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Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.

This study examined the factor structure of the English version of the Intolerance of Uncertainty Scale (IUS; French version: M. H. Freeston, J. Rhéaume, H. Letarte, M. J. Dugas, & R. Ladouceur, 1994; English version: K. Buhr & M. J. Dugas, 2002) using a substantially larger sample than has been used in previous studies. Nonclinical undergraduate students and adults from the community (M age = 23.74 years, SD = 6.36; 73.0% female and 27.0% male) who participated in 16 studies in the Anxiety Disorders Laboratory at Concordia University in Montreal, Canada were randomly assigned to 2 datasets. Exploratory factor analysis with the 1st sample (n = 1,230) identified 2 factors: the beliefs that "uncertainty has negative behavioral and self-referent implications" and that "uncertainty is unfair and spoils everything." This 2-factor structure provided a good fit to the data (Bentler-Bonett normed fit index = .96, comparative fit index = .97, standardized root-mean residual = .05, root-mean-square error of approximation = .07) upon confirmatory factor analysis with the 2nd sample (n = 1,221). Both factors showed similarly high correlations with pathological worry, and Factor 1 showed stronger correlations with generalized anxiety disorder analogue status, trait anxiety, somatic anxiety, and depressive symptomatology.

Several studies have been conducted to examine whether the construct of intolerance of uncertainty (IU) (Dugas, Gagnon, Ladouceur, & Freeston, Behaviour Research and Therapy, 36, 215-226, 1998b) meets formal criteria as a cognitive vulnerability for excessive and uncontrollable worry. Cognitive models of anxiety suggest that vulnerability is manifest in the manner in which individuals process information. As such, cognitive bias is expected to be observed in individuals characterized by high levels of a putative cognitive vulnerability. In this study, individuals low (n = 110) and high (n = 89) on IU were compared on their appraisals of ambiguous, negative, and positive situations. Individuals high on IU appraised all situation types as more disconcerting relative to the comparison group. However, when controlling for demographics, generalized anxiety disorder (GAD) symptoms, and mood variables, the groups differed only in their appraisals of ambiguous situations. Further, in the high-vulnerability group, degree of IU was a stronger predictor of appraisals of ambiguous situations than were GAD symptoms and mood variables. Tests of mediation showed that appraisals of ambiguous situations partly mediated the relationship of IU to worry, the main symptom of GAD; however, worry also emerged as a partial mediator of the relation of IU to appraisals of ambiguous situations. An exploratory analysis revealed that in individuals high on IU, appraisals were not specific to the content of current worries, whereas they were to some extent in individuals low on IU. The results are discussed within the context of findings emerging from cognitive models of GAD, in particular the model proposed by Dugas et al. (1998b).