Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression

doi:10.1016/j.janxdis.2012.01.011

Journal of Anxiety Disorders

Volume 26, Issue 3, April 2012, Pages 468-479

https://doi.org/10.1016/j.janxdis.2012.01.011 Get rights and content

Abstract

Intolerance of uncertainty (IU) – a dispositional characteristic resulting from negative beliefs about uncertainty and its implications – may be an important construct in anxiety disorders and depression. Despite the potential importance of IU, clinical data on the construct remains relatively scant and focused on generalized anxiety disorder and obsessive-compulsive disorder. The present study systematically investigated IU, as measured by the Intolerance of Uncertainty Scale-12 (IUS-12), across groups diagnosed with anxiety disorders (i.e., social anxiety disorder, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder) or depression (clinical sample: n = 376; 61% women), as well as undergraduate (n = 428; 76% women) and community samples (n = 571; 67% women). Analysis of variance revealed only one statistically significant difference in IUS-12 scores across diagnostic groups in the clinical sample; specifically, people with social anxiety disorder reported higher scores (p < .01; η² = .03) than people with panic disorder. People diagnosed with an anxiety disorder or depression reported significantly and substantially higher IUS-12 scores relative to community and undergraduate samples. Furthermore, IUS-12 score distributions were similar across diagnostic groups as demonstrated by Kernel density estimations, with the exception of panic disorder, which may have a relatively flat distribution of IU. Response patterns were invariant across diagnostic groups as demonstrated by multi-group confirmatory factor analyses, but varied between clinical and nonclinical samples. Overall, the findings suggest IU may serve as an important transdiagnostic feature across anxiety disorders and depression. In addition, robust support was found for the proposed 2-factor model of the IUS-12. Comprehensive findings, implications, and future research directions are discussed.

Highlights

► We assess intolerance of uncertainty scores across anxiety disorders and depression. ► We demonstrate invariant response patterns across anxiety disorders and depression. ► We provide robust support for a two-factor structure for the IUS-12.

Section snippets

Participants

The primary participants for this study included patients (n = 376; 146 men [M_age = 36.55; SD = 13.58] and 230 women [M_age = 35.09; SD = 11.81]) from an established outpatient anxiety treatment and research center. Participants received a principal Axis I diagnosis based upon the disorder that was found to be most disabling at the time of the assessment, including SAD (n = 120; 32%), panic disorder with or without agoraphobia (PDA; n = 89; 24%), GAD (n = 63; 17%), OCD (n = 60; 16%), or major depressive disorder

Descriptive statistics and sex comparisons

Descriptive statistics are presented in Table 2. There was a higher proportion, χ²(2) = 21.56, p < .01, V = .13, of women in the undergraduate sample (76%) relative to the clinical sample (61%) and the community sample (67%). There were no differences in age between the diagnostic groups, F(4, 351) = 2.24, p > .05, eta² = .03; however, the undergraduate sample was significantly younger than the community sample (mean difference = 7.14; p < .01), which was significantly younger than the clinical sample (mean

Discussion

The present study makes three important contributions to the IU literature. First, the study presents the first direct comparative analyses of IU response patterns and empirical distributions – as measured by the IUS-12 – across clinical samples of people endorsing criteria for a principal diagnosis of GAD, OCD, SAD, PDA, or MDD relative to undergraduate and community samples. Doing so provided an empirical assessment of how IU may not be specific to any given anxiety disorders or depression,

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