Abstract
Intolerance of uncertainty (IU) and the tendency to repetitively think in a negative way about oneself are established contributors to depression; however, no study has yet examined the unique and interacting effects of these variables to depression symptoms and diagnoses amongst people with major depressive disorder (MDD). People with MDD (n = 48) and diagnoses-free, community controls (n = 66) completed self-report measures of depression, anxiety and IU, as well as constructive (focusing on how events occurred) and unconstructive (focusing on how events felt) rumination. In a linear regression, greater IU and diminished constructive rumination, and the interaction between IU and unconstructive rumination, each explained variance in depression symptoms, even when anxiety symptoms were accounted for. In a logistic regression, these variables did not contribute towards MDD diagnoses once anxiety symptoms were accounted for. Rumination about one’s mood is associated with enhanced distress during uncertainty, with detrimental effects for one’s depression symptoms.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA, VA: American Psychiatric Association https://doi.org/10.1176/appi.books.9780890425596.744053.
Beck, A., Steer, R., & Brown, G. (1996). Beck Depression Inventory-II. San Antonio, TX: Psychological Corperation. https://doi.org/10.1037/t00742-000.
Carleton, R. N. (2016a). Fear of the unknown: one fear to rule them all? Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2016.03.011.
Carleton, R. N. (2016b). Into the unknown: a review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2016.02.007.
Carleton, R. N., Mulvogue, M. K., Thibodeau, M. A., McCabe, R. E., Antony, M. M., & Asmundson, G. J. G. (2012). Increasingly certain about uncertainty: intolerance of uncertainty across anxiety and depression. Journal of Anxiety Disorders, 26(3), 468–479 https://doi.org/10.1016/j.janxdis.2012.01.011.
Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007). Fearing the unknown: A short version of the Intolerance of Uncertainty Scale. Journal of Anxiety Disorders, 21(1), 105–117 https://doi.org/10.1016/j.janxdis.2006.03.014.
de Jong-Meyer, R., Beck, B., & Riede, K. (2009). Relationships between rumination, worry, intolerance of uncertainty and metacognitive beliefs. Personal Individ Differ, 46(4), 547–551 https://doi.org/10.1016/j.paid.2008.12.010.
Di Schiena, R., Luminet, O., Chang, B., & Philippot, P. (2013). Why are depressive individuals indecisive? Different modes of rumination account for indecision in non-clinical depression. Cogn Ther Res, 37(4), 713–724 https://doi.org/10.1007/s10608-012-9517-9.
Di Schiena, R., Luminet, O., & Philippot, P. (2011). Adaptive and maladaptive rumination in alexithymia and their relation with depressive symptoms. Personal Individ Differ, 50(1), 10–14 https://doi.org/10.1016/j.paid.2010.07.037.
Di Schiena, R., Luminet, O., Philippot, P., & Douilliez, C. (2012). Adaptive and maladaptive perfectionism in depression: preliminary evidence on the role of adaptive and maladaptive rumination. Personal Individ Differ, 53(6), 774–778 https://doi.org/10.1016/j.paid.2012.05.017.
Douilliez, C., Heeren, A., Lefevre, N., Watkins, E., Barnard, P., & Philippot, P. (2014). Validation of the French version of a questionnaire that evaluates constructive and non-constructive repetitive thoughts. Can J Psychiatry. https://doi.org/10.1037/a0033185.
Douilliez, C., Philippot, P., Heeren, A., Watkins, E. R., & Barnard, P. (2012). The Mini-CERTS (Cambridge-Exeter Repetitive Thought Scale): a short questionnaire to assess constructive and unconstructive repetitive thinking. Can J Psychiatry, 1–19.
Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clin Psychol Rev, 31(6), 923–933 https://doi.org/10.1016/j.cpr.2011.05.001.
Grynberg, D., de Timary, P., Philippot, P., D’Hondt, F., Briane, Y., Devynck, F., et al. (2016). Abstract and concrete repetitive thinking modes in alcohol-dependence. J Addict Dis, 35(4), 238–243 https://doi.org/10.1080/10550887.2016.1207970.
Hong, R. Y. (2013). From dispositional traits to psychopathological symptoms: social-cognitive vulnerabilities as intervening mechanisms. J Psychopathol Behav Assess, 35(4), 407–420 https://doi.org/10.1007/s10862-013-9350-9.
Hong, R. Y., & Cheung, M. W. L. (2015). The structure of cognitive vulnerabilities to depression and anxiety: evidence for a common core etiologic process based on a meta-analytic review. Clin Psychol Sci, 3(6), 892–912 https://doi.org/10.1177/2167702614553789.
Hong, R. Y., & Paunonen, S. V. (2011). Personality vulnerabilities to psychopathology: relations between trait structure and affective-cognitive processes. J Pers, 79(3), 527–562 https://doi.org/10.1111/j.1467-6494.2011.00683.x.
Jacoby, R. J., Abramowitz, J. S., Reuman, L., & Blakey, S. M. (2015). Enhancing the ecological validity of the beads task as a behavioral measure of intolerance of uncertainty. Journal of Anxiety Disorders, 41, 43–49 https://doi.org/10.1016/j.janxdis.2016.02.003.
Jensen, D., Cohen, J. N., Mennin, D. S., Fresco, D. M., & Heimberg, R. G. (2016). Clarifying the unique associations among intolerance of uncertainty, anxiety, and depression*. Cogn Behav Ther, 45(6), 431–444 https://doi.org/10.1080/16506073.2016.1197308.
Liao, K. Y. H., & Wei, M. (2011). Intolerance of uncertainty, depression, and anxiety: the moderating and mediating roles of rumination. J Clin Psychol, 67(12), 1220–1239 https://doi.org/10.1002/jclp.20846.
Mahoney, A. E. J., & McEvoy, P. M. (2012). A transdiagnostic examination of intolerance of uncertainty across anxiety and depressive disorders. Cogn Behav Ther, 41(3), 212–222 https://doi.org/10.1080/16506073.2011.622130.
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnorm Psychol, 109(3), 504–511 https://doi.org/10.1037/0021-843X.109.3.504.
Olatunji, B. O., Naragon-Gainey, K., & Wolitzky-Taylor, K. B. (2013). Specificity of rumination in anxiety and depression: a multimodal meta-analysis. Clinical Psychology: Science & Practice, 20(3), 225–257 https://doi.org/10.1111/cpsp.12037.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Janavs, J., Weiller, E., Keskiner, A., et al. (2000). MINI International Neuropsychiatric Interview, MINI. European Psychiatry. https://doi.org/10.1016/S0924-9338(97)83297-X.
Shihata, S., Mcevoy, P. M., Ann, B., & Carleton, R. N. (2016). Intolerance of uncertainty in emotional disorders: what uncertainties remain? Journal of Anxiety Disorders, 41, 115–124 https://doi.org/10.1016/j.janxdis.2016.05.001.
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA, CA: Consulting Psychologists Press, Inc.. https://doi.org/10.1002/ana.22691.
Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychol Bull, 134(2), 163–206 https://doi.org/10.1037/0033-2909.134.2.163.
Watkins, E. R., Mullan, E., Wingrove, J., Rimes, K., Steiner, H., Bathurst, N., et al. (2011). Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial. Br J Psychiatry, 199(4), 317–322 https://doi.org/10.1192/bjp.bp.110.090282.
White, R. G., & Gumley, A. (2010). Intolerance of uncertainty and distress associated with the experience of psychosis. Psychol Psychother Theory Res Pract, 83(3), 317–324 https://doi.org/10.1348/147608309X477572.
Yook, K., Kim, K. H., Suh, S. Y., & Lee, K. S. (2010). Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 24(6), 623–628 https://doi.org/10.1016/j.janxdis.2010.04.003.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The study procedure complied with international and national standards for studies with human participants. Ethical approval for the study was provided by the Research Committee of the Albacete, Spain, Health Area (05/2017CEIm).
Conflict of Interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Barry, T.J., García-Moreno, C., Sánchez-Mora, C. et al. The Unique and Interacting Contributions of Intolerance of Uncertainty and Rumination to Individual Differences in, and Diagnoses of, Depression. J Cogn Ther 12, 260–273 (2019). https://doi.org/10.1007/s41811-019-00057-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s41811-019-00057-3