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Reliability and Validity of a Brief Version of the Intolerance of Uncertainty Scale in Outpatients with Psychosis

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Abstract

Individual differences in intolerance of uncertainty are hypothesized to play a role in certain difficulties and distress in individuals with psychosis. However, the few studies that have directly explored this have yielded mixed results, which are difficult to interpret because measures of intolerance of uncertainty have not been formally validated for use with this population. To this end, the primary goal of the present study was to validate a brief (9-item) version of the Intolerance of Uncertainty Scale (Freeston et al. Personality and Individual Differences, 17, 791–802 1994) in an outpatient sample of 252 adults with psychosis. Results showed strong evidence for reliability (internal consistency and 6-month test-retest), as well as concurrent, predictive, and discriminant validity. Scores from the brief IUS were significantly correlated with emotional distress (e.g., anxiety, depression, hopelessness), quality of life, global functioning, and delusions, but not hallucinations. Further, these scores predicted changes in levels of general anxiety over time. Notably, intolerance of uncertainty was associated with symptoms/distress and functioning above and beyond pertinent cognitive variables (e.g., defeatist beliefs, asocial beliefs), suggesting this brief scale has incremental validity. Overall, results suggest it is a promising tool for future research on psychosis, and possibly clinical work with this population.

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Notes

  1. One additional (reverse-scored) item was initially included, but was dropped because of low correlations with these other six items in the present sample.

  2. Distributions of clinical symptoms ratings are typically non-normal (because low scores are common), which can pose a concern for interpreting results from parametric statistical analyses (e.g., Pearson correlations). Importantly, consistent results emerged when alternative analytic strategies were utilized for these rating scores (i.e., non-parametric [Spearman] correlations, Poisson regression).

  3. Importantly, these studies suggest that identified subfacets on the full IUS are strongly correlated with one another (e.g., (Buhr and Dugas 2002; Sexton and Dugas 2009), supporting the examination/use of full scale scores (in addition to subscale scores).

References

  • American Psychiatric Association (2000). Diagnositc and statistical manual of mental disorders (4th ed.). Washington, D.C.

  • Andersen, S. M., & Schwartz, A. H. (1992). Intolerance of ambiguity and depression - a cognitive vulnerability factor linked to hopelessness. Social Cognition, 10(3), 271–298. https://doi.org/10.1521/soco.1992.10.3.271.

    Article  Google Scholar 

  • Andreasen, N. C. (1984a). Scale for the assessment of negative symptoms (SANS). Iowa City: University of Iowa.

    Google Scholar 

  • Andreasen, N. C. (1984b). Scale for the assessment of positive symptoms (SAPS). Iowa City: University of Iowa.

    Google Scholar 

  • Andreasen, N., Flaum, M., Arndt, S., Alliger, R., & Swayze, V. W. (1991). Positive and negative symptoms: assessment and validity. In Negative versus positive schizophrenia (pp. 28–51). Berlin, Heidelberg: Springer.

  • Arntz, A., Dreessen, L., Schouten, E., & Weertman, A. (2004). Beliefs in personality disorders: a test with the personality disorder belief questionnaire. Behaviour Research and Therapy, 42(10), 1215–1225. https://doi.org/10.1016/j.brat.2003.08.004.

    Article  PubMed  Google Scholar 

  • Ask, K., & Granhag, P. A. (2005). Motivational sources of confirmation bias in criminal investigations: the need for cognitive closure. Journal of Investigative Psychology and Offender Profiling, 2, 43–63.

    Article  Google Scholar 

  • Baker, S. L., Heinrichs, N., Kim, H. J., & Hoffman, S. G. (2002). The Liebowitz social anxiety scale as a self-report instrument: a preliminary psychometrics analysis. Behaviour Research and Therapy, 40, 701–715.

    Article  Google Scholar 

  • Beck, A. T., & Beck, J. (1991). The personality belief questionnaire. Bala Cynwyd, PA: The Beck Institute for Cognitive Therapy and Research.

    Google Scholar 

  • Beck, A. T., & Warman, D. M. (2004). Cognitive insight: Theory and assessment. In X. F. Amador & A. S. David (Eds.), Insight and psychosis: Awareness of illness in schizophrenia and related disorders (2nd ed., pp. 79–87). New York: Oxford University Press.

    Chapter  Google Scholar 

  • Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting and Clinical Psychology, 42(6), 861–865.

    Article  Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897.

    Article  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, 78(2), 490–498.

  • Beck, A. T., Rector, N. A., Stolar, N., & Grant, P. M. (2009). Schizophrenia: Cognitive theory, research, and therapy. New York: Guilford Press.

    Google Scholar 

  • Bentall, R. P., & Swarbrick, R. (2003). The best laid schemas of paranoid patients: autonomy, sciotropy and need for closure. Psychol Psychother, 76, 163–171.

    Article  Google Scholar 

  • Berenbaum, H., Bredemeier, K., & Thompson, R. J. (2008). Intolerance of uncertainty: exploring its dimensionality and associations with need for cognitive closure, psychopathology, and personality. Journal of Anxiety Disorders, 22(1), 117–125. https://doi.org/10.1016/j.janxdis.2007.01.004.

    Article  PubMed  Google Scholar 

  • Bhar, S. S., Beck, A. T., & Butler, A. C. (2012). Beliefs and personality disorders: an overview of the personality beliefs questionnaire. Journal of Clinical Psychology, 68(1), 88–100. https://doi.org/10.1002/jclp.20856.

    Article  PubMed  Google Scholar 

  • Birchwood, M. J., Macmillan, F., & Smith, J. (1992). Early Intervention. In M. J. Birchwood & N. Tarrier (Eds.), Innovations in the psychological management of schizophrenia: Assessment, treatment, and services (pp. 115–145). Oxford, U.K.: Wiley.

    Google Scholar 

  • Birrell, J., Meares, K., Wilkinson, A., & Freeston, M. (2011). Toward a definition of intolerance of uncertainty: a review of factor analytical studies of the intolerance of uncertainty scale. Clinical Psychology Review, 31(7), 1198–1208. https://doi.org/10.1016/j.cpr.2011.07.009.

    Article  PubMed  Google Scholar 

  • Boelen, P. A. (2010). Intolerance of uncertainty and emotional distress following the death of a loved one. Anxiety, Stress, and Coping, 23(4), 471–478. https://doi.org/10.1080/10615800903494135.

    Article  PubMed  Google Scholar 

  • Boelen, P. A., & Reijntjes, A. (2009). Intolerance of uncertainty and social anxiety. Journal of Anxiety Disorders, 23(1), 130–135. https://doi.org/10.1016/j.janxdis.2008.04.007.

    Article  PubMed  Google Scholar 

  • Boswell, J. F., Thompson-Hollands, J., Farchione, T. J., & Barlow, D. H. (2013). Intolerance of uncertainty: a common factor in the treatment of emotional disorders. Journal of Clinical Psychology, 69(6), 630–645. https://doi.org/10.1002/jclp.21965.

    Article  PubMed  Google Scholar 

  • Bredemeier, K., & Berenbaum, H. (2008). Intolerance of uncertainty and perceived threat. Behaviour Research and Therapy, 46(1), 28–38. https://doi.org/10.1016/j.brat.2007.09.006.

    Article  PubMed  Google Scholar 

  • Bredemeier, K., Beck, A. T., & Grant, P. M. (2017). Exploring the temporal relationship between cognitive insight and neurocognition in schizophrenia: A prospective analysis. Clinical Psychological Science, 6(1), 76–89. https://doi.org/10.1177/2167702617734019.

    Article  Google Scholar 

  • Broome, M. R., Johns, L. C., Valli, I., Woolley, J. B., Tabraham, P., Brett, C., ... McGuire, P. K. (2007). Delusion formation and reasoning biases in those at clinical high risk for psychosis. British Journal of Psychiatry. Supplement, 51, s38–s42. https://doi.org/10.1192/bjp.191.51.s38.

  • Buhr, K., & Dugas, M. J. (2002). The intolerance of uncertainty scale: psychometric properties of the English version. Behaviour Research and Therapy, 40(8), 931–945. https://doi.org/10.1016/s0005-7967(01)00092-4.

    Article  PubMed  Google Scholar 

  • Buhr, K., & Dugas, M. J. (2006). Investigating the contruct validity of intolerance of uncertainty and its unique relationship with worry. J Anxiety Disord, 20, 222–236.

    Article  Google Scholar 

  • Carleton, R. N., Norton, M. A., & Asmundson, G. J. (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.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Collimore, K. C., & Asmundson, G. J. (2010). “It’s not just the judgments—It’s that I don’t know”: Intolerance of uncertainty as a predictor of social anxiety. J Anxiety Disord, 24, 189–195.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Clark, L. A., & Watson, D. (1995). Constructing validity: basic issues in objective scale development. Psychological Assessment, 7(3), 309–319. https://doi.org/10.1037//1040-3590.7.3.309.

    Article  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Erlbaum Associates.

    Google Scholar 

  • Colbert, S. M., & Peters, E. R. (2002). Need for closure and jumping-to-conclusions in delusion-prone individuals. Journal of Nervous and Mental Disease, 190(1), 27–31.

    Article  Google Scholar 

  • Colbert, S. M., Peters, E. R., & Garety, P. A. (2006). Need for closure and anxiety in delusions: a longitudinal investigation in early psychosis. Behaviour Research and Therapy, 44(10), 1385–1396. https://doi.org/10.1016/j.brat.2005.06.007.

    Article  PubMed  Google Scholar 

  • Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation, 10(7).

  • Cougle, J. R., Fitch, K. E., Fincham, F. D., Riccardi, C. J., Keough, M. E., & Timpano, K. R. (2012). Excessive reassurance seeking and anxiety pathology: tests of incremental associations and directionality. Journal of Anxiety Disorders, 26(1), 117–125. https://doi.org/10.1016/j.janxdis.2011.10.001.

    Article  PubMed  Google Scholar 

  • Debbane, M., Van der Linden, M., Balanzin, D., Billieux, J., & Eliez, S. (2012). Associations among metacognitive beliefs, anxiety and positive schizotypy during adolescence. Journal of Nervous and Mental Disease, 200(7), 620–626. https://doi.org/10.1097/NMD.0b013e31825bfc1a.

    Article  PubMed  Google Scholar 

  • Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck depression inventory - II. Psychological Assessment, 10(2), 83–89. https://doi.org/10.1037/1040-3590.10.2.83.

    Article  Google Scholar 

  • Drake, R., Haddock, G., Tarrier, N., Bentall, R., & Lewis, S. (2007). The psychotic symptom rating scales (PSYRATS): their usefulness and properties in first episode psychosis. Schizophrenia Research, 89(1–3), 119–122. https://doi.org/10.1016/j.schres.2006.04.024.

    Article  PubMed  Google Scholar 

  • Dudley, R., Shaftoe, D., Cavanagh, K., Spencer, H., Ormrod, J., Turkington, D., & Freeston, M. (2011). ‘Jumping to conclusions’ in first-episode psychosis. Early Intervention in Psychiatry, 5(1), 50–56. https://doi.org/10.1111/j.1751-7893.2010.00258.x.

    Article  PubMed  Google Scholar 

  • Dudley, R., Daley, K., Nicholson, M., Shaftoe, D., Spencer, H., Cavanagh, K., & Freeston, M. (2013). ‘Jumping to conclusions’ in first-episode psychosis: a longitudinal study. British Journal of Clinical Psychology, 52(4), 380–393. https://doi.org/10.1111/bjc.12023.

    Article  PubMed  Google Scholar 

  • Dudley, R., Taylor, P., Wickham, S., & Hutton, P. (2016). Psychosis, delusions, an the “jumping to conclusions” reasoning bias: a systematic review and meta-analysis. Schizophrenia Bulletin, 42, 652–665.

    Article  Google Scholar 

  • Dugas, M. J., & Ladouceur, R. (2000). Treatment of GAD. Targeting intolerance of uncertainty in two types of worry. Behavior Modification, 24(5), 635–657. https://doi.org/10.1177/0145445500245002.

    Article  PubMed  Google Scholar 

  • 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(2), 215–226.

    Article  Google Scholar 

  • Dugas, M. J., Ladouceur, R., Leger, E., Freeston, M. H., Langlois, F., Provencher, M. D., & Boisvert, J. M. (2003). Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up. Journal of Consulting and Clinical Psychology, 71(4), 821–825.

    Article  Google Scholar 

  • Dugas, M. J., Hedayati, M., Karavidas, A., Buhr, K., Francis, K., & Phillips, N. A. (2005a). Intolerance of uncertainty and information processing: evidence of biased recall and interpretations. Cognitive Therapy and Research, 29(1), 57–70. https://doi.org/10.1007/s10608-005-1648-9.

    Article  Google Scholar 

  • Dugas, M. J., Marchand, A., & Ladouceur, R. (2005b). Further validation of a cognitive-behavioral model of generalized anxiety disorder: diagnostic and symptom specificity. Journal of Anxiety Disorders, 19(3), 329–343. https://doi.org/10.1016/j.janxdis.2004.02.002.

    Article  PubMed  Google Scholar 

  • Eckblad, M. L., Chapman, L. J., Chapman, J. P., & Mishlove, M. (1982). The revised social anhedonia scale. Unpublished test. University of Wisconsin, Madison.

  • Einstein, D. A. (2014). Extension of the transdiagnostic model to focus on intolerance of uncertainty: a review of the literature and implications for treatment. Clinical Psychology, 21(3), 280–300. https://doi.org/10.1111/cpsp.12077.

    Article  PubMed  PubMed Central  Google Scholar 

  • Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J. (1976). The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33(6), 766–771. https://doi.org/10.1001/archpsyc.1976.01770060086012.

    Article  PubMed  Google Scholar 

  • Fergus, T. A. (2013). Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to internet searches for medical information. Cyberpsychology, Behavior and Social Networking, 16(10), 735–739. https://doi.org/10.1089/cyber.2012.0671.

    Article  PubMed  Google Scholar 

  • Fetzner, M. G., Horswill, S. C., Boelen, P. A., & Carleton, R. N. (2013). Intolerance of uncertainty and PTSD symptoms: exploring the construct relationship in a community sample with a heterogeneous trauma history. Cognitive Therapy and Research, 37(4), 725–734. https://doi.org/10.1007/s10608-013-9531-6.

    Article  Google Scholar 

  • Frank, G. K., Roblek, T., Shott, M. E., Jappe, L. M., Rollin, M. D., Hagman, J. O., & Pryor, T. (2012). Heightened fear of uncertainty in anorexia and bulimia nervosa. International Journal of Eating Disorders, 45(2), 227–232. https://doi.org/10.1002/eat.20929.

    Article  PubMed  Google Scholar 

  • Freeman, D., & Garety, P. A. (1999). Worry, worry processes and dimensions of delusions: an exploratory investigation of a role for anxiety processes in the maintenance of delusional distress. Behavioral Cognitive Psychopathology, 27, 47–62.

    Google Scholar 

  • Freeman, D., Garety, P. A., & Kuipers, E. (2001). Persecutory delusions: developing the understanding of belief maintenance and emotional distress. Psychological Medicine, 31(7), 1293–1306.

    Article  Google Scholar 

  • Freeman, D., Startup, H., Dunn, G., Cernis, E., Wingham, G., Pugh, K., ... Kingdon, D. (2014). Understanding jumping to conclusions in patients with persecutory delusions: working memory and intolerance of uncertainty. Psychological Medicine, 44(14), 3017–3024. https://doi.org/10.1017/S0033291714000592.

  • Freeston, M. H., Rheaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791–802.

    Article  Google Scholar 

  • Fresco, D. M., Coles, M. E., Heimberg, R. G., Liebowitz, M. R., Hami, S., Stein, M. B., & Goetz, D. (2001). The Liebowitz social anxiety scale: a comparison of the psychometric properties of self-report and clinician-administered formats. Psychological Medicine, 31(6), 1025–1035.

    Article  Google Scholar 

  • Frisch, M. B. (1994). Quality of life inventory (QOLI). Journal of Consulting and Clinical Psychology, 4, 92–101.

    Article  Google Scholar 

  • Frisch, M. B. (2014). Quality-of-life-inventory. In Encyclopedia of quality of life and well-being research (pp. 5374–5377). Dordrecht: Springer.

  • Furnham, A., & Ribchester, T. (1995). Tolerance of ambiguity: a review of the concept, its measurement and applications. Current Psychology, 14(3), 179–199. https://doi.org/10.1007/Bf02686907.

    Article  Google Scholar 

  • Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the Beck anxiety inventory. Journal of Anxiety Disorders, 6(1), 55–61. https://doi.org/10.1016/0887-6185(92)90026-4.

    Article  Google Scholar 

  • Garety, P. A., Kuipers, E., Fowler, D., Freeman, D., & Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31(2), 189–195. https://doi.org/10.1017/S0033291701003312.

    Article  PubMed  Google Scholar 

  • 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. Clinical Psychology Review, 31(6), 923–933. https://doi.org/10.1016/j.cpr.2011.05.001.

    Article  PubMed  Google Scholar 

  • Grant, P. M., & Beck, A. T. (2009a). Defeatist beliefs as a mediator of cognitive impairment, negative symptoms, and functioning in schizophrenia. Schizophrenia Bulletin, 35(4), 798–806. https://doi.org/10.1093/schbul/sbn008.

    Article  PubMed  Google Scholar 

  • Grant, P. M., & Beck, A. T. (2009b). Evaluation sensitivity as a moderator of communication disorder in schizophrenia. Psychological Medicine, 39(7), 1211–1219. https://doi.org/10.1017/S0033291709005479.

    Article  PubMed  Google Scholar 

  • Grant, P. M., & Beck, A. T. (2010). Asocial beliefs as predictors of asocial behavior in schizophrenia. Psychiatry Research, 177(1–2), 65–70. https://doi.org/10.1016/j.psychres.2010.01.005.

    Article  PubMed  Google Scholar 

  • Grant, P. M., Huh, G. A., Perivoliotis, D., Stolar, N. M., & Beck, A. T. (2012). Randomized trial to evaluate the efficacy of cognitive therapy for low-functioning patients with schizophrenia. Archives of General Psychiatry, 69(2), 121–127. https://doi.org/10.1001/archgenpsychiatry.2011.129.

    Article  PubMed  Google Scholar 

  • Green, M. F. (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? The American Journal of Psychiatry, 153(3), 321–330. https://doi.org/10.1176/ajp.153.3.321.

    Article  PubMed  Google Scholar 

  • Grenier, S., Barrette, A. M., & Ladouceur, R. (2005). Intolerance of uncertainty and intolerance of ambiguity: similarities and differences. Personality and Individual Differences, 39(3), 593–600. https://doi.org/10.1016/j.paid.2005.02.014.

    Article  Google Scholar 

  • Haddock, G., McCarron, J., Tarrier, N., & Faragher, E. B. (1999). Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine, 29(4), 879–889. https://doi.org/10.1017/S0033291799008661.

    Article  PubMed  Google Scholar 

  • Holaway, R. M., Heimberg, R. G., & Coles, M. E. (2006). A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 20(2), 158–174. https://doi.org/10.1016/j.janxdis.2005.01.002.

    Article  PubMed  Google Scholar 

  • Horan, W. P., Rassovsky, Y., Kern, R. S., Lee, J., Wynn, J. K., & Green, M. F. (2010). Further support for the role of dysfunctional attitudes in models of real-world functioning in schizophrenia. Journal of Psychiatric Research, 44(8), 499–505. https://doi.org/10.1016/j.jpsychires.2009.11.001.

    Article  PubMed  Google Scholar 

  • Jacoby, R. J., Abramowitz, J. S., Reuman, L., & Blakey, S. M. (2016). 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.

    Article  PubMed  Google Scholar 

  • Jones, S. H., Burrell-Hodgson, G., & Tate, G. (2007). Relationships between the personality beliefs questionnaire and self-rated personality disorders. British Journal of Clinical Psychology, 46(Pt 2), 247–251. https://doi.org/10.1348/014466506X164791.

    Article  PubMed  Google Scholar 

  • Koerner, N., & Dugas, M. J. (2008). An investigation of appraisals in individuals vulnerable to excessive worry: the role of untolerance of uncertainty. Cognitive Therapy and Research, 32, 619–638.

    Article  Google Scholar 

  • Kruglanski, A. W., Webster, D. M., & Klem, A. (1993). Motivated resistance and openness to persuasion in the presence or absence of prior information. Journal of Personality and Social Psychology, 65(5), 861–876.

    Article  Google Scholar 

  • Ladouceur, R., Dugas, M. J., Freeston, M. H., Leger, E., Gagnon, F., & Thibodeau, N. (2000a). Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial. Journal of Consulting and Clinical Psychology, 68(6), 957–964.

    Article  Google Scholar 

  • Ladouceur, R., Gosselin, P., & Dugas, M. J. (2000b). Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry. Behaviour Research and Therapy, 38(9), 933–941.

    Article  Google Scholar 

  • Lee, J. K., Orsillo, S. M., Roemer, L., & Allen, L. B. (2010). Distress and avoidance in generalized anxiety disorder: exploring the relationships with intolerance of uncertainty and worry. Cognitive Behaviour Therapy, 39(2), 126–136. https://doi.org/10.1080/16506070902966918.

    Article  PubMed  PubMed Central  Google Scholar 

  • Liebowitz, M. R. (1987). Social phobia. Modern Problems in Pharmacopsychiatry, 22, 141–173.

    Article  Google Scholar 

  • Mahoney, A. E., & McEvoy, P. M. (2012). A transdiagnositc examination of intolerance of uncertainty across anxiety and depressive disorders. Cognitive Behaviour Therapy, 41, 212–222.

    Article  Google Scholar 

  • Martin, J. M., Warman, D. M., & Lysaker, P. H. (2010). Cognitive insight in non-psychiatric individuals and individuals with psychosis: an examination using the Beck cognitive insight scale. Schizophrenia Research, 121(1–3), 39–45. https://doi.org/10.1016/j.schres.2010.03.028.

    Article  PubMed  Google Scholar 

  • McEvoy, P. M., & Erceg-Hurn, D. M. (2016). The search for universal transdiagnositc and trans-therapy change processes: evidence for intolerance of uncertainty. Journal of Anxiety Disorders, 41, 96–107.

    Article  Google Scholar 

  • McKay, R., Langdon, R., & Coltheart, M. (2006). Need for closure, jumping to conclusions, and decisiveness in delusion-prone individuals. Journal of Nervous and Mental Disease, 194(6), 422–426. https://doi.org/10.1097/01.nmd.0000221353.44132.25.

    Article  PubMed  Google Scholar 

  • McKay, R., Langdon, R., & Coltheart, M. (2007). Jumping to delusions? Paranoia, probabilistic reasoning, and need for closure. Cognitive Neuropsychiatry, 12(4), 362–376. https://doi.org/10.1080/13546800701203769.

    Article  PubMed  Google Scholar 

  • McMillan, D., Gilbody, S., Beresford, E., & Neilly, L. I. Z. (2007). Can we predict suicide and non-fatal self-harm with the Beck hopelessness scale? A meta-analysis. Psychological Medicine, 37, 769–778.

    Article  Google Scholar 

  • Mosca, O., Lauriola, M., & Carleton, R. N. (2016). Intolerance of uncertainty: a temporary experimental induction procedure. PLoS One, 11(6), e0155130. https://doi.org/10.1371/journal.pone.0155130.

    Article  PubMed  PubMed Central  Google Scholar 

  • Neuberg, S. L., Judice, T. N., & West, S. G. (1997). What the need for closure scale measures and what is does not: toward differentiating among related epistemic motives. Journal of Personality and Social Psychology, 72, 1396–1412.

    Article  Google Scholar 

  • Pedrelli, P., McQuaid, J. R., Granholm, E., Patterson, T. L., McClure, F., Beck, A. T., & Jeste, D. V. (2004). Measuring cognitive insight in middle-aged and older patients with psychotic disorders. Schizophrenia Research, 71(2–3), 297–305. https://doi.org/10.1016/j.schres.2004.02.019.

    Article  PubMed  Google Scholar 

  • Roets, A., & Van Hiel, A. (2007). Separating ability from need: clarifying the dimensional structure of the need for closure scale. Personality and Social Psychology Bulletin, 33(2), 266–280. https://doi.org/10.1177/0146167206294744.

    Article  PubMed  Google Scholar 

  • Rytwinski, N. K., Fresco, D. M., Heimberg, R. G., Coles, M. E., Liebowitz, M. R., Cissell, S., ... Hofmann, S. G. (2009). Screening for social anxiety disorder with the self-report version of the Liebowitz social anxiety scale. Depression and Anxiety, 26(1), 34–38. https://doi.org/10.1002/da.20503.

  • Sexton, K. A., & Dugas, M. J. (2009). Defining distinct negative beliefs about uncertainty: validating the factor structure of the intolerance of uncertainty scale. Psychological Assessment, 21(2), 176–186. https://doi.org/10.1037/a0015827.

    Article  PubMed  Google Scholar 

  • Startup, H., Pugh, K., Dunn, G., Cordwell, J., Mander, H., Cernis, E., ... Freeman, D. (2016). Worry processes in patients with persecutory delusions. British Journal of Clinical Psychology, 55(4), 387–400. https://doi.org/10.1111/bjc.12109.

  • Steed, L. (2001). Further validity and reliability evidence for Beck hopelessness scale scores in a nonclinical sample. Educational and Psychological Measurement, 61, 303–316.

    Article  Google Scholar 

  • Steer, R. A., Ranieri, W. F., Beck, A. T., & Clark, D. A. (1993). Further evidence for the validity of the Beck anxiety inventory with psychiatric outpatients. Journal of Anxiety Disorders, 7(3), 195–205. https://doi.org/10.1016/0887-6185(93)90002-3.

    Article  Google Scholar 

  • Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1997). Further evidence for the construct validity of the Beck depression inventory-II with psychiatric outpatients. Psychological Reports, 80(2), 443–446.

    Article  Google Scholar 

  • Sternheim, L., Startup, H., & Schmidt, U. (2011). An experimental exploration of behavioral and cognitive-emotional aspects of intolerance of uncertainty in eating disorder patients. Journal of Anxiety Disorders, 25(6), 806–812. https://doi.org/10.1016/j.janxdis.2011.03.020.

    Article  PubMed  Google Scholar 

  • Strauss, J. S., & Carpenter, W. T. (1974). The prediction of outcome in schizophrenia: II. Relationships between predictor and outcome variables: a report from the WHO international pilot study of schizophrenia. Archives of General Psychiatry, 31, 37–42.

    Article  Google Scholar 

  • Strauss, J. S., & Carpenter, W. T. (1977). Prediction of outcome in schizophrenia: III. Five-year outcome and its predictors. Archives of General Psychiatry, 34, 159–163.

    Article  Google Scholar 

  • Sullivan, H. S. (1927). The onset of schizophrenia. American Journal of Psychiatry, 84, 105–134.

    Article  Google Scholar 

  • Thomas, E. C., Luther, L., Zullo, L., Beck, A. T., & Grant, P. M. (2017). From neurocognition to community participation in serious mental illness: the intermediary role of dysfunctional attitudes and motivation. Psychological Medicine, 47(5), 822–836. https://doi.org/10.1017/S0033291716003019.

    Article  PubMed  Google Scholar 

  • Tolin, D. F., Abramowitz, J. S., Brigidi, B. D., & Foa, E. B. (2003). Intolerance of uncertainty in obsessive-compulsive disorder. Journal of Anxiety Disorders, 17(2), 233–242.

    Article  Google Scholar 

  • van Dam, D. S., van Nierop, M., Viechtbauer, W., Velthorst, E., van Winkel, R., Bruggeman, R., & Wiersma, D. (2014). Childhood abuse and neglect in relation to the presence and persistence of psychotic and depressive symptomatology.

  • Webster, D. M., & Kruglanski, A. W. (1994). Individual differences in need for cognitive closure. Journal of Personality and Social Psychology, 67(6), 1049–1062. https://doi.org/10.1037/0022-3514.67.6.1049.

    Article  PubMed  Google Scholar 

  • Webster, D. M., & Kruglanski, A. W. (1997). Cognitive and social consequences of the need for cognitive closure. European Review of Social Psychology, 8, 133–173.

    Article  Google Scholar 

  • Weissman, A. N., & Beck, A. T. (1978). Development and validation of the dysfunctional attitude scale: A preliminary investigation. Paper presented at the Association for the Advancement of Behavior Therapy, Chicago.

  • White, R. G., & Gumley, A. I. (2009). Postpsychotic posttraumatic stress disorder: associations with fear of recurrence and intolerance of uncertainty. Journal of Nervous and Mental Disease, 197(11), 841–849. https://doi.org/10.1097/NMD.0b013e3181bea625.

    Article  PubMed  Google Scholar 

  • White, R. G., & Gumley, A. (2010). Intolerance of uncertainty and distress associated with the experience of psychosis. Psychology and Psychotherapy, 83(Pt 3), 317–324. https://doi.org/10.1348/147608309X477572.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

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Acknowledgements

Preliminary results were presented at the Association for Behavioral and Cognitive Therapies 48th Annual Convention Philadelphia, PA. The authors would like to express their gratitude to the individuals who participated in this research project. We also thank Jason Cha, Ashley Chambers, Kara Devers, Sean Gallahger, Samantha Goodin, Gloria Huh, David Loeb, Michael Ovalle, Mary Tabit, Lucas Zullo, Marguerite Cruz, and Nina Bertolami for their assistance with this project.

Funding

This study was supported in part by a Distinguished Investigator Award (Dr. Beck) from the National Alliance for Research on Schizophrenia and Depression, the Fieldstone 1793 Foundation, and the Foundation for Cognitive Therapy.

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Author notes

  1. Kerry McCole

    Present address: Yale New Haven Health Center for Outcomes Research and Evaluation, New Haven, CT, USA

  2. Lauren Luther

    Present address: Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA

Authors and Affiliations

  1. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Keith Bredemeier, Kerry McCole, Lauren Luther, Aaron T. Beck & Paul M. Grant

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  1. Keith Bredemeier
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Correspondence to Paul M. Grant.

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Informed consent was obtained from all individual participants included in the study.

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Keith Bredemeier, Kerry McCole, Lauren Luther, Aaron T. Beck, and Paul M. Grant declare that they have no conflict of interest to disclose.

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Appendix 1

Appendix 1

Items from the brief version of the Intolerance of Uncertainty Scale (IUS) evaluated in the present study (item numbers are from the original, 27-item IUS; Freeston et al. 1994)

  1. 1.

    The smallest doubt can stop me from acting. (full IUS item 20)

  2. 2.

    Being uncertain means I lack confidence. (full IUS item 22)

  3. 3.

    Uncertainty makes me uneasy, anxious, or stressed. (full IUS item 6)

  4. 4.

    When I am uncertain, I can’t go forward. (full IUS item 14)

  5. 5.

    Unlike me, others always seem to know where they are going. (full IUS item 16, with minor rewording)

  6. 6.

    I must get away from uncertain situations. (full IUS item 25, with minor rewording)

  7. 7.

    It frustrates me not to have all the information I need. (full IUS item 8, with minor rewording)

  8. 8.

    Uncertainty keeps me from having a full life. (full IUS item 9, with minor rewording)

  9. 9.

    If I am uncertain, then there is a strong possibility that my worst fears will come true. (newly written by authors for this scale)

Note: Instructions to participants – “Below are a number of statements concerning beliefs or attitudes people have. Indicate how frequently each attitude is characteristic and descriptive of you by checking the box. Please be as honest as possible. Remember, answer each statement according to how you think most of the time.”; Response options – Never (0), Occasionally (1), Much of the Time (2), Most of the Time (3), Always (4)

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Bredemeier, K., McCole, K., Luther, L. et al. Reliability and Validity of a Brief Version of the Intolerance of Uncertainty Scale in Outpatients with Psychosis. J Psychopathol Behav Assess 41, 221–234 (2019). https://doi.org/10.1007/s10862-018-9714-2

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