title: Pathways from uncertainty to anxiety: An evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms.
abstract: Uncertainty is central to anxiety-related pathology and intolerance of uncertainty (IU) appears to be a transdiagnostic risk and maintaining factor. The aim of the present study was to evaluate a hierarchical model to identify the unique contributions of trait and disorder-specific IU (i.e., uncertainty specific to generalised anxiety disorder, social anxiety, obsessive compulsive disorder, and panic disorder) to disorder-specific symptoms, beyond other disorder-specific cognitive vulnerabilities (i.e., negative metacognitive beliefs, fear of negative evaluation, inflated responsibility, and agoraphobic cognitions, respectively). Participants (N=506) completed a battery of online questionnaires. Structural equation modelling was used to evaluate model fit, as well as direct and indirect pathways. Trait and disorder-specific IU were significantly associated with multiple cognitive vulnerability factors and disorder symptoms. Indirect effects between trait IU and symptoms were observed through disorder-specific IU and cognitive vulnerabilities. The relative contribution of trait IU and disorder-specific IU to symptoms varied and theoretical and clinical implications are highlighted. Limitations include the cross-sectional design and reliance on self-report. Avenues for further research include a need for replication and extension of the model in different samples and using experimental and multi-method research methods.
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Shihata
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Perth, Australia; Centre of Clinical Interventions, Perth, Australia. Electronic address: peter.mcevoy@curtin.edu.au.
authors.forename: Peter M
authors.initials: PM
authors.lastname: McEvoy
authors.affiliation: Health Psychology and Behavioural Medicine Research Group, Curtin University, Perth, Australia; School of Psychology, University of Sydney, Sydney, Australia.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Mullan
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000523:psychology*; D003071:Cognition; D003430:Cross-Sectional Studies; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D035501:Uncertainty; D055815:Young Adult
keywords: Anxiety disorders; Cognitive vulnerability; Disorder-specific; Intolerance of uncertainty; Transdiagnostic