated substantial decreases in GAD symptoms, general psychopathology, and IU by posttreatment that were generally maintained at 6-month follow-up. Six of seven participants demonstrated moderate to high end-state functioning at posttreatment and 6-month follow-up. Research and clinical implications are discussed.     

Frustration Intolerance as a Multidimensional Concept

The Rational Emotive Behavior Therapy (REBT) concept of frustration intolerance is briefly reviewed and placed in historical context. It is argued that this concept includes a wide range of belief content, and is best considered as a multidimensional construct. A multidimensional model is presented, and the implications for theory and practice discussed.     

Unemployment and civil commitment: a test of the intolerance hypothesis

We theorize that the reported association between economic indicators and the incidence of civil commitment for mental illness may result, at least in part, from reduced tolerance in the community for impaired behavior among minorities. Earlier work suggests that economically induced intolerance will be focused primarily on minority males. Based on this literature, we hypothesize that the median level of functioning among African-American males subjected to civil commitment will vary positively with earlier changes in the unemployment rate. The test applies Box-Jenkins methods to 156 months (August 1985-July 1998) of data from California. Consistent with theory, results support the hypothesis.     

DIMENSIONS OF FRUSTRATION INTOLERANCE AND THEIR RELATIONSHIP TO SELF-CONTROL PROBLEMS

Frustration intolerance beliefs are central to the theory and practice of Rational Emotive Behavior Therapy. However, there has been little investigation of the content of these beliefs, and empirical evidence linking specific beliefs to distinct psychological problems is sparse. To redress this, the Frustration–Discomfort Scale has been developed as a multidimensional measure. This was used to explore the relationship between the four dimensions of frustration intolerance (emotional intolerance, demands for entitlement, comfort, and achievement) and problems of self-control. Results indicated that the Frustration–Discomfort sub-scales showed differential relationships with self-control problems, independent of self-worth beliefs. This supported the validity and usefulness of the scale and the importance of distinguishing between dimensions of frustration intolerance. This paper is based on research submitted to the University of Edinburgh in part fulfillment of a Doctorate of Philosophy degree. Address correspondence to Neil Harrington, Psychology Department, Stratheden Hospital, Cupar, Fife, KY15 5RR, UK; e-mail: neil@nharr.freeserve.co.uk.     

Stress and worry: examining intolerance of uncertainty's moderating effect

Intolerance of uncertainty (IU), or the way an individual perceives, interprets, and reacts to uncertainty in life, has been frequently investigated in relation to anxiety and worry. While a substantial body of research suggests that individual differences in IU foster stress and anxiety, IU's involvement as a potential moderator in the relation between stressful events and worry has only recently been investigated. Therefore, the present study examined the moderating effect of IU on the relation between daily hassles and worry as well as major life events and worry in a sample of 1092 young adults. Results revealed that IU showed a significant moderation effect in the relation between daily stress and worry. More specifically, when the two factors were examined individually only inhibitory IU served as a moderator between daily stress and worry. While major life events significantly predicted worry, no moderation effect was found for this relation. These findings highlight the need to better understand the mechanisms through which IU impacts worry and contributes to anxiety.     

The Differential Effects of Right‐Wing Authoritarianism and Social Dominance Orientation on Political Intolerance

Decades of scholarship have identified several determinants of political intolerance, including authoritarianism and normative threat. Previous attempts in the literature to associate other individual difference variables (i.e., social dominance orientation [SDO]) and situational variables (i.e., out‐groups' gains in power and status) have been unsuccessful. Using a dual‐process motivational (DPM) model framework, in Study 1 we found that SDO predicted political intolerance of groups with hierarchy‐attenuating political objectives. This relationship was consistent over and above other well‐known predictors of political intolerance, including right‐wing authoritarianism (RWA). RWA predicted intolerance of groups with both hierarchy‐attenuating and cohesion‐reducing objectives. In Study 2, we manipulated whether an immigrant‐rights group was described as presenting a normative threat or as gaining power and status. Consistent with extant findings, RWA moderated the effect of normative threat on political intolerance. More interestingly, SDO moderated the effect of gains in power and status on political intolerance. The implications of these findings are discussed.     

The Country's Crime Rate Moderates the Relation Between Authoritarian Predispositions and the Manifestations of Authoritarianism: A Multilevel,Multinational Study

We performed a multilevel, multinational test of Stenner's model on authoritarianism using the 2008 European Values Survey dataset (N = 55 199, nested in 38 nations). We focussed on the effects exerted on four authoritarian manifestations (racial intolerance, political intolerance, negative attitudes towards immigrants, and moral intolerance) by the cross‐level interaction between participants' authoritarian predispositions (assessed in terms of childrearing values) and their country's crime rate. Associations between authoritarian predispositions and racial intolerance, political intolerance, negative attitudes towards immigrants, and moral intolerance were significantly stronger among participants living in countries characterised by high crime rates than those among participants living in countries with low crime rates. Limitations, implications, and future directions of this study are discussed. Copyright © 2013 European Association of Personality Psychology.     

Behavioral Experiments for Intolerance of Uncertainty: A Randomized Clinical Trial for Adults With Generalized Anxiety Disorder

Sophisticated multicomponent treatments for adults with generalized anxiety disorder (GAD) have been developed over the past three decades. Although these comprehensive treatments have produced encouraging results, they appear to be less efficacious than treatments for other anxiety disorders. The goal of this randomized controlled trial is to test a newly developed, highly focused treatment for adults with GAD: Behavioral Experiments for Intolerance of Uncertainty. Sixty (60) participants (51 women, 9 men), with a mean age of 34.60 years (range: 19 to 67 years), were randomized to either treatment (n = 30) or wait-list control (n = 30). Treatment consisted of 12 weekly 1-hour sessions in which participants learned to use behavioral experiments to test their catastrophic beliefs about uncertainty. Assessments were conducted at pre-, mid- and postcondition, and at 6- and 12-month follow-up. The primary outcome was the severity of GAD, and secondary outcomes were worry, depression, somatic anxiety, and intolerance of uncertainty. Using growth curve modeling, we found that (1) the treatment group was superior to the wait-list group in terms of change from pre- to posttest on all outcomes; (2) the combined sample (once wait-listed participants received treatment) evidenced large and significant decreases on all outcomes; and (3) treatment gains were either maintained or increased over the 12-month follow-up period of the study. The new treatment is a promising treatment option for adults with GAD considering that it may be as efficacious as more comprehensive evidence-based psychological treatments for GAD.