Changes in intolerance of uncertainty during cognitive behavior group therapy for social phobia

Mahoney, Alison; McEvoy, Peter M.

doi:10.1016/j.jbtep.2011.12.004

Cited by 77 publications

(43 citation statements)

References 40 publications

(59 reference statements)

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“…The intervention also included disorder-specific modules addressing exposure to internal and external cues (e.g., imaginal exposure to worry themes) and cognitive restructuring (e.g., generating alternative thoughts in response to catastrophic negative predictions). Modules did not specifically aim to target IU; however, in the course of therapy participants completed activities or discussed thoughts that may have addressed concerns about uncertainty (see Mahoney & McEvoy, 2012, and van der Heiden et al, 2012 for examples of general CBT's effects on IU). Modules were presented in a computer-assisted, interactive module format that directed the clinician and patient.…”

Section: Methodsmentioning

confidence: 99%

Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder

Bomyea

Ramsawh

Ball³

et al. 2015

Journal of Anxiety Disorders

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Growing evidence suggests that intolerance of uncertainty (IU) is a cognitive vulnerability that is a central feature across diverse anxiety disorders, including generalized anxiety disorder (GAD). Although cognitive behavioral therapy (CBT) has been shown to reduce IU, it remains to be established whether or not reductions in IU mediate reductions in worry. This study examined the process of change in IU and worry in a sample of 28 individuals with GAD who completed CBT. Changes in IU and worry, assessed bi-weekly during treatment, were analyzed using multilevel mediation models. Results revealed that change in IU mediated change in worry (ab = -0.20; 95% CI [-.35, -.09]), but change in worry did not mediate change in IU (ab = -0.16; 95% CI [-.06, .12]). Findings indicated that reductions in IU accounted for 59% of the reductions in worry observed over the course of treatment, suggesting that changes in IU are not simply concomitants of changes in worry. Findings support the idea that IU is a critical construct underlying GAD.

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Section: Methodsmentioning

confidence: 99%

Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder

Bomyea

Ramsawh

Ball³

et al. 2015

Journal of Anxiety Disorders

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“…For instance, increasing non-clinical individuals' tolerance of uncertainty may help preventing the development of GAD (Dugas, et al, 2001). Moreover, research has indicated that cognitive-behavioural treatment targeting IU is effective in reducing excessive worry in GAD patients Dugas, et al, 2003;, but also results in relief of SAD symptoms (Carleton, Collimore, et al, 2010;Mahoney and McEvoy, 2012), as many social-evaluative situations comprise a great deal of uncertainty (Boelen & Reijntjes, 2009). As mentioned earlier, individuals' scores on the subscales of the IUS may indicate which treatment strategies are most appropriate for a particular person (McEvoy & Mahoney, 2011).…”

Section: Cfa Indicated That the Ius-12 Model With The Two Factors Promentioning

confidence: 98%

Confirmatory factor analysis of the Dutch Intolerance of Uncertainty Scale: Comparison of the full and short version

Helsen

Bussche

Vlaeyen

et al. 2013

Journal of Behavior Therapy and Experimental Psychiatry

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Background and Objectives. The Intolerance of Uncertainty Scale (IUS) was developed for assessing reactions to ambiguous situations, uncertainty, and future events. The IUS has been validated in different languages, but equivocal factor structures, in combination with highly interrelated items and factors, resulted in a redundancy of the items of the English version. In the current study, the psychometric properties of the Dutch version of the IUS were examined, and compared with the shortened 12-item version (IUS-12).Methods. Confirmatory factor analyses were used to investigate different factor structures of both the full and short version of the IUS. Results. Results indicated that the IUS-12 model with two factors (ProspectiveAnxiety and Inhibitory Anxiety) provides the best fit. The reduced measure has equally good internal consistency, and is highly correlated with the full version.Limitations. Future research could investigate whether the current findings generalize to clinical populations. Conclusion.To summarize, the usage of the short 12-item version of the IUS should be encouraged in future research concerning intolerance of uncertainty.

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“…Future researchers should strive to understand the connections between genetic, neural, and cognitive correlates, all of which may facilitate IU and psychopathology (Sanislow et al, 2010). Advancing our understanding of the neurobiological, genetic, and environmental origins of IU is important for advancing our understanding of multifinality and divergent disorder-specific trajectories, as well as preventative and therapeutic interventions (Mahoney & McEvoy, 2012b;Simmons et al, 2008;Wever et al, 2015).…”

Section: What Is Unknown?mentioning

confidence: 99%

“…Research has also examined other cognitive-behavioral interventions that do not specifically target IU, but nonetheless have shown a reduction in IU and symptoms of social anxiety (Hewitt, Egan, & Rees, 2009;Mahoney & McEvoy, 2012b), health anxiety (Langlois & Ladouceur, 2004), anxiety and depressive disorders (Bomyea et al, 2015), delivered as individual and group transdiagnostic interventions (Boswell et al, 2013; Abramowitz and Arch (2014) made a compelling argument that exposure-driven cognitive-behavioral treatment for obsessive-compulsive disorder may benefit from strengthening inhibitory learning of nonthreatening associations (e.g., uncertainty is intolerable), such that uncertainty becomes increasingly acceptable as normal across contexts. Abramowitz and Arch (2014) suggest treatment should emphasize tolerating uncertainty through exposure, which may strengthen inhibitory associations.…”

Section: What Is Known?mentioning

confidence: 99%

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

Shihata

McEvoy

Mullan

et al. 2016

Journal of Anxiety Disorders

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189

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The current paper presents a future research agenda for intolerance of uncertainty (IU), which is a transdiagnostic risk and maintaining factor for emotional disorders. In light of the accumulating interest and promising research on IU, it is timely to emphasize the theoretical and therapeutic significance of IU, as well as to highlight what remains unknown about IU across areas such as development, assessment, behavior, and relationships to emotional disorders. The present paper was designed to provide a synthesis of what is known and unknown about IU, and, in doing so, proposes broad and novel directions for future research to address the remaining uncertainties in the literature.Keywords: intolerance of uncertainty, review, emotional disorders, transdiagnostic, disorder-specific, research agenda WHAT UNCERTAINTIES REMAIN? 3 Intolerance of Uncertainty in Emotional Disorders: What Uncertainties Remain?The current paper briefly reviews what is known about intolerance of uncertainty (IU) before highlighting what remains unknown. Due to rapidly increasing interest and research focus on IU, culminating in the current special issue, a review is both timely and necessary to set a future research agenda. This paper will review IU with respect to conceptual foundations and definitional issues, development, assessment, behavioral consequences, associations to threat and risk, other cognitive vulnerability factors, emotional disorders, as well as clinical applications.Within each of these domains, what is currently known will first be briefly reviewed followed by what remains unknown. The major contribution of the current paper is the description of future research avenues to address the known unknowns. Conceptual Foundations of Intolerance of Uncertainty What is known?Models of psychopathology posit that uncertainty is a central feature in anxiety-related experience (Carleton, 2016) and the incapacity to endure unknowns appears to be a robust vulnerability factor associated with a range of psychological disorders (Grupe & Nitschke, 2013;Hong & Cheung, 2015). IU was originally defined as a broad construct that reflects "cognitive, emotional, and behavioral reactions to uncertainty in everyday life situations" (Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994, p. 792). Freeston and colleagues (1994) speculated that people with IU may engage in worry to increase their sense of certainty and control when faced with ambiguity. The definition of IU evolved as research on IU shifted from an initial focus on generalized anxiety disorder (GAD) to other disorders. A revised and broader definition described IU as a predisposition to negatively perceive and respond to uncertain information and situations irrespective of its probability and outcomes (Ladouceur, Blais, WHAT UNCERTAINTIES REMAIN? 4 Freeston, & Dugas, 1998;Ladouceur, Gosselin, & Dugas, 2000). IU has also been conceptualized as a cognitive filter and as the excessive tendency to perceive and interpret negative events as unacceptable (Buhr & Dugas...

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Changes in intolerance of uncertainty during cognitive behavior group therapy for social phobia

Cited by 77 publications

References 40 publications

Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder

Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder

Confirmatory factor analysis of the Dutch Intolerance of Uncertainty Scale: Comparison of the full and short version

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

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