Está en la página 1de 8

Cognitive Therapy and Research, Vol. 25, No. 5, 2001, pp.

551558
Intolerance of Uncertainty and Worry: Investigating
Specicity in a Nonclinical Sample
Michel J. Dugas,
1,3
Patrick Gosselin,
2
and Robert Ladouceur
2
The goal of this study was to explore the specicity of the relationship between
intolerance of uncertainty and worry in a nonclinical sample. Three hundred and
forty-seven university students completed measures of worry, obsessions/compul-
sions, and panic sensations. They also completed measures of process variables known
to be associated with worry (intolerance of uncertainty), obsessions/compulsions
(responsibility), and panic sensations (anxiety sensitivity). The results show that
intolerance of uncertainty was highly related to worry, moderately related to
obsessions/compulsions, and weakly related to panic sensations. Further, the relation-
ship between intolerance of uncertainty and worry remained strong after shared
variance with other study variables was removed. The ndings are discussed in terms
of their implications for understanding worry and preventing generalized anxiety dis-
order.
KEY WORDS: intolerance of uncertainty; worry, specicity; generalized anxiety disorder.
Worry is a fundamental human experience and is common in both nonclinical
and clinical individuals. Tallis, Davey, and Capuzzo (1994) found that 38% of
their nonclinical sample worried at least once a day. From a clinical perspective,
pathological worry is the hallmark of generalized anxiety disorder (GAD) and an
associated feature in many anxiety and mood disorders (American Psychiatric
Association, 1994). MacLeod, Williams, and Bekerian (1991) proposed a denition
of worry that includes the common features of other denitions (e.g., Barlow, 1988;
Borkovec, Robinson, Pruzinsky, & DePree, 1983). They suggested that Worry is a
cognitive phenomenon, it is concerned with future events where there is uncertainty
about the outcome, the future being thought about is a negative one, and this is
accompanied by feelings of anxiety (p. 478). This denition underscores the central
role of uncertainty about future events, which is not surprising as many researchers
1
Department of Psychology, Concordia University, Montreal, Quebec, Canada.
2
E

cole de Psychologie, Universite Laval, Quebec, Quebec, Canada.


3
Correspondence should be directed to Michel J. Dugas, Ph.D., Department of Psychology, Concordia
University, 7141 Sherbrooke Street West, Montreal, Quebec, Canada, H4B 1R6; e-mail: dugas@vax2.
concordia.ca.
551
0147-5916/01/1000-0551$19.50/0 2001 Plenum Publishing Corporation
552 Dugas, Gosselin, and Ladouceur
have noted that uncertainty represents an important variable in our understanding
of worry (e.g., Dugas, Freeston, & Ladouceur, 1997; Tallis & Eysenck, 1994).
Recently, our research team presented a cognitivebehavioral model of exces-
sive worry that has intolerance of uncertainty as its main component (Dugas, Gag-
non, Ladouceur, & Freeston, 1998). At a general level, intolerance of uncertainty
may be conceptualized as the way an individual perceives information in uncertain
situations and responds to this information with a set of cognitive, emotional and
behavioral reactions (Freeston, Rhe aume, Letarte, Dugas, & Ladouceur, 1994).
Intolerance of uncertainty may be dened more specically as the excessive ten-
dency of an individual to consider it unacceptable that a negative event may occur,
however small the probability of its occurrence. Considering that daily life is fraught
with uncertain situations, individuals who are intolerant of uncertainty may perceive
several unacceptable and disturbing events in the course of a single day.
Previous research shows that intolerance of uncertainty is highly related to
worry in nonclinical and clinical populations. Freeston and colleagues (1994) demon-
strated that the relationship between intolerance of uncertainty and worry is not
accounted for by shared variance with negative affect and that intolerance of uncer-
tainty distinguishes individuals meeting GAD criteria by questionnaire from those
who do not. Moreover, a recently completed study showed that experimentally
increasing intolerance of uncertainty leads to increases in worry (Ladouceur,
Gosselin, & Dugas, 2000). Taken together, these results indicate that intolerance
of uncertainty represents a key variable for our understanding of worry.
Although there exists a considerable amount of evidence showing that intoler-
ance of uncertainty and worry are highly related, only one previous study has
systematically examined the specicity of this relationship (Ladouceur et al., 1999).
The main objective of the present study is to explore the specicity of the relationship
between intolerance of uncertainty and worry in a nonclinical sample. The rst
hypothesis states that intolerance of uncertainty will be more highly related to
worry than to obsessions/compulsions and panic sensations. The second hypothesis
predicts that intolerance of uncertainty will account for a signicant amount of
variance in worry scores over and above that accounted for by responsibility and
anxiety sensitivity. The nal hypothesis states that worry will account for a signicant
amount of variance in intolerance of uncertainty scores above and beyond that
accounted for by obsessions/compulsions and panic symptoms.
METHOD
Participants
Three hundred and forty-seven (347) undergraduate university students partici-
pated in the study. The total sample consisted of 272 female participants with an
average age of 22.79 years (SD 5.56) and 68 male participants with an average
age of 23.13 years (SD 5.53). Seven participants omitted recording their gender.
Specicity of Intolerance of Uncertainty 553
Instruments
Self-report questionnaires were used to assess worry (Penn State Worry Ques-
tionnaire), obsessions/compulsions (Padua Inventory), and panic sensations (Body
Sensations Questionnaire). Other self-report questionnaires were used to assess
process variables associated with worry (Intolerance of Uncertainty Scale),
obsessions/compulsions (responsibility: R-Scale), and panic sensations (Anxiety
Sensitivity Index).
The Penn State Worry Questionnaire (PSWQ; Meyer, Miller, Metzger, &
Borkovec, 1990) is comprised of 16 items designed to evaluate the tendency to
engage in excessive and uncontrollable worry. Examples of items from the PSWQ
include Many situations make me worry and Once I start worrying, I cant
stop. The PSWQ has high internal consistency, .86.95, and very good
testretest reliability, r .74.93 (Molina & Borkovec, 1994). It also shows
evidence of convergent and divergent validity, as it is more highly correlated
with other measures of worry than with measures of anxiety and depression
(Molina & Borkovec, 1994).
The Padua Inventory (PI; Sanavio, 1988) consists of 60 items designed to
evaluate obsessive and compulsive symptoms. Items from the PI include When I
start thinking of certain things, I become obsessed with them and I tend to keep
on checking things more often than necessary. The questionnaire has excellent
internal consistency, .94, and testretest reliability, r .83 (Kyrios, Bhar, &
Wade, 1996). The PI also displays evidence of convergent and divergent validity
in nonclinical samples (Sternberger & Burns, 1990). Although the questionnaire
has a four-factor structure (Kyrios et al., 1996; Sternberger & Burns, 1990), only
the PI total score was retained for this study because individual subscale scores
were not needed to test the studys hypotheses.
The Body Sensations Questionnaire (BSQ; Chambless, Caputo, Bright, & Gal-
lagher, 1984) is comprised of 17 items that evaluate the physical sensations generally
associated with a panic attack. Examples of sensations assessed by the BSQ include
heart palpitations, feeling short of breath, and dizziness. The scale has very
good internal consistency, .87, is moderately stable over 4 weeks, r .67, and
shows signs of convergent and divergent validity with a variety of measures of
psychopathology (Chambless et al., 1984).
The Intolerance of Uncertainty Scale (IUS; Freeston et al., 1994) measures
intolerance of uncertainty, a cognitive process known to be associated with worry.
The questionnaire includes 27 items relating to uncertainty, emotional and behav-
ioral reactions to ambiguous situations, the consequences of uncertainty, and at-
tempts to control future events. Items include Being uncertain means that I am
not rst rate and I cant stand being taken by surprise. The IUS shows excellent
internal consistency, .91 (Freeston et al., 1994), and good testretest reliability
over 5 weeks, r .78 (Dugas et al., 1997).
The R-Scale (RS; Salkovskis, 1992) is comprised of 27 items evaluating beliefs
associated with responsibility, a process associated with obsessions/compulsions.
Examples of items from the RS include I often feel responsible for things which
go wrong and Inactivity can cause as much harm as deliberate bad intentions.
554 Dugas, Gosselin, and Ladouceur
The RS shows very good internal consistency, .94, and evidence of convergent
validity with measures of obsessions/compulsions and other measures of responsibil-
ity (Rhe aume, Freeston, Dugas, Letarte, & Ladouceur, 1995).
The Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986)
consists of 16 items about sensitivity to the presence of anxiety, a process related
to panic attacks. Examples of ASI items include It is important to stay in control
of my emotions and Unusual bodily sensations scare me. Reiss and colleagues
(1986) showed that the questionnaires items are moderately to highly interrelated.
Further, the ASI has adequate test-retest reliability over 2 weeks, r .75, and good
known-groups validity (Reiss et al., 1986).
Procedure
The self-report questionnaires were completed at the beginning of lectures in
various university courses. The experimenter explained that the study aimed at
identifying the thoughts associated with various symptoms of anxiety. The partici-
pants signed an informed-consent form and responded to the questionnaires on a
voluntary basis. All questionnaires were identied by a code number to preserve
participant anonymity. The administration of the test battery took approximately
30 min.
RESULTS
The mean and standard deviation for each of the study measures were as
follows. PSWQ: M 44.77, SD 10.99; PI: M 35.13, SD 24.11; BSQ:
M 29.74, SD 11.22; IUS: M 51.64, SD 16.79; RS: M 56.84, SD 15.35;
and ASI: M15.76, SD9.31. Acorrelation matrix was calculated using participant
demographics (age and gender) and the total score from each measure. The results
show that intolerance of uncertainty (IUS) was highly correlated with worry
(PSWQ), moderately correlated with obsessions/compulsions (PI), and weakly cor-
related with panic sensations (BSQ). Follow-up analyses testing for differences
between two nonindependent samples (Howell, 1997, p. 263) showed that the corre-
lation between intolerance of uncertainty and worry was signicantly stronger than
the one between intolerance of uncertainty and obsessions/compulsions, t(344)
5.17, p .001, and the one between intolerance of uncertainty and panic sensations,
t(344) 10.72, p .001. The correlation matrix is presented in Table I.
To examine further the specicity of the relationship between intolerance of
uncertainty and worry, two hierarchical regressions were carried out. Preliminary
analyses conrmed that all variables respected the conditions of normality, linearity,
and homoscedasticity. In the rst regression, the tendency to worry (PSWQ) was
the predicted variable. The demographic variables (age and gender) were entered
in the rst step and did not make, as a set, a signicant contribution to the prediction
of worry scores. Other process variables, i.e., responsibility (RS) and anxiety sensi-
tivity (ASI), were then entered into the equation. This second set yielded a signicant
result, accounting for 9.8% of the variance in worry scores. Finally, intolerance of
Specicity of Intolerance of Uncertainty 555
Table I. Correlation Matrix for All Measures (N 344)
Age Gender PSWQ PI BSQ IUS RS ASI
Age .02 .04 .05 .12* .02 .00 .07
Gender
a
.12* .04 .13* .11* .04 .03
PSWQ .39*** .12* .70*** .28*** .23***
PI .38*** .48*** .57*** .50***
BSQ .12* .27*** .63***
IUS .40*** .33***
RS .34***
ASI
Note: PSWQ, Penn State Worry Questionnaire (worry); PI, Padua Inventory (OC symptoms); BSQ,
Body Sensations Questionnaire (panic symptoms); IUS, Intolerance of Uncertainty Scale (intolerance
of uncertainty); RS, R-Scale (responsibility); SI, Anxiety Sensitivity Index (anxiety sensitivity).
a
Gender coding: 0 female; 1 male.
* p .05; ** p .01; *** p .001.
uncertainty (IUS) was entered in the last step and accounted for 42.0% of the
variance of worry scores above and beyond what had already been explained by
participant demographics and other process variables.
Intolerance of uncertainty (IUS) was the predicted variable for the second
regression. Participant demographics were entered in the rst step and did not
make a signicant contribution to the prediction of intolerance of uncertainty scores.
The measures of obsessions/compulsions (PI) and panic sensations (BSQ), which
were entered in the second step, made a signicant contribution and explained
22.1% of the variance in intolerance of uncertainty scores. Worry (PSWQ) was
entered in the third and nal step and accounted for an additional 33.9% of the
variance in intolerance of uncertainty scores. Table II presents the results of
both regressions.
DISCUSSION
The goal of the present study was to investigate the specicity of the relationship
between intolerance of uncertainty and worry in a nonclinical sample. The rst
hypothesis, stating that intolerance of uncertainty would be more highly related to
worry than to obsessions/compulsions and panic sensations, was supported. Results
from the correlation matrix reveal that intolerance of uncertainty was highly related
to the tendency to worry, moderately related to obsessions/compulsions, and weakly
related to panic sensations. This pattern of results ts nicely with the fact that in
nonclinical populations worries and obsessions share many features. Although some
worries (e.g., thoughts about being late for an appointment) are easily discernible
from some obsessions (e.g., thoughts about yelling obscenities in church), other
intrusive thoughts are more difcult to t into one of these categories. For example,
persistent thoughts about the possibility of ones spouse being unfaithful may be
conceptualized as worry in some cases and as an obsession in others.
The second and third hypotheses were also supported. In the rst hierarchical
regression, intolerance of uncertainty accounted for a signicant amount of variance
556 Dugas, Gosselin, and Ladouceur
Table II. Hierarchical Regression: Specicity of Relationship Between Intolerance of Uncertainty
and Worry
Variables R
2
B SE B
Prediction of worry (PSWQ) scores (N 344)
Demographic .014
Age .033 .075 .016
Gender
a
5.460 1.056 .196***
Other processes .098***
Responsibility (RS) .001 .030 .002
Anxiety sensitivity (ASI) .016 .048 .013
Intolerance of uncertainty (IUS) .420*** .475 .028 .728***
Prediction of intolerance of uncertainty (IUS) scores (N 346)
Demographic .014
Age .042 .110 .014
Gender
a
7.535 1.547 .179***
Other symptoms .221***
OC symptoms (PI) .158 .029 .228***
Panic symptoms (BSQ) .021 .059 .014
Worry (PSWQ) .339*** .975 .060 .637***
Note: PSWQ, Penn State Worry Questionnaire; RS, R-Scale; ASI, Anxiety Sensitivity Index; IUS,
Intolerance of Uncertainty Scale; PI, Padua Inventory; BSQ, Body Sensations Questionnaire.
a
Gender coding: 0 female; 1 male.
* p .05; ** p .01; *** p .001.
in worry scores over and above that accounted for by responsibility and anxiety
sensitivity. Likewise, in the second regression, worry accounted for a signicant
amount of variance in intolerance of uncertainty scores above and beyond that
accounted for by obsessions/compulsions and panic symptoms. Thus it appears that
intolerance of uncertainty in nonclinical populations is specically associated with
excessive and uncontrollable worry. Given that pathological worry is the main
feature of generalized anxiety disorder (GAD) and that intolerance of uncertainty
is associated with the diagnosis of GAD (Dugas et al., 1998; Ladouceur, Blais,
Freeston, & Dugas, 1998), these ndings suggest that helping nonclinical individuals
to become more tolerant of uncertainty may go some way in preventing the develop-
ment of GAD. Moreover, by linking intolerance of uncertainty with developmental
factors such as childhood relationships (Borkovec & Newman, 1999) and mainte-
nance factors such as beliefs about worry (Davey, Tallis, & Capuzzo, 1996), we
may gain a fuller understanding of why certain individuals eventually come to suffer
from GAD.
One limitation of this research resides in the gender composition of the sample.
Given that female participants were overrepresented in the sample, the generaliz-
ability of the ndings for male individuals is questionable. A second limitation of
the study relates to the fact that intolerance of uncertainty (IUS) and worry (PSWQ)
are largely cognitive constructs. Although beliefs about responsibility (RS) and
anxiety sensitivity (ASI) are also predominantly cognitive constructs, obsessions/
compulsions (PI) and bodily sensations (BSQ) are not. This raises the possibility
that the studys ndings were inuenced by the domains being measured by the
questionnaires. In other words, two questionnaires measuring constructs from the
same domain would have a greater chance of being highly related. However, given
Specicity of Intolerance of Uncertainty 557
that the rst regression controlled for other constructs from the cognitive domain
(beliefs about responsibility and anxiety sensitivity) in assessing the relationship
between intolerance of uncertainty and worry, this argues against the ndings being
inuenced in a substantive manner by the domains of the constructs.
In summary, this study shows that the relationship between intolerance of
uncertainty and worry shows evidence of specicity in a nonclinical population.
Future research should pursue this line of investigation by testing the relationship
between intolerance of uncertainty, social anxiety, and depression. Worry is an
important component of social anxiety and depression; consequently they represent
excellent choices for furthering the investigation of the specicity of intolerance of
uncertainty with regard to worry.
ACKNOWLEDGMENT
This study was funded by the Fonds de la Recherche en Sante du Que bec.
REFERENCES
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th
ed.). Washington, DC: Author.
Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New
York: Guilford Press.
Borkovec, T. D., & Newman, M. G. (1999). Worry and generalized anxiety disorder. In A. S. Bellack,
M. Hersen, & P. Salkovskis (Eds.), Comprehensive clinical psychology: Vol. 4. Adults: Clinical
formulation and treatment (pp. 439459). Oxford: Elsevier Science.
Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983). Preliminary exploration of worry:
Some characteristics and processes. Behaviour Research and Therapy, 21, 916.
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in
agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire.
Journal of Consulting and Clinical Psychology, 52, 10901097.
Davey, G. C. L., Tallis, F., & Capuzzo, N. (1996). Beliefs about the consequences of worrying. Cognitive
Therapy and Research, 5, 499520.
Dugas, M. J., Freeston, M. H., & Ladouceur, R. (1997). Intolerance of uncertainty and problem orienta-
tion in worry. Cognitive Therapy and Research, 21, 593606.
Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A
preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215226.
Freeston, M. H., Rhe aume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry?
Personality and Individual Differences, 17, 791802.
Howell, D. C. (1997). Statistical methods for psychology (4th ed.). Belmont, CA: Wadsworth.
Kyrios, M., Bhar, S., & Wade, D. (1996). The assessment of obsessive-compulsive phenomena: Psycho-
metric and normative data on the Padua Inventory from an Australian non-clinical student sample.
Behaviour Research and Therapy, 34, 8595.
Ladouceur, R., Blais, F., Freeston, M. H., &Dugas, M. J. (1998). Problemsolving and problemorientation
in generalized anxiety disorder. Journal of Anxiety Disorders, 12, 139152.
Ladouceur, R., Dugas, M. J., Freeston, M. H., Rhe aume, J., Blais, F., Gagnon, F., Thibodeau, N., &
Boisvert, J.-M. (1999). Specicity of generalized anxiety disorder symptoms and processes. Behavior
Therapy, 30, 191207.
Ladouceur, R., Gosselin, P., & Dugas, M. J. (2000). Experimental manipulation of intolerance of
uncertainty: A study of a theoretical model of worry. Behaviour Research and Therapy, 38, 933941.
MacLeod, A. K., Williams, M. G., &Bekerian, D. A. (1991). Worry is reasonable: The role of explanations
in pessimism about future personal events. Journal of Abnormal Psychology, 100, 478486.
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of
the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487496.
558 Dugas, Gosselin, and Ladouceur
Molina, S. T., & Borkovec, T. D. (1994). The Penn State Worry Questionnaire: Psychometric properties
and associated characteristics. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on
theory, assessment and treatment (pp. 265283). New York: Wiley.
Reiss, S., Peterson, R. S., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety, frequency
and the prediction of fearfulness. Behaviour Research and Therapy, 24, 18.
Rhe aume, J., Freeston, M. H., Dugas, M. J., Letarte, H., & Ladouceur, R. (1995). Perfectionism,
responsibility and obsessive-compulsive symptoms. Behaviour Research and Therapy, 33, 785794.
Salkovskis, P. M. (1992, June). Cognitive models of therapy of obsessive-compulsive disorder. Paper
presented at the World Congress of Cognitive Therapy, Toronto, Ontario, Canada.
Sanavio, E. (1988). Obsessions and compulsions: The Padua Inventory. Behaviour Research and Therapy,
26, 169177.
Sternburger, L. G., & Burns, G. L. (1990). Obsessions and compulsions: Psychometric properties of
the Padua Inventory with an American college population. Behaviour Research and Therapy,
28, 341345.
Tallis, F., Davey, G. C. L., & Capuzzo, N. (1994). The phenomenology of non-pathological worry: A
preliminary investigation. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory,
assessment and treatment (pp. 6189). New York: Wiley.
Tallis, F., & Eysenck, M. H. (1994). Worry: Mechanisms and modulating inuences. Behavioural and
Cognitive Psychotherapy, 22, 3756.

También podría gustarte