Skip to main content

Youth Intolerance of Uncertainty – Parent-Report (YIU-PR): A Developmentally Sensitive Measure of Intolerance of Uncertainty in Children and Adolescents

Journal of Psychopathology and Behavioral Assessment volume 45, pages 194–206 (2023)Cite this article

Abstract

Although intolerance of uncertainty (IU) has been proposed as a transdiagnostic feature of anxiety, there has been little consensus on its definition and its subcomponents – especially in youth. We report on the development and initial validation of the Youth Intolerance of Uncertainty – Parent-report (YIU-PR), a developmentally sensitive, parent-report measure of IU. Also, we explored age as a possible moderator of the relationship between YIU-PR and symptoms of obsessive-compulsive disorder and anxiety disorders. Caregivers (N = 731, 61.7% female, 73.2% non-Hispanic White) with children between 6 and 17 years old were recruited via Amazon Mechanical Turk and reported on their child’s IU and anxiety. An exploratory factor analysis of YIU-PR items yielded 4 subscales: Difficulty Tolerating Waiting Periods (α = 0.90), Doubting and Reassurance Seeking (α = 0.90), Overestimation of Negative Events (α = 0.92), and Physical and Behavioral Responses (α = 0.87). The 26-item YIU-PR demonstrated excellent internal consistency overall (α = 0.96) as well as concurrent and discriminant validity. There was evidence that IU, as measured by the YIU-PR, was distinct from youth anxiety. The YIU-PR significantly predicted separation anxiety, generalized anxiety, social anxiety, and obsessive-compulsive symptoms in the full sample and generalized anxiety and social anxiety in the clinical subsample. Age did not moderate the relationship between the YIU-PR and anxiety symptoms. Results provide preliminary support for the use of the YIU-PR to measure youth intolerance of uncertainty in clinical and nonclinical settings.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Notes

  1. Zero-order correlations between YIU-PR, IUSC, RULES, and anxiety symptoms reflect similar patterns. YIU-PR was most strongly correlated with the RULES (r = .85, p < .001) and IUSC (r = .80, p < .001), followed by anxiety symptoms (r = .76, p < .001).

References

  • 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

  • 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

  • Boulter, C., Freeston, M., South, M., & Rodgers, J. (2014). Intolerance of uncertainty as a framework for understanding anxiety in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(6), 1391–1402. https://doi.org/10.1007/s10803-013-2001-x

  • Brown, T. A. (2006). Introduction to CFA. In D. A. Kenny (Ed.), Confirmatory factor analysis for applied research (pp. 40–102). Guilford Press.

  • 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

  • Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56(2), 81–105. https://doi.org/10.1037/h0046016

  • Carleton, R. N. (2012). The intolerance of uncertainty construct in the context of anxiety disorders: Theoretical and practical perspectives. Expert Review of Neurotherapeutics, 12(8), 937–947. https://doi.org/10.1586/ern.12.82

  • Carleton, R. N. (2016). Fear of the unknown: One fear to rule them all? Journal of Anxiety Disorders, 41, 5–21. https://doi.org/10.1016/j.janxdis.2016.03.011

  • Carleton, R. N., Duranceau, S., Freeston, M. H., Boelen, P. A., McCabe, R. E., & Antony, M. M. (2014). “But it might be a heart attack”: Intolerance of uncertainty and panic disorder symptoms. Journal of Anxiety Disorders, 28(5), 463–470. https://doi.org/10.1016/j.janxdis.2014.04.006

  • Carleton, R. N., Gosselin, P., & Asmundson, G. J. G. (2010). The intolerance of uncertainty index: Replication and extension with an English sample. Psychological Assessment, 22(2), 396–406. https://doi.org/10.1037/a0019230

  • 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

  • Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the revised child anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy, 43(3), 309–322. https://doi.org/10.1016/j.brat.2004.02.004

  • Coles, M. E., Frost, R. O., Heimberg, R. G., & Rhéaume, J. (2003). “Not just right experiences”: Perfectionism, obsessive-compulsive features and general psychopathology. Behaviour Research and Therapy, 41(6), 681–700. https://doi.org/10.1016/s0005-7967(02)00044-x

  • Comer, J. S., Roy, A. K., Furr, J. M., Gotimer, K., Beidas, R. S., Dugas, M. J., & Kendall, P. C. (2009). The intolerance of uncertainty scale for children: A psychometric evaluation. Psychological Assessment, 21(3), 402–411. https://doi.org/10.1037/a0016719

  • Cornacchio, D., Sanchez, A. L., Coxe, S., Roy, A., Pincus, D. B., Read, K. L., Holaway, R. M., Kendall, P. C., & Comer, J. S. (2018). Factor structure of the intolerance of uncertainty scale for children. Journal of Anxiety Disorders, 53, 100–107. https://doi.org/10.1016/j.janxdis.2017.07.003

  • Cowie, J., Clementi, M. A., & Alfano, C. A. (2018). Examination of the intolerance of uncertainty construct in youth with generalized anxiety disorder. Journal of Clinical Child & Adolescent Psychology, 47(6), 1014–1022. https://doi.org/10.1080/15374416.2016.1212358

  • Curran, P. J., West, S., & Finch, J. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1(1), 16–29. https://doi.org/10.1037/1082-989X.1.1.16

  • de Mooij, M., & Beniflah, J. (2017).Measuring cross-cultural differences of ethnic groups within nations: Convergence or divergence of cultural values? The case of the United States. Journal of International Consumer Marketing, 29(1), 2–10. https://doi.org/10.1080/08961530.2016.1227758

  • DeSimone, J. A., Harms, P. D., & DeSimone, A. J. (2015). Best practice recommendations for data screening. Journal of Organizational Behavior, 36(2), 171–181. https://doi.org/10.1002/job.1962

  • 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. https://doi.org/10.1016/S0005-7967(97)00070-3

  • Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: Investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25(5), 551–558. https://doi.org/10.1023/A:1005553414688

  • Ebesutani, C., Chorpita, B. F., Higa-McMillan, C. K., Nakamura, B. J., Regan, J., & Lynch, R. E. (2011). A psychometric analysis of the revised child anxiety and Depression Scales–parent version in a school sample. Journal of Abnormal Child Psychology, 39(2), 173–185. https://doi.org/10.1007/s10802-010-9460-8

  • 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: Science and Practice, 21(3),280–300. https://doi.org/10.1111/cpsp.12077

  • Fabrigar, L. R., & Wegener, D. T. (2012). Exploratory factor analysis. Oxford University Press.

  • Fergus, T. A. (2013). A comparison of three self-report measures of intolerance of uncertainty: An examination of structure and incremental explanatory power in a community sample. Psychological Assessment, 25(4), 1322–1331. https://doi.org/10.1037/a0034103

  • Fialko, L., Bolton, D., & Perrin, S. (2012). Applicability of a cognitive model of worry to children and adolescents. Behaviour Research and Therapy, 50(5), 341–349. https://doi.org/10.1016/j.brat.2012.02.003

  • Field, A. P. (2018). Discovering statistics using SPSS: North American Edition (5th ed.). Los Angeles: SAGE Publications.

  • Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299. https://doi.org/10.1037/1040-3590.7.3.286

  • Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17(6), 791–802.

  • 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

  • Gosselin, P., Ladouceur, R., Evers, A., Laverdière, A., Routhier, S., & Tremblay-Picard, M. (2008). Evaluation of intolerance of uncertainty: Development and validation of a new self-report measure. Journal of Anxiety Disorders, 22(8), 1427–1439. https://doi.org/10.1016/j.janxdis.2008.02.005

  • 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

  • Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd edition). New York: The Guilford Press.

  • Hearn, C. S., Donovan, C. L., Spence, S. H., & March, S. (2017). A worrying trend in social anxiety: To what degree are worry and its cognitive factors associated with youth social anxiety disorder? Journal of Affective Disorders, 208, 33–40. https://doi.org/10.1016/j.jad.2016.09.052

  • Hofmann, S. G., & Hinton, D. E. (2014). Cross-cultural aspects of anxiety disorders. Current Psychiatry Reports, 16(6), 450. https://doi.org/10.1007/s11920-014-0450-3

  • Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6(2), 65–70. http://www.jstor.org/stable/4615733

  • Horn, J. L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30(2), 179–185. https://doi.org/10.1007/BF02289447.

  • Hofstede, G. (2011). Dimensionalizing cultures: The Hofstede model in context. Online Readings in Psychology and Culture, 2(1). https://doi.org/10.9707/2307-0919.1014

  • 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

  • Kendall, P. C., Norris, L. A., Rabner, J. C., Crane, M. E., & Rifkin, L. S. (2020). Intolerance of uncertainty and parental accommodation: Promising targets for personalized intervention for youth anxiety. Current Psychiatry Reports, 22(9), 1–8. https://doi.org/10.1007/s11920-020-01170-3

  • 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(9), 933–941. https://doi.org/10.1016/S0005-7967(99)00133-3

  • Lewin, A. B., Caporino, N., Murphy, T. K., Geffken, G. R., & Storch, E. A. (2010). Understudied clinical dimensions in pediatric obsessive-compulsive disorder. Child Psychiatry & Human Development, 41(6), 675–691. https://doi.org/10.1007/s10578-010-0196-z

  • Linehan, M., M (2014). DBT Training Manual. New York, NY: The Guilford Press.

  • Mahoney, A. E. J., & McEvoy, P. M. (2012). Changes in intolerance of uncertainty during cognitive behavior group therapy for social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 849–854. https://doi.org/10.1016/j.jbtep.2011.12.004

  • McEvoy, P. M., Hyett, M. P., Shihata, S., Price, J. E., & Strachan, L. (2019). The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clinical Psychology Review, 73, 101778. https://doi.org/10.1016/j.cpr.2019.101778

  • McEvoy, P. M., & Mahoney, A. E. J. (2011). Achieving certainty about the structure of intolerance of uncertainty in a treatment-seeking sample with anxiety and depression. Journal of Anxiety Disorders, 25(1), 112–122. https://doi.org/10.1016/j.janxdis.2010.08.010

  • Neil, L., Olsson, N. C., & Pellicano, E. (2016). The relationship between intolerance of uncertainty, sensory sensitivities, and anxiety in autistic and typically developing children. Journal of Autism and Developmental Disorders, 46(6), 1962–1973. https://doi.org/10.1007/s10803-016-2721-9

  • Norton, P. J. (2005). A psychometric analysis of the. Intolerance of Uncertainty Scale among four racial groups. Journal of Anxiety Disorders, 19(6), 699–707. https://doi.org/10.1016/j.janxdis.2004.08.002

  • Osmanağaoğlu, N., Creswell, C., & Dodd, H. F. (2018). Intolerance of uncertainty, anxiety, and worry in children and adolescents: a meta-analysis. Journal of Affective Disorders, 225, 80–90. https://doi.org/10.1016/j.jad.2017.07.035

  • Palitz, S. A., Rifkin, L. S., Norris, L. A., Knepley, M., Fleischer, N. J., Steinberg, L., & Kendall, P. C. (2019). But what will the results be?: Learning to tolerate uncertainty is associated with treatment-produced gains. Journal of Anxiety Disorders, 68, 102146. https://doi.org/10.1016/j.janxdis.2019.102146

  • Pinciotti, C. M., Riemann, B. C., & Abramowitz, J. S. (2021). Intolerance of uncertainty and obsessive-compulsive disorder dimensions. Journal of Anxiety Disorders, 81, 102417. https://doi.org/10.1016/j.janxdis.2021.102417

  • Read, K. L., Comer, J. S., & Kendall, P. C. (2013). The intolerance of uncertainty scale for children (IUSC): Discriminating principal anxiety diagnoses and severity. Psychological Assessment, 25(3), 722–729. https://doi.org/10.1037/a0032392

  • Rifkin, L. S., & Kendall, P. C. (2020). Intolerance of uncertainty in youth: Psychometrics of the Intolerance of Uncertainty Index-A for Children. Journal of Anxiety Disorders, 71, 102197. https://doi.org/10.1016/j.janxdis.2020.102197

  • Roberson-Nay, R., Eaves, L. J., Hettema, J. M., Kendler, K. S., & Silberg, J. L. (2012). Childhood separation anxiety disorder and adult onset panic attacks share a common genetic diathesis. Depression and Anxiety, 29(4), 320–327. https://doi.org/10.1002/da.21931

  • Sanchez, A. L., Cornacchio, D., Chou, T., Leyfer, O., Coxe, S., Pincus, D., & Comer, J. S. (2017). Development of a scale to evaluate young children’s responses to uncertainty and low environmental structure. Journal of Anxiety Disorders, 45, 17–23. https://doi.org/10.1016/j.janxdis.2016.11.006

  • Sarawgi, S., Oglesby, M. E., & Cougle, J. R. (2013). Intolerance of uncertainty and obsessive-compulsive symptom expression. Journal of Behavior Therapy and Experimental Psychiatry, 44(4), 456–462. https://doi.org/10.1016/j.jbtep.2013.06.001

  • 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

  • Shihata, S., McEvoy, P. M., Mullan, B. A., & 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

  • Steiger, J. H. (1980). Tests for comparing elements of a correlation matrix. Psychological Bulletin, 87(2), 245–251. https://doi.org/10.1037/0033-2909.87.2.245

  • Strom, N. I., Soda, T., Mathews, C. A., & Davis, L. K. (2021). A dimensional perspective on the genetics of obsessive-compulsive disorder. Translational Psychiatry, 11, 401. https://doi.org/10.1038/s41398-021-01519-z

  • 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. https://doi.org/10.1016/S0887-6185(02)00182-2

  • U.S. Census Bureau (2020). Race and Ethnicity in the United States: 2010 Census and 2020 Census. https://www.census.gov/library/visualizations/interactive/race-and-ethnicity-in-the-united-state-2010-and-2020-census.html

  • van der Heiden, C., Muris, P., & van der Molen, H. T. (2012). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behaviour Research and Therapy, 50(2), 100–109. https://doi.org/10.1016/j.brat.2011.12.005

Download references

Acknowledgements

The authors thank Dr. Julie Edmunds, Ph.D., Dr. Kendra Read, Ph.D., Dr. Monica Wu, Ph.D., Dr. Nina Shriffin, Ph.D., and Dr. Eric Schuler, Ph.D. for their assistance with this study.

Author information

Authors and Affiliations

  1. Department of Psychology, American University, Washington, D.C., USA

    Joyce X. Wong & Nicole E. Caporino

Authors
  1. Joyce X. Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicole E. Caporino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joyce X. Wong.

Ethics declarations

Statements and Declarations

Partial financial support was received from the American University. The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wong, J.X., Caporino, N.E. Youth Intolerance of Uncertainty – Parent-Report (YIU-PR): A Developmentally Sensitive Measure of Intolerance of Uncertainty in Children and Adolescents. J Psychopathol Behav Assess 45, 194–206 (2023). https://doi.org/10.1007/s10862-022-10016-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-022-10016-6

Keywords

  • Youth
  • Intolerance of Uncertainty
  • Anxiety
  • Measure Development
  • Exploratory Factor Analysis