Watson D, Clark L, Tellegan A. Conversely, it has been suggested that the significant associations observed between worry severity (as measured by the PSWQ, for example) and IU may be partially explained by the IU measure. Worrying: Perspectives on theory, assessment, and treatment. Accessibility Once you have a list of behaviours that you do to reduce or avoid uncertainty, then start picking small items that you can do to practise tolerating uncertainty. A sample of treatment sessions were recorded and reviewed as part of this supervision process. Although often past rather than future oriented, rumination involves repeated attempts to better understand the nature of past outcomes (e.g., guilt over things that one should have done, should not have done, or could have done differently) and has been found to mediate the relationship between IU and depressive symptoms (Liao & Wei, 2011). Going to a movie without knowing anything about it. Many people feel good about uncertainty and live lives where they seek excitement. Mattick RP, Clarke JC. The systematic review sought to evaluate the status of evidence pertaining to IU's proposed causal influence upon symptoms of psychological conditions. All therapists underwent extensive training and certification prior to treating study patients, and therapists produced statistically equivalent outcomes across their patients. They might hold negative beliefs about uncertainty and may try to avoid it, or use strategies to try to control or eliminate it. Using the same approach as the analysis comparing baseline IU levels (presence or absence of each diagnosis coded as a 0 or 1 for each participant), consistent with our hypothesis, results from a univariate ANOVA showed no statistical difference in the magnitude of pre-post treatment change in IUS scores among principal diagnoses, univariate F (4, 28) = 1.83, p = 16, p2 = .23. Therapists for the study were three doctoral students with 2 to 4 years of clinical experience and one licensed doctoral-level psychologist with 7 years of experience. Correlations in parentheses are partial correlations when controlling for negative affectivity with the PANAS-NA. 2022 Psychology Tools. Intolerance of uncertainty involves the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events. Barlow DH, Allen LB, Choate ML. The role of positive beliefs about worry in generalized anxiety disorder and its treatment. Given that IU appears to be associated with disorders that are also characterized by negative affect, we conducted a second, exploratory analysis within this aim to test whether these relationships (between IU and symptom levels) held when controlling for levels of negative affect. One factor that has emerged as crucial for the development of both anxiety and depression is the intolerance of uncertainty. If, however, you did not like the food, you might write down something like "I had something else to eat when I got home" or "I was quite upset with myself for having chosen the wrong restaurant.". Milne, S., Lomax, C., & Freeston, M. H. (2019). The .gov means its official. For the overall sample, the mean number of sessions completed was 15.26 (SD = 4.60). The other question asked about how other people tolerate uncertainty in their lives. One question asked about how you tolerate uncertainty in certain areas of your life. Dealing with uncertainty is an unavoidable part of daily life. Information processing biases toward potentially threatening stimuli are present across the spectrum of anxiety disorders (Barlow, 2002; Eysenck, 1997). We chose to focus on these two commonly used outcome indicators for the sake of statistical parsimony and because they were not designed to be diagnosis-specific. Transdiagnostic approaches to the treatment of anxiety disorders: A meta-analytic review. Other people find uncertainty aversive, stressful, or distressing, and dont function as well in uncertain situations. Data for this study were derived from a randomized control trial (RCT; Farchione et al., 2012) investigating the efficacy of the UP compared to a 16-week waitlist/delayed-treatment condition. A series of zero-order correlations were conducted to examine the associations between baseline IU (sample mean = 40.35, SD = 22.29) and initial symptom levels across disorder-specific (GAD, OCD, social phobia, panic disorder, depression) and general symptom measures (see Table 2). will also be available for a limited time. Univariate ANOVA results indicated that the presence or absence of any particular diagnosis did not have an effect on baseline IUS scores, univariate F (5, 35) = 0.57, p = .83, p2 = .31 (see bottom half of Table 3). In one of the few treatment studies to target IU and examine changes in IU over the course of psychotherapy (Ladouceur et al. To score the IUS as a unifactorial tool, add up the responses for each of the items. Content is reviewed before publication and upon substantial updates. 2. Uncertainty as an allergy Being intolerant of uncertainty is a lot like having an allergy. McHugh RK, Barlow DH. Freeston MH, Rhaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? These results would also have implications for understanding IU in light of potentially related transdiagnostic constructs, such as perceived control. (2011), by demonstrating significant reductions in IU over the course of treatment. A second series of partial correlations were then conducted specifically with IUS, this time controlling for negative affectivity. Buhr K, Dugas MJ. In the validation sample, internal consistency and test-retest reliability were high ( = .90; r = .71). Conversely, a nonsignificant difference in IUS scores was observed in the delayed-treatment condition, t (9) = 0.43, p = .68, d = 0.05, CI = 0.98: 0.87, with a small, negative effect size between pretreatment (M = 38.56, SD = 23.69) and post-waitlist (M = 40.11, SD = 30.09) scores, across diagnoses. STEP 3: Practice Tolerating Uncertainty. the Cognitive Behaviour Therapist. data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAKAAAAB4CAYAAAB1ovlvAAADOUlEQVR4Xu3XQUpjYRCF0V9RcOIW3I8bEHSgBtyJ28kmsh5x4iQEB6/BWQ . Participants are asked to indicate how often they feel a particular way on a 5-point Likert scale. Shihata, S., McEvoy, P. M., Mullan, B. Two multiple regression models were then tested to see if pre-post change in IU was related to posttreatment symptom levels on the HARS and HDRS. The lack of association with OCD symptoms was somewhat surprising, given results from previous studies (Gentes & Ruscio, 2011; Steketee et al., 1998). The IU construct has been associated predominantly (conceptually and empirically) with generalized anxiety disorder (GAD; Dugas, Freeston, & Ladouceur, 1997) and obsessive-compulsive disorder (OCD; Lind & Boschen, 2009; Steketee, Frost, & Cohen, 1998). Wilkinson, A., Meares, K., Freeston, M. 2011. Descriptive statistics for the IUS and symptom measures are reported in Table 1. Everything you could need: a PDF of the resource, therapist instructions, and description with theoretical context and references. The significant and reliable reduction in IU observed across diagnostic categories indicates that the UP may effectively affect control processes as an important element underlying emotional disorders. The UP comprises five core treatment modules designed to target key aspects of emotional processing and regulation of emotional experiences, including decreasing maladaptive avoidance and control processes. The intolerance of uncertainty scale: Psychometric properties of the English version. SD = standard deviation; IUS = Intolerance of Uncertainty Scale; HARS = Hamilton Anxiety Rating Scale; HDRS = Hamilton Depression Rating Scale; BAI = Beck Anxiety Inventory; BDI = Beck Depression Inventory-II; PSWQ = Penn State Worry Questionnaire; PDSS-SR = Panic Disorder Severity Scale-Self Report; SIAS = Social Inhibition and Anxiety Scale; YBOCS Yale-Brown Obsessive-Compulsive Scale. Independent clinical evaluators received extensive training on the SIGH-A and had to demonstrate acceptable levels of reliability prior to their participation in the trial. A patient's statistical likelihood of exhibiting reliable change on the IUS was unrelated to principal diagnosis, 2 (4) = 6.84, p = .15, yet, descriptively, more people with principal panic disorder demonstrated reliable change than any other principal diagnosis (see Table 4). The Intolerance Of Uncertainty information handout describes IU in the context of worry, and outlines some of the unhelpful strategies that people high in IU tend to use to control how they feel. The present study was aimed at investigating IU, measured with the IUS, in the context of a transdiagnostic treatment for emotional disorders. Federal government websites often end in .gov or .mil. Questionnaires and other measures are provided here solely as a courtesy to accompany our scoring code. All treatment completers received all treatment modules. The IUS has 27 items- none reversed scored. Clinical Psychology: Science and Practice. ITEM CODING The IUS has 27 items- none reversed scored. The most important component is known as intolerance of uncertainty, and is thought of as a higher-order process that leads directly to worry through three other processes: People with GAD are thought to have higher intolerance of uncertainty than those with other anxiety disorders. They have a belief system in which uncertainty is viewed as stressful, unfair, upsetting, and to be avoided. Brown TA, Barlow DH. Shear MK, Vander Bilt J, Rucci P. Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH-A). The Abramowitz JS, Deacon BJ. Brown TA, DiNardo PA, Lehman CL, Campbell LA. We hypothesized that change in IU scores over the course of treatment would be correlated with posttreatment symptom levels, regardless of diagnosis. Behav Modif. Of the 35 patients who fully initiated treatment, n = 15 were assigned a clinical diagnosis of GAD (principal or comorbid), n = 15 were assigned a clinical diagnosis of social phobia, n = 12 were assigned a clinical diagnosis of panic disorder with agoraphobia, n = 11 were assigned a clinical diagnosis of OCD, and n = 12 were assigned a clinical diagnosis of a depressive disorder (MDD or dysthymia). Baseline IUS scores were significantly correlated with higher pretreatment HARS and HDRS scores. sharing sensitive information, make sure youre on a federal A total of 32 patients were labeled treatment completers (operationalized by completing at least eight sessions; see below for further details). Patients diagnosed with heterogeneous anxiety and depressive disorders received up to 18 weeks of a transdiagnostic cognitive-behavioral therapy intervention. Anxiety is experienced before (anticipatory), during, and after social situations, which involves a sense of uncertainty related to current or future social evaluation. The first aim was to examine the association between IU scores and disorder specific (GAD, OCD, panic disorder, social phobia, and depressive disorder) and general measures of symptom severity prior to treatment. This study investigates the relationship between intolerance of uncertainty, worry, and statistics anxiety. Buhr K, Dugas MJ. J Anxiety Disord. Journal of Personality and Social Psychology. Results showed that change in IU was a significant predictor of posttreatment symptom severity on the HARS ( = .60, SE = .05, t = 3.53, p < .01, CI = 0.07:0.25, pr = .57) and HDRS ( = .58, SE = .04, t = 3.67, p < .01, CI = 0.06:0.22, pr = .59), such that greater reductions in IU were associated with reduced anxiety and depression symptom severity. A total of 37 patients consented to treatment and were randomized to either the immediate-treatment (n = 26) or delayed-treatment (waitlist, n = 11) conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al., 2011) is an emotion-focused CBT treatment that distills and incorporates common evidence-based treatment strategies (e.g., restructuring maladaptive appraisals, changing mal-adaptive action tendencies, prevention of experiential avoidance, exposure), and is designed to be applied to anxiety and unipolar mood disorders, as well as other problem areas with strong emotional components. https://www.psychologytools.com/resource/what-keeps-generalized-anxiety-and-worry-going/, Using strategies from anxiety treatments to target uncertainty distress | Mark Freeston | 2020, Its not just the threat, its the uncertainty: Understanding and managing uncertainty and distress | Mark Freeston | 2020. Accumulating evidence appears to support this, and further consideration of the construct of perceived control may help to integrate and consolidate findings related to IU's concomitant lack of narrow specificity to GAD and strong relationship with measures of worry. Initiation of therapy with the UP for the waitlist/delayed treatment participants began immediately after the post-waitlist assessment at Week 16, with an average of 2 weeks between the post-waitlist assessment and the first UP session. High levels of comorbidity observed between GAD and MDD (Simon, 2009) may be partially explained by IU and its related cognitive avoidance processes: worry and rumination. The inability to tolerate uncertainty is an attitude many people have towards life. Coping With Fear of the Ocean or Deep Water, Daily Tips for a Healthy Mind to Your Inbox. Intolerance of uncertainty (IU) is a characteristic predominantly associated with generalized anxiety disorder (GAD); however, emerging evidence indicates that IU may be a shared element of emotional disorders. Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. Items describe either positive or negative affect; however, only the negative affect scale was used in this study. Furthermore, excessive worriers report that worrying helps them to problem solve, prepare for potential outcomes, prevent negative outcomes from occurring, and minimize emotional reactions to negative outcomes (Borkovec, Hazlett-Stevens, & Diaz, 1999; Freeston, Rhaume, Letarte, Dugas, & Ladouceur, 1994). Buhr K, Dugas MJ. For example, increasing our understanding of the common, underlying information processing biases that emerge in the face of uncertainty (see Eysenck, 1997) could lead to improved transdiagnostic interventions. They have published a selection of materials and measures. The Hamilton scales and the Hopkins Symptom Checklist (SCL-90). Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Analysis of an anxiety model and the process of change during exposure plus response prevention treatment of bulimia nervosa Behaviour Therapy (1984) E. Leger et al. Uncontrollability and unpredictability in post-traumatic stress disorder: An animal model. Generalized anxiety disorder (GAD) involves chronic, excessive, and uncontrollable worry about a range of everyday problems. Unlike other anxiety disorders that involve specific types of fears, such as the fear of negative evaluation in social anxiety disorder, and the fear of escalating physical symptoms in panic disorder, the fear in GAD is more difficult to pinpoint. 2000; Dugas & Ladouceur 2000) found a significant reduction in IU in a cognitive-behaviorally oriented treatment for principal GAD; similar reductions in IU were observed in a more recent study examining the efficacy of an IU-targeted treatment (Intolerance of Uncertainty Treatment [IUT]; van der Heiden, Muris, & van der Molen, 2011) for GAD. In the morning, you might be worried about making it to a dentist appointment on time, while by evening you could be fretting about making a decision over which cell phone plan to choose. Similar magnitudes of change in IU were observed across diagnoses (principal and comorbid). Several self-report measures with established reliability and validity were used to assess diagnosis-specific symptoms. This was important because heightened levels of negative affect could explain most of the variance in IU that is associated with diverse symptomatology, rather than distress regarding uncertainty per se. Williams (2013) defines statistics anxiety as the. How individual perceives information in uncertainor ambiguous situations An assumption that uncertaintyis stressful and upsetting Uncertain events are negative and should be avoidedat all costs jacqui.rodgers@ncl.ac.uk Fear of uncertainty Journal of Consulting and Clinical Psychology. Intolerance of uncertainty (IU) refers to the tendency to fear the unknown and to worry excessively about potential future negative outcomes. Anxiety and its disorders The nature and treatment of anxiety and panic. A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. J Consult Clin Psychol. Carleton, R. N., Mulvogue, M. K., Thibodeau, M. A., McCabe, R. E., Antony, M. M., Asmundson, G. J. Lind C, Boschen MJ. Negative affect was measured using the 20-item PANAS. As noted, one potential explanation is a measure-effectIUS items may be geared toward worry processes and GAD. Thus, if associations between IU and symptom severity hold when controlling for negative affect, this rival hypothesis (e.g., that IU is simply a proxy for distressing negative affect), becomes less plausible. Generalized anxiety disorder and psychiatric comorbidities such as depression, bipolar disorder, and substance abuse. Therapist learning tool to improve your familiarity with a psychological construct. and transmitted securely. Borkovec TD. Intolerance of uncertainty (IU) is proposed to be a transdiagnostic causal mechanism of psychological difficulties. If you always leave for appointments an hour early, you will never learn how much time youreally need to get there on time. J Clin Psychol. Participants rate items on a 5-point Likert scale ranging from 1 = "not at all characteristic of me" to 5 = "entirely characteristic . Dugas MJ, Ladouceur R. Treatment of GAD: Targeting intolerance of uncertainty in two types of worry. (Dugas, Buhr, & Ladouceur, 2004). PMC legacy view You may think that worrying is a The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A randomized controlled trial. All rights reserved. Individuals with panic disorder may also react more strongly to the physiological component of the emotional response to uncertainty, perhaps before reacting cognitively or behaviorally. Behavioral experiments involve testing out feared predictions. The IUS-12 is a short version of the original 27-item Intolerance of Uncertainty Scale (Freeston, Rhaume, Letarte, Dugas, & Ladouceur, 1994) that measures responses to uncertainty, ambiguous situations, and the future (Carleton, in press). An additional assessment was then conducted at posttreatment. Over time, the goal of the behavioral experiments is to move from small events to larger ones, across multiple settings (work, home, social settings) and to observe that in most uncertain situations, the outcome is tolerable, and when it is not, that it can be managed. Affective Negative Reinforcement in Addiction, Mechanisms for Intoxicated Emotion and Behavior. 2013;69(6). Psychotherapy, Theory, Research, Practice, Training. In this model, when you worry, you are trying to reduce feelings of uncertainty. Chorpita BF, Brown TA, Barlow DH. HHS Vulnerability Disclosure, Help Teaching resource a learning tool during training. 2022 Dotdash Media, Inc. All rights reserved, Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety.". Diagnostic and Statistical Manual of Mental Disorders. Verywell Mind's content is for informational and educational purposes only. Houck PR, Spiegel DA, Shear MK, Rucci P. Reliability of the self-report version of the Panic Disorder Severity Scale. (2002) The intolerance of uncertainty scale: Psychometric properties of the English version. Development and validation of brief measures of positive and negative affect: The PANAS scales. official website and that any information you provide is encrypted Development and validation of measures of social phobia, scrutiny fear and social interaction anxiety. The average number of sessions in the trial for individuals with a principal diagnosis of GAD was 14.88 sessions (SD = 6.36), social phobia = 15.67 sessions (SD = 3.14), panic disorder = 15.00 sessions (SD = 2.71), OCD = 17.88 sessions (SD = 0.35), and other = 15.60 sessions (2.88). This type of therapy can take different forms and involve different components: Here you are taught how to identify problems that you can solve versus those that are outside of your control, and strategies that can be used for each type of problem. (2016). In the case of OCD, doubting obsessions, compulsions, and ritualistic behaviors serve a similar experiential avoidance and control function (Steketee et al., 1997, 1998). Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Similar to the implications of aim three, if the relationship between change in IU and posttreatment outcome is not tied to the presence or absence of a specific diagnosis, this would provide additional support for the transdiagnostic relevance of IU in treatment. For example, uncertainty regarding leaving the stove on leads to negatively valenced arousal that is diminished, if only momentarily, through checking behaviors; mental compulsions are thought to decrease or eliminate the chances of a potential catastrophic event occurring (e.g., death of a loved one), and elaborate cleaning rituals prevent future illness that could potentially lead to death (Grayson, 2004). Psychometric properties and construct validity of the ObsessiveCompulsive InventoryRevised: Replication and extension with a clinical sample. Given that distress related to experiences of uncertainty has been associated with levels of symptom severity in several emotional disorders, and strategies utilized to avoid uncertainty and increase perceived control are closely tied with diagnostic factors and sequelae that are hypothesized to strengthen and maintain psychopathology, IU may represent an important factor in treatment. government site. No significant differences in initial severity, motivation, or IU scores were observed between the immediate and delayed treatment groups. 2013 Jun; 69(6): 10.1002/jclp.21965. RCI = 13.82. The nature, functions, and origins of worry. The 12 items are rated on a 5-point Likert scale ranging from 1 (not at all characteristic of me) to 5 (entirely characteristic of me). Thank you, {{form.email}}, for signing up. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.). 8600 Rockville Pike Research focused on cross-sectional reporting, manipulating attitudes toward objective and impersonal events or on treatments designed to reduce IU in clinical populations. In addition to the training procedures, staff held weekly meetings during which all initial diagnostic interviews were discussed and a consensus diagnosis was reached. Life in the future versus life in the present. Cogn Behav Ther. Pretreatment symptom scores were included in each model and entered simultaneously with pre-post change in IUS scores. Knowledge - Education is powerful. A univariate analysis of variance (ANOVA) was conducted to investigate the effect of the presence or absence of principal diagnoses on baseline IUS scores. Additionally, the PANAS-NA was significantly correlated with the Hopkins Symptoms Checklist (Derogatis, Lipman, Ulenhuth, & Covi, 1976), which has been shown to measure general distress (r = .74). For the delayed treatment group, the baseline assessment was post-waitlist, immediately prior to the onset of treatment. 2000;24(5):635-657. doi:10.1177/0145445500245002. By Arlin Cuncic Anxiety is a well . When taken as a whole, this study's results are consistent with emerging evidence questioning the narrow specificity of IU to GAD (see Garber & Hollon, 1991). 2013;110(17):300-309. doi:10.3238/arztebl.2013.0300, Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. GAD symptom severity was assessed using the Penn State Worry Questionnaire (PSWQ; Meyer, Miller, Metzger, & Borkovec, 1990; alpha = .93 in the present sample). In order to manage your anxiety about uncertainty, you can engage in various mindfulness practices such as mindful breathing to help you stay in the moment and mindfulness meditation to learn how to quiet your mind.. However, the worry in generalized anxiety disorder can be so severe that it becomes a problem itself. However, with the exception of OCD (see Grayson, 2004, and Wilhelm & Steketee, 2006), IU has yetto be examined in the treatment of many anxiety and mood disorders, or across multiple emotional disorders in the context of a single treatment study. Additionally, the presence or absence of any specific principal or comorbid diagnosis was unrelated to magnitude of change in IU, univariate F (5, 28) = 1.11, p = .43, p2 = .60. The key to managing your fear is to learn to live with uncertainty rather than to avoid it. Baseline IU correlated significantly with clinician-rated and patient self-report measures of both anxiety and depressive symptomology, levels of IU were comparably high in individuals with principal panic disorder, and the presence or absence of GAD did not have a significant effect on baseline IUS scores or the degree of change in IU observed between pretreatment and posttreatment. More research is needed to increase understanding of the role of IU in emotional disorders and their treatment (Gentes & Ruscio, 2011). When one has this attitude, uncertainty, unpredictability, and doubt are seen as awful and unbearable experiences that must be avoided at all costs. Even if the odds are really small that a bad thing will happen, that tiny chance is enough to really upset us. hey gwuapo preset Patient self-reported IU and self-report and clinician-rated symptom/functioning measures were administered at pretreatment and posttreatment. Bethesda, MD 20894, Web Policies The HDRS was used to evaluate depressive symptoms and was administered in accordance with the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D; Williams, 1988). Change in IU can be observed across problem areas in transdiagnostic treatment and such change is correlated with treatment outcome. If IU is most relevant to GAD or OCD, then we might expect a greater amount of change in IU during treatment in individuals with these diagnoses. It is not surprising that GAD and OCD have received most of the attention in the IU literature. The five core modules are preceded by a module focused on enhancing motivation, readiness for change, and treatment engagement, as well as an introductory module educating patients on the nature of emotions and providing a framework for understanding their emotional experiences. However, IU may also have particular relevance to GAD because it represents a slice of a broader construct, such as perceived control (Barlow, 2002). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Dtsch Arztebl Int. However, the PSWQ and BDI-II were the only diagnosis-specific self-report symptom measures that correlated significantly with IUS. Thus, conceptual analysis indicates that difficulty tolerating uncertainty is present in various emotional disorders characterized by negative affect (Boelen & Reijntes, 2009; Deacon & Abramowitz, 2008; Dugas, Gosselin, & Ladouceur, 2001; Foa, Zinbarg, & Rothbaum, 1992), as are cognitive and behavioral attempts to reduce uncertainty and enhance perceptions of control (over both internal and external experiences and outcomes). Liao K, Wei M. Intolerance of uncertainty, depression, and anxiety: The moderating and mediating roles of rumination. Utilizing Jacobson and Truax's (1991) formula for calculating a reliable change index (RCI), the mean pre-post treatment difference exceeded the RCI criterion (13.82 IUS points). Because of the high degree of comorbidity in the sample, a second univariate ANOVA was conducted to investigate the effect of the presence of absence of any (principal or comorbid) clinical diagnosis on baseline IUS scores. In addition, a recent meta-analysis found strong associations between IU and general symptom levels of GAD, OCD, and MDD (Gentes & Ruscio, 2011), providing further evidence that IU may be a shared feature of emotional disorders. To be eligible for participation, patients had to receive a principal (most interfering and severe) diagnosis of an anxiety disorder, be 18 years or older, be fluent in English, able to complete all study-related tasks, and provide informed consent. That is, some people are okay with having a lot of uncertainty in their lives, and other people cannot stand even a small amount of uncertainty.
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