Wu, Kevin D.
Ph.D. (Doctor of Philosophy)
Department of Psychology
Anxiety is considered a fear response to threat, driven by the absence of certainty and elevated perceptions of the cost of harm. It has been suggested that exaggerated responding to uncertainty underlies all anxiety disorders. Although no longer classified under the anxiety disorders section of the Diagnostic and Statistical Manual (DSM), anxiety still is considered a primary component of obsessive-compulsive disorder (OCD). OCD is a chronic, debilitating condition that affects multiple domains of functioning. The current gold standard of treatment for OCD is exposure and response prevention (ERP), a form of cognitive-behavioral psychotherapy. However, ERP is not effective for all individuals with OCD, as about 50-70% of individuals respond to treatment. Given the heterogeneous nature of OCD, treatment research may need to be targeted toward individual difference variables. Cognitive-behavioral models suggest that dysfunctional beliefs contribute to the etiology and maintenance of OC symptoms (OCCWG, 1997). One such dysfunctional belief, intolerance of uncertainty (IU), is the tendency to find uncertainty intolerable and view oneself as unable to cope in the face of change. IU has been suggested to contribute to the etiology and maintenance of OCD.
The effect of uncertainty on anxious responding is somewhat unclear in the literature. Experimental manipulations of threat (electric shocks) revealed that participants did not become more physiologically aroused when threat was 50% or 100% likely; further, participants did not endorse a preference for the lower probability of shocks. Alternatively, Nelson and Shankman found that participants with high levels of IU endorsed more anxiety when faced with uncertain versus certain threat. A recent experimental paradigm found that trait IU was significantly associated with anxiety in the face of uncertain threat. However, no known studies have examined these factors in the context of OCD.
The current study had a sample of N = 187 students complete a measure of IU and then undergo the paradigm created by Oglesby and Schmidt in which they were randomized into either a certain threat condition or an uncertain threat condition. In the certain threat condition, participants were told that they would complete a threatening task at the end of the study. In the uncertain threat condition, participants were told that the result of a coin toss would determine whether they completed a threatening task. Participants then were asked to report distress ratings and complete the threatening task (based on the thought-action fusion literature), in which they were asked to write “I hope [loved one] is in a car accident today.”
Results suggest that participants felt distressed by the sentence task. However, an ANCOVA revealed that there were no differences between conditions on distress ratings prior to completing the threatening task, controlling for thought-action fusion beliefs. A hierarchical regression found that IU significantly predicted distress ratings but did not moderate the relationship between conditions and distress ratings. Implications, limitations, and future directions are discussed.
Martyn, Hannah Faleer, "An Experimental Examination of intolerance of Uncertainty in Obsessive-Compulsive Disorder" (2019). Graduate Research Theses & Dissertations. 7409.
Northern Illinois University
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