Intolerance of uncertainty as a factor linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of the novel coronavirus (COVID-19) in the United States

The impact of the coronavirus pandemic on specific symptom dimensions and severity in OCD: A comparison before and during COVID-19 in the context of stress responses

“…COVID-19 poses significant challenges for many that would be expected to result in an increase in OC symptoms across different dimensions. COVID-19 has been previously been noted to have negative effects on mental health due to increased levels of uncertainty and unpredictability ( Tull et al, 2020 ; Wheaton et al, 2021 ; Zandifar & Badrfam, 2020 ), distress, fear, anxiety ( Elhai, Yang, McKay, & Asmundson, 2020 ; Mertens, Gerritsen, Duijndam, Salemink, & Engelhard, 2020 ), and health-related worries and concerns ( Jungmann & Witthöft, 2020 ; Taylor et al, 2020b ). Indeed, when OC symptoms emerge in community individuals due to the COVID-19 ( Zheng, Xiao, Xie, Wang, & Wang, 2020 ), it is not surprising to find an increase in symptoms across multiple dimensions in patients with OCD, especially in those with pre-existing OCD than those recently diagnosed with OCD ( Nissen et al, 2020 ).…”

“…The coronavirus disease-2019 (COVID-19 ) pandemic has affected mental health in patients with obsessive-compulsive disorder (OCD) ( Pan et al, 2021 ) and has raised specific concerns for those with OCD due to their tendency to respond to danger and uncertainty ( Khosravani, Asmundson, Taylor, Bastan, & Ardestani, 2021 ; Wheaton, Messner, & Marks, 2021 ). In particular, it has been suggested that hygienic recommendations in the context of the pandemic may intensify illness severity, especially for those with obsessional fears of contamination ( Fineberg et al, 2020 ; Fontenelle & Miguel, 2020 ; Lee, 2020 ).…”

“…Stressful life events, as well as distress in general, have previously been shown to be associated with the exacerbation of OC symptoms ( Adams et al, 2018 ; Imthon et al, 2020 ; Khosravani, Bastan, et al, 2020 ; Khosravani, Ardestani, et al, 2020 ; Rosso, Albert, Asinari, Bogetto, & Maina, 2012 ). COVID-19-related stress is significantly associated with OCD-like stress symptoms ( Taylor et al, 2020a ), intrusive thoughts ( Lee, 2020 ; Marroquín, Vine, & Morgan, 2020 ), reassurance-seeking ( Shafran, Coughtrey, & Whittal, 2020 ), intolerance of uncertainty, OCD symptoms, health anxiety ( Wheaton et al, 2021 ), anxiety symptoms, and avoidance behaviors ( McKay, Yang, Elhai, & Asmundson, 2020a ; Nissen et al, 2020 ; Seçer & Ulaş, 2020 ), especially in individuals with anxiety-related disorders ( Asmundson et al, 2020 ) and those with OCD ( Khosravani et al, 2021 ). Consequently, an increase in symptoms of OCD as the result of the current pandemic would be expected to be significantly predicted by what has recently been labeled as “COVID Stress Syndrome” ( Khosravani et al, 2021 ; Taylor et al, 2020c ).…”

Effects of anxiety sensitivity, disgust, and intolerance of uncertainty on the COVID stress syndrome: a longitudinal assessment of transdiagnostic constructs and the behavioural immune system

“…IU has been shown to play a critical role in anxiety (Gentes & Ruscio, 2011) and associated with greater monitoring of health threats (Rosen et al, 2007), and greater anxiety towards H1N1 (Taha et al, 2014) and COVID-19 (Taylor et al, 2020a). IU may also be a particularly relevant factor in the context of the earlier stages of the COVID-19 pandemic, given the uncertainty associated with the virus during that time period (Wheaton et al, 2021). Individuals with high IU may rely on activation from the BIS to provide some sense of perceptible information within the highly uncertain context of a pandemic (Paluszek et al, 2020;Taylor, 2019); as such, pre-COVID-19 levels of IU may further amplify the effect of disgust and ASphysical concerns on facets of COVID stress syndrome.…”

A Biopsychosocial Approach to Understanding Panic Buying: Integrating Neurobiological, Attachment-Based, and Social-Anthropological Perspectives

“…The onset of OCD symptoms during the COVID-19 pandemic has been associated with an intolerance of uncertainty and distress ( 70 ) as well as with an increase in and a higher level of perceived threat ( 71 , 72 ) have both been associated with the emergence of de novo OCD symptoms during the pandemic. These psychological mechanisms are related to both hoarding behavior ( 73 ) and panic buying ( 21 ), which would be expected if these behaviors have common psychological roots.…”