Intolerance of Uncertainty–Focused Treatment for Adolescents With Excessive Worry: A Pilot Feasibility Study

Wahlund, Tove; Andersson, Erik; Jolstedt, Maral; Perrin, Sean; Vigerland, Sarah; Serlachius, Eva

doi:10.1016/j.cbpra.2019.06.002

Cited by 28 publications

(21 citation statements)

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“…However, no significant changes were found for positive beliefs about worry. The same pattern of findings for the four cognitive processes were reported by both Holmes et al (2014) and Wahlund et al (2019). This trial was not designed to test for mediation and so it not possible to conclude that changes in the primary or secondary outcomes occurred because of changes in IU, cognitive avoidance, or negative problem orientation, or that the interventions themselves were responsible for any observed changes in these processes.…”

Section: Discussionmentioning

confidence: 71%

“…The five-item measures of IU, CA, and PBW were also administered to 515 British youth (aged 7-19 years) and found to have high levels of internal consistency, similar factor structures as the fulllength originals, and to correlate (positively) in the moderate to large range with self-reported worry and anxiety (Fialko et al 2012). Swedish-language versions of the same fiveitem cognitive process measures used in this trial were found to be sensitive to the effects of an IU-focused CBT program for excessive worry in adolescents (aged 13-18 years) (Wahlund et al 2019). Intolerance of Uncertainty (IU) was assessed using the child-report, Brief Intolerance of Uncertainty Scale (Brief-IUS; Fialko et al 2012).…”

Section: Cognitive Processes From the Laval Model Of Worrymentioning

confidence: 69%

“…The absence of findings for positive beliefs about worry in the present trial requires further comment. It is possible that the lack of change in this process during treatment, not just in this trial but also in Holmes et al (2014) and Wahlund et al (2019), reflects a problem with the way that positive beliefs about worry were measured. Both this trial and Wahlund et al (2019), used a 5-item version of the 25-item, Why Worry Scale-II scale for adults (Holowka et al 2000).…”

Section: Discussionmentioning

confidence: 94%

“…After an average of 9.7 sessions (and no dropouts), 81% of the 16 participants (aged 7-17 years) were free of their GAD diagnosis, with 59% losing their comorbid anxiety and depressive disorders, and large effect size reductions in child-reported worry and anxiety. Wahlund et al (2019) administered a 12-session, IU-focused CBT program to 12 adolescents (aged 13-18 years; no drop-outs) with excessive worry, nine of whom had GAD. The adolescentfocused sessions were supplemented by an internet-delivered program for parents designed to teach them about worry, IU, and helpful parenting behaviors.…”

mentioning

confidence: 99%

“…Based on the results of a previous uncontrolled trial of the current treatment approach (Payne et al 2011), as well as outcomes reported in the literature for GAD-specific treatments for youth (described above), we anticipated that the current treatment would be well tolerated (i.e., < 10% drop-outs), and would yield differences in GAD remission relative to wait-list controls in excess of 50% at post-treatment. Based on the results from the two GAD-specific treatment trials that administered measures of IU, CA, NPO, and PBW (Holmes et al 2014;Wahlund et al 2019), we anticipated moderate to large effect-size differences for the four cognitive measures between CBT and wait-list at post-treatment, and between pre-treatment and post-treatment/follow-up for treated participants.…”

mentioning

confidence: 99%

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GAD-Specific Cognitive Behavioral Treatment for Children and Adolescents: A Pilot Randomized Controlled Trial

et al. 2019

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Cognitive behavioral therapy (CBT) designed to target generalized anxiety disorder (GAD) in youth was examined in a pilot feasibility trial. Participants (aged 10-18 years) were randomized to either 10 weeks of individual CBT (n = 20) or supported wait-list (n = 20). Diagnostic status (primary outcome) was assessed blindly at post-treatment for both groups, and at a 3-month follow-up for treated participants. Two participants failed to complete CBT and retained their GAD during the trial. Intention-to-treat analyses revealed large between-group differences in favor of CBT at post-treatment for remission from GAD (80% vs 0%) and comorbid disorders (83% vs 0%), and for all secondary outcomes (child and parent-reported). All gains were maintained at 3-month follow-up in the CBT group. Consistent with the treatment model, significant pre-to post-treatment reductions in several cognitive processes were found for CBT but not wait-listed participants, with these gains maintained at follow-up. Further investigations are warranted. Trial registry: ISRCTN.com Identifier ISRCTN50951795

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Section: Discussionmentioning

confidence: 71%

Section: Cognitive Processes From the Laval Model Of Worrymentioning

confidence: 69%

Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

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confidence: 99%

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GAD-Specific Cognitive Behavioral Treatment for Children and Adolescents: A Pilot Randomized Controlled Trial

et al. 2019

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Friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors in times of COVID‐19

Ceccon,

Moscardino

2023

Journal of Adolescence

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IntroductionThis cross‐sectional study used a convergent parallel mixed‐method design to investigate friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors (UIMs) during the second wave of the COVID‐19 pandemic in Italy.MethodParticipants were 80 male UIMs (Mage = 17 years, standard deviation = 0.84) hosted in residential care communities. Individual interviews comprising questionnaires and open‐ended questions assessed the constructs of interest. Qualitative data were analyzed through thematic content analysis, whereas descriptive statistics and regression analysis were computed on quantitative data.ResultsSeveral UIMs mentioned positive relationships with peers, but more than half also felt reluctant to trust others and build new friendships due to events experienced before and during migration. However, in quantitative data, 69% identified themselves with the secure friendship attachment style. Regarding intolerance of uncertainty, participants expressed feelings of worry about the pandemic, but also emphasized their resources in terms of confidence, optimism, and planning skills, as well as being accustomed to uncertainty; indeed, levels of this variable were low‐to‐medium. In regression analysis, insecure attachment and higher intolerance of uncertainty were each associated with greater psychological distress. Moreover, psychological distress was lower among securely attached UIMs with low (vs. high) levels of intolerance of uncertainty.ConclusionThe findings suggest that, even in conditions of societal insecurity, UIMs display resilience and employ effective coping strategies; however, a lack of trust in peer relationships and the inability to tolerate uncertainty may undermine their psychological adjustment. Implications for developmental theory and practice are discussed.

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Intolerance of Uncertainty is Associated with Heightened Arousal During Extinction Learning and Retention: Preliminary Evidence from a Clinical Sample with Anxiety and Obsessive-Compulsive Disorders

Morriss,

Rodriguez-Sobstel,

Steinman

2024

Cogn Ther Res

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Background Uncertainty-related distress is considered a hallmark of anxiety and obsessive compulsive disorders (OCD). Previous research in community samples has demonstrated that individuals with high Intolerance of Uncertainty (IU), the tendency to find uncertainty aversive, display altered threat extinction learning and retention. Methods Here, we conducted an exploratory secondary analysis of an existing dataset (Steinman et al., 2022) to examine the extent to which IU in a clinical sample with anxiety and OCD predicts threat extinction learning and retention. Participants with an anxiety disorder and/or OCD completed a differential threat learning task across two days (n = 27). Skin conductance response (SCR) was used as an index of conditioned responding. Results No significant effects of self-reported IU were observed for differential SCR during any of the experimental phases. However, higher self-reported IU, while controlling for trait anxiety, was specifically associated with greater SCR overall during same-day extinction training, next-day extinction training, and next-day reinstatement test. Conclusions Such findings provide preliminary evidence that higher IU within clinical samples with anxiety and/or OCD may be associated with heightened arousal under uncertainty, and highlight IU as a promising treatment target for anxiety and OCD.

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Intolerance of Uncertainty–Focused Treatment for Adolescents With Excessive Worry: A Pilot Feasibility Study

Cited by 28 publications

References 60 publications

GAD-Specific Cognitive Behavioral Treatment for Children and Adolescents: A Pilot Randomized Controlled Trial

GAD-Specific Cognitive Behavioral Treatment for Children and Adolescents: A Pilot Randomized Controlled Trial

Friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors in times of COVID‐19

Intolerance of Uncertainty is Associated with Heightened Arousal During Extinction Learning and Retention: Preliminary Evidence from a Clinical Sample with Anxiety and Obsessive-Compulsive Disorders

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