Do individual differences in intolerance of uncertainty affect health monitoring?

Rosen, Natalie O.; Knaüper, Bärbel; Sammut, Jessica

doi:10.1080/14768320600941038

Cited by 58 publications

(56 citation statements)

References 35 publications

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“…These beliefs pertain to the uncertain world, a small unforeseen event that can spoil everything (Koerner & Dugas, 2008). Beliefs about uncertainty are also self-referent (Koerner & Dugas, 2008) and an individual difference (Koerner & Dugas, 2008;Rosen, Knauper & Sammut, 2007) assumed to remain relatively stable across situations and may affect a person's ability to choose appropriate coping mechanisms, which may lead, therefore, to a more adaptive health behavior (Rosen et al, 2007). However, Boelen (2010) emphasizes that people who experience IU may see the possible occurrence of future negative events as stressful and may have difficulty functioning well in an uncertain situation.…”

Section: Intolerance Of Uncertaintymentioning

confidence: 99%

A Structural Equation Modelling on the Factors Affecting Intolerance of Uncertainty and Worry Among a Select Group of Filipino Elderly

Guzman

Lacao

Larracas

2014

Educational Gerontology

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Across the literature, the interest in the phenomenon of intolerance of uncertainty (IU) and worry has increased exponentially. However, limited empirical studies exist about the factors that affect IU and worry among older people. The purpose of the study was to examine the impact of spirituality, selfefficacy, and knowledge about aging on IU and worry. A total of 219 Filipino elderly were recruited from institutionalized and hospital care settings. A multiaspect questionnaire was utilized to measure spirituality, self-efficacy, knowledge, intolerance uncertainty, and worry. Exploratory factor analysis (EFA) was used to explore the dimensions of IU and worry. Moreover, structural equation modelling was used to test the hypothesized model. Results of EFA identified four factor dimensions of uncertainty, namely: perfection-driven uncertainty, apprehension-driven uncertainty, avoidance-driven uncertainty, negativism-driven uncertainty. Further, three factor dimensions of worry were also distinguished: constant worriers, obsessive-compulsive worriers, and happy-go-lucky worriers. Moreover, results of structural equation modeling (SEM) showed interaction among the variables presented. Additionally, spirituality showed a positive effect on self-efficacy. However, self-efficacy does not have an effect on IU and worry. Nevertheless, an emerging path between knowledge and IU supported the claim of Nuevo, Wetherell, Montorio, Ruiz, and Cabrera (2009). The study was able to determine the positive effect of spirituality to self-efficacy and its existing correlation with knowledge about aging in relation to elderly's IU and worry. The emerging model can serve as a reference for nurses to address the sociopsychological needs of the geriatric clients employing spirituality and psychiatric nursing.Intolerance of uncertainty is defined as a cognitive bias that affects how a person perceives, interprets, and responds to uncertain situations on a cognitive, emotional, and behavioral level

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Section: Intolerance Of Uncertaintymentioning

confidence: 99%

A Structural Equation Modelling on the Factors Affecting Intolerance of Uncertainty and Worry Among a Select Group of Filipino Elderly

Guzman

Lacao

Larracas

2014

Educational Gerontology

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“…Of note, a cognitive-behavioral treatment based on the IU model of GAD has been developed and validated in previous controlled trials (for a review, see Dugas and Robichaud 2007). Experimental studies in adult samples have shown that changes in IU lead to corresponding changes in worry and monitoring behavior (Grenier and Ladouceur 2004;Ladouceur et al 2000;Rosen and Knäuper 2009;Rosen et al 2007). Although the IU model has been tested extensively with adults, only two studies have tested the model in samples of adolescents (i.e., Barahmand 2008;Laugesen et al 2003).…”

mentioning

confidence: 99%

Intolerance of Uncertainty, Fear of Anxiety, and Adolescent Worry

Dugas

Laugesen

Bukowski

2012

J Abnorm Child Psychol

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A 5 year, ten wave longitudinal study of 338 adolescents assessed the association between two forms of cognitive vulnerability (intolerance of uncertainty and fear of anxiety) and worry. Multilevel mediational analyses revealed a bidirectional and reciprocal relation between intolerance of uncertainty and worry in which change in one variable partially explained change in the other. Fear of anxiety and worry also showed evidence of a bidirectional relation, although change in fear of anxiety had a much weaker mediational effect on change in worry than vice versa. The findings show that relative to fear of anxiety, intolerance of uncertainty may play a greater role in the etiology of worry in adolescents.

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“…29,30 Data also suggest that intolerance of uncertainty is a causal risk factor for high levels of worry and GAD; for example, changes in intolerance of uncertainty precede changes in worry over the course of treatment, 31 and the experimental manipulation of intolerance of uncertainty leads to corresponding changes in worry and monitoring behaviour. 32,33 Thus, data from correlational, longitudinal and experimental studies suggest that intolerance of uncertainty plays a key role in GAD. The Dugas and Koerner model 28 is one of three CBT protocols for GAD, which guides IAPT services in how to carry out CBT effectively and in line with best practice.…”

Section: Cognitive Behavioural Therapymentioning

confidence: 99%

Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological treatments as defined by the National Institute for Health and Care Excellence guidelines

Buszewicz

Cape

Serfaty

et al. 2017

Health Technol Assess

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Background Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. Objectives To assess clinical effectiveness and cost-effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE-defined low-intensity psychological interventions. Design Participant randomised trial comparing treatment with sertraline with high-intensity CBT for patients with GAD who had not responded to low-intensity psychological interventions. Setting Community-based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. Participants People considered likely to have GAD and not responding to low-intensity psychological interventions identified at review by IAPT psychological well-being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder-7 (GAD-7) anxiety measure were asked to consider involvement in the trial. Inclusion criteria Aged ≥ 18 years, a score of ≥ 10 on the GAD-7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE-defined low-intensity interventions. Exclusion criteria Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing greater distress than GAD, significant dependence on alcohol or illicit drugs, comorbid psychotic disorder, received antidepressants in past 8 weeks or high-intensity psychological therapy in previous 6 months and any contraindications to treatment with sertraline. Randomisation Consenting eligible participants randomised via an independent, web-based, computerised system. Interventions (1) The SSRI sertraline prescribed in therapeutic doses by the patient’s general practitioner for 12 months and (2) 14 (± 2) CBT sessions delivered by high-intensity IAPT psychological therapists in accordance with a standardised manual designed for GAD. Main outcome measures The primary outcome was the Hospital Anxiety and Depression Scale – Anxiety component at 12 months. Secondary outcomes included measures of depression, social functioning, comorbid anxiety disorders, patient satisfaction and economic evaluation, collected by postal self-completion questionnaires. Results Only seven internal pilot participants were recruited against a target of 40 participants at 7 months. Far fewer potential participants were identified than anticipated from IAPT services, probably because PWPs rarely considered GAD the main treatment priority. Of those identified, three-quarters declined participation; the majority (30/45) were reluctant to consider the possibility of randomisation to medication. Limitations Poor recruitment was the main limiting factor, and the trial closed prematurely. Conclusions It is unclear how much of the recruitment difficulty was a result of conducting the trial within a psychological therapy service and how much was possibly a result of difficulty identifying participants with primary GAD. Future work It may be easier to answer this important question by recruiting people from primary care rather than from those already engaged in a psychological treatment service. Trial registration Current Controlled Trials ISCRTN14845583. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 45. See the NIHR Journals Library website for further project information.

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Do individual differences in intolerance of uncertainty affect health monitoring?

Cited by 58 publications

References 35 publications

A Structural Equation Modelling on the Factors Affecting Intolerance of Uncertainty and Worry Among a Select Group of Filipino Elderly

A Structural Equation Modelling on the Factors Affecting Intolerance of Uncertainty and Worry Among a Select Group of Filipino Elderly

Intolerance of Uncertainty, Fear of Anxiety, and Adolescent Worry

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