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

Gentes, Emily L.; Ruscio, Ayelet Meron

doi:10.1016/j.cpr.2011.05.001

Cited by 485 publications

(404 citation statements)

References 65 publications

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“…However, although a cueing procedure similar to ours was implemented in that study, the participants were explicitly informed that the neutral and aversive pictures occurred equiprobably after uncertain cues. Since IU is associated with increased sensitivity and negative emotion toward uncertainty (Gentes & Ruscio, 2011), this information might have failed to induce sufficient subjective uncertainty, and thus reduced uncertainty-related processes in low-IU individuals. In fact, the lack of any knowledge about the contingencies related to the uncertain cue in the present study may have been an important factor driving attentional allocation.…”

Section: Discussionmentioning

confidence: 99%

Uncertainty is associated with increased selective attention and sustained stimulus processing

Dieterich

Endraß

Kathmann

2016

Cogn Affect Behav Neurosci

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Uncertainty about future threat has been found to be associated with an overestimation of threat probability and is hypothesized to elicit additional allocation of attention. We used event-related potentials to examine uncertainty-related dynamics in attentional allocation, exploiting brain potentials' high temporal resolution and sensitivity to attention. Thirty participants performed a picture-viewing task in which cues indicated the subsequent picture valence. A certain-neutral and a certain-aversive cue accurately predicted subsequent picture valence, whereas an uncertain cue did not. Participants overestimated the effective frequency of aversive pictures following the uncertain cue, both during and after the task, signifying expectancy and covariation biases, and they tended to express lower subjective valences for aversive pictures presented after the uncertain cue. Pictures elicited increased P2 and LPP amplitudes when their valence could not be predicted from the cue. For the LPP, this effect was more pronounced in response to neutral pictures. Uncertainty appears to enhance the engagement of early phasic and sustained attention for uncertainly cued targets. Thus, defensive motivation related to uncertainty about future threat elicits specific attentional dynamics implicating prioritization at various processing stages, especially for nonthreatening stimuli that tend to violate expectations.

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Section: Discussionmentioning

confidence: 99%

Uncertainty is associated with increased selective attention and sustained stimulus processing

Dieterich

Endraß

Kathmann

2016

Cogn Affect Behav Neurosci

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“…IU has been found to be associated with, and to mediate, symptoms of social anxiety disorder, panic disorder and agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, and depression (Boelen & Reijntjes, 2009;Carleton, Collimore, & Asmundson, 2010;Carleton, Mulvogue, Thibodeau, McCabe, Antony, & Asmundson, 2012;Dugas, Gosselin, & Ladouceur, 2001;Gentes & Ruscio, 2011;Holaway, Heimberg, & Coles, 2006;Lind & Boschen, 2009;Mahoney & McEvoy, 2012a, b;McEvoy & Mahoney, 2011. The S-REF model (Wells & Matthews, 1996) is a transdiagnostic model describing the contribution of metacognitions to engagement in the Cognitive Attentional Syndrome (CAS), which consists of RNT along with heightened self-focus, maladaptive coping behavior, and threat monitoring.…”

Section: Introductionmentioning

confidence: 99%

Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders

McEvoy

Mahoney

2013

Journal of Anxiety Disorders

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This study aimed to replicate and extend a hierarchical model of vulnerability to worry, with neuroticism and extraversion as higher-order factors and negative metacognitions and intolerance of uncertainty as second-order factors. The model also included a transdiagnostic measure of repetitive negative thinking (RNT) and depression symptoms as outcome variables to determine whether relationships would extend beyond worry, which has traditionally been studied within the context of generalized anxiety disorder (GAD). Participants (N = 99) were referrals to a specialist anxiety disorders clinic with a principal anxiety disorder who completed a battery of self-report questionnaires assessing neuroticism, extraversion, metacognitions, intolerance of uncertainty, worry, RNT, and depression symptoms.Mediational analyses using bootstrapping provided support for transdiagnostic and diagnosis-specific mediation effects. Negative metacognitions fully mediated the relationship between neuroticism and RNT for the whole sample and for subsamples with and without generalized anxiety disorder (GAD). Intolerance of uncertainty mediated the relationship between neuroticism and worry (for the whole sample and for those with GAD) and between neuroticism and RNT (for those with GAD).Implications for theory, treatment, and nosology are discussed.

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“…We are not aware of studies in more specialized settings or in settings using more standardized diagnostic instruments, where diagnostic classification may be more accurate. On the other hand, while both the PSWQ and IUS‐12 measure constructs closely related to GAD, neither worrying nor intolerance of uncertainty are exclusively related to GAD but also present in MD (Carleton et al., 2012; Chelminski & Zimmerman, 2003; Gentes & Ruscio, 2011; Starcevic, 1995). Screening questionnaires designed specifically for GAD such as the GAD‐7, the ASQ or dimensional ratings such as the dimensional anxiety scales for DSM‐5 (dimensional scale for GAD: GAD‐D; Beesdo‐Baum et al., 2012; Lebeau et al., 2012) may therefore be better suited for the task of detecting GAD and might have supported diagnostic classification.…”

Section: Discussionmentioning

confidence: 99%

Separating generalized anxiety disorder from major depression using clinical, hormonal, and structural MRI data: A multimodal machine learning study

et al. 2017

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BackgroundGeneralized anxiety disorder (GAD) is difficult to recognize and hard to separate from major depression (MD) in clinical settings. Biomarkers might support diagnostic decisions. This study used machine learning on multimodal biobehavioral data from a sample of GAD, MD and healthy subjects to differentiate subjects with a disorder from healthy subjects (case‐classification) and to differentiate GAD from MD (disorder‐classification).MethodsSubjects with GAD (n = 19), MD without GAD (n = 14), and healthy comparison subjects (n = 24) were included. The sample was matched regarding age, sex, handedness and education and free of psychopharmacological medication. Binary support vector machines were used within a nested leave‐one‐out cross‐validation framework. Clinical questionnaires, cortisol release, gray matter (GM), and white matter (WM) volumes were used as input data separately and in combination.ResultsQuestionnaire data were well‐suited for case‐classification but not disorder‐classification (accuracies: 96.40%, p < .001; 56.58%, p > .22). The opposite pattern was found for imaging data (case‐classification GM/WM: 58.71%, p = .09/43.18%, p > .66; disorder‐classification GM/WM: 68.05%, p = .034/58.27%, p > .15) and for cortisol data (38.02%, p = .84; 74.60%, p = .009). All data combined achieved 90.10% accuracy (p < .001) for case‐classification and 67.46% accuracy (p = .0268) for disorder‐classification.ConclusionsIn line with previous evidence, classification of GAD was difficult using clinical questionnaire data alone. Particularly cortisol and GM volume data were able to provide incremental value for the classification of GAD. Findings suggest that neurobiological biomarkers are a useful target for further research to delineate their potential contribution to diagnostic processes.

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

Cited by 485 publications

References 65 publications

Uncertainty is associated with increased selective attention and sustained stimulus processing

Uncertainty is associated with increased selective attention and sustained stimulus processing

Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders

Separating generalized anxiety disorder from major depression using clinical, hormonal, and structural MRI data: A multimodal machine learning study

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