Pathways from uncertainty to anxiety: An evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms

摘要

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. (C) 2016 Elsevier Ltd. All rights reserved.