A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive–compulsive disorder

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Abstract

Intolerance of uncertainty (IU) has been suggested to reflect a specific risk factor for generalized anxiety disorder (GAD), but there have been no systematic attempts to evaluate the specificity of IU to GAD. This meta-analysis examined the cross-sectional association of IU with symptoms of GAD, major depressive disorder (MDD), and obsessive–compulsive disorder (OCD). Random effects analyses were conducted for two common definitions of IU, one that has predominated in studies of GAD (56 effect sizes) and another that has been favored in studies of OCD (29 effect sizes). Using the definition of IU developed for GAD, IU shared a mean correlation of .57 with GAD, .53 with MDD, and .50 with OCD. Using the alternate definition developed for OCD, IU shared a mean correlation of .46 with MDD and .42 with OCD, with no studies available for GAD. Post-hoc significance tests revealed that IU was more strongly related to GAD than to OCD when the GAD-specific definition of IU was used. No other differences were found in the magnitude of associations between IU and the three syndromes. We discuss implications of these findings for models of shared and specific features of emotional disorders and for future research efforts.

Research highlights

► Past findings on association of IU to anxiety and mood disorders are inconsistent. ► Intolerance of uncertainty is associated with GAD, MDD, and OCD. ► Strength of association depends on IU measure and population sampled.

Section snippets

Literature search

Relevant studies were identified via PsycINFO searches through August 2010 using combinations of the following keywords: uncertainty, intolerance of ambiguity, tolerance for ambiguity, tolerance of ambiguity WITH generalized anxiety disorder, generalised anxiety disorder, GAD, worry, depression, major depressive disorder, rumination, obsessive compulsive disorder, obsessive–compulsive disorder, OCD, and obsession. Searches were limited to studies that were written in English, sampled from adult

Results

Effect sizes have been converted from Fisher's Z values back to r values for clarity of presentation.

Discussion

The current paper estimated the relationship of IU to symptoms of GAD, MDD, and OCD using two separate definitions of IU, one developed in relation to GAD and operationalized by scores on the IUS, and a second developed in relation to OCD and operationalized by scores on the OBQ. Using both definitions, IU was found to be significantly related to symptoms of GAD, MDD, and OCD. Thus, according to established guidelines for etiological specificity (Garber & Hollon, 1991), IU did not demonstrate

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    References marked with an asterisk indicate studies included in the meta-analysis.

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