How Do Elements of a Reduced Capacity to Withstand Uncertainty Relate to the Severity of Health Anxiety?

Abstract

Intolerance of uncertainty (IU)—a multidimensional cognitive vulnerability factor—is associated with a variety of anxiety disorders and health anxiety (HA). To date, few studies have assessed whether IU dimensions (prospective and inhibitory IU) are differentially associated with HA and whether their contributions are independent of anxiety sensitivity (AS). This study addressed these issues using independent community (n = 155; 81% women) and undergraduate (n = 560; 86% women) samples. Results indicated that prospective IU, but not inhibitory IU, had significant positive associations with HA in community dwellers and undergraduate students. AS somatic and cognitive concerns were also significant predictors among both samples. In addition, severity of IU dimensions among individuals reporting elevated HA were compared against individuals diagnosed with generalized anxiety disorder, social anxiety disorder, panic disorder, and obsessive–compulsive disorder. Results indicated minimal differences between those with elevated HA and each of the anxiety disorder diagnoses. Findings lend support to the unique transdiagnostic nature of IU and support commonalities between HA and anxiety disorders.

Keywords::

• health anxiety
• intolerance of uncertainty
• anxiety sensitivity

Notes

^1. Participants in the clinical sample were gathered from an established research and treatment center wherein each participant was screened for the presence of Axis I disorders according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSM-IV TR; American Psychiatric Association, 2000) standards. Diagnoses were made using the Structured Clinical Interview for DSM-IV (SCID-I; First, Spitzer, Gibbon, & Williams, 1996). Only participants with social anxiety disorder (n = 120), generalized anxiety disorder (n = 63), obsessive–compulsive disorder (n = 60), and panic disorder (n = 89) were retained for this study. Post-traumatic stress disorder was not included as it is not a disorder treated at the treatment center. The most common secondary diagnosis in the current sample was depression (29.5%). In addition to the clinician-administered interview, participants were also asked to complete a paper-and-pencil measure assessing IU along with a bank of additional measures assessing risk factors for anxiety disorders.