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01-08-2013 | Original Article

The Interactive Effect of Worry and Intolerance of Uncertainty on Posttraumatic Stress Symptoms

Auteurs: Joseph R. Bardeen, Thomas A. Fergus, Kevin D. Wu

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 4/2013

Abstract

In this study, relations among worry, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSS) were examined in N = 89 participants with a trauma history. Both worry and IU shared significant zero-order correlations with each of the three DSM-IV posttraumatic stress symptom clusters. Partial correlations, controlling for the overlap among the symptom clusters, suggested that both worry and IU shared unique associations only with hyperarousal. Finally, and consistent with predictions, IU moderated the relation between worry and PTSS. When examining each PTSS cluster separately, evidence of the moderating role of IU was found only in relation to hyperarousal. More specifically, simple effects revealed that worry had a significant positive association with PTSS and hyperarousal only at high levels of IU. These findings suggest a specific risk profile of high worry in conjunction with high IU for the development and maintenance of PTSS, with particular relevance to hyperarousal symptoms. Conceptual and practical implications of these findings regarding common PTSD treatment approaches are discussed.

vorige artikel Intolerance of Uncertainty and Uncertainty-Related Attentional Biases: Evidence of Facilitated Engagement or Disengagement Difficulty?

volgende artikel Managing Obsessive Thoughts During Brief Exposure: An Experimental Study Comparing Mindfulness-Based Strategies and Distraction in Obsessive–Compulsive Disorder

Criterion A2 has limited clinical utility and is the topic of debate (Bovin and Marx 2011; Kilpatrick et al. 2009; Kubany et al. 2010). In fact, its exclusion from the DSM-5 PTSD diagnostic criteria has been strongly encouraged (Friedman et al. 2011). As such, we also ran all regression models with the larger sample of participants who endorsed a potentially traumatic event (N = 106; i.e., Criterion A1); that is, participants did not need to also endorse Criterion A2. For this larger sample, the interaction and follow-up simple effects were unchanged; statistically significant findings remained significant and nonsignificant findings remained nonsignificant.

Among the 15 (17%) participants who met DSM PTSD Criteria B, C, and D (i.e., 1+ symptom of reexperiencing, 3+ symptoms of avoidance, and 2+ symptoms of hyperarousal), the IUS-12 total score (M = 31.21, SD = 8.96) was lower than in other anxiety disorder samples, including social anxiety (M = 41.65, SD = 10.23), panic (M = 37.01, SD = 12.45), generalized anxiety (M = 40.38, SD = 11.26), and obsessive–compulsive (M = 40.78, SD = 10.71; Carleton et al., 2012). The small size and student nature from which this subset was drawn should be taken into account when considering the generalizability of this finding to individuals with PTSD.

To ensure that the observed interaction effects were not due to associations among IU, worry, general anxiety, or depressed mood rather than specific to posttraumatic stress, we ran all regression models in 46 participants who endorsed at least moderate levels of reexperiencing symptoms. That is, all participants met Schnurr et al.’s (1993) criteria for “partial PTSD” in reference to the reexperiencing symptom cluster. The interaction and follow-up simple effects were unchanged; statistically significant associations remained significant and nonsignificant findings remained nonsignificant.

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Titel: The Interactive Effect of Worry and Intolerance of Uncertainty on Posttraumatic Stress Symptoms
Auteurs: Joseph R. Bardeen
Thomas A. Fergus
Kevin D. Wu
Publicatiedatum: 01-08-2013
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 4/2013
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-012-9512-1

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