(PS14-19) The Role of Intolerance of Uncertainty and Cognitive Inflexibility in Eating Disorder Psychopathology

There is a critical need to identify potential maintenance factors contributing to elevated eating disorder (ED) psychopathology. Intolerance of uncertainty, characterized by negative beliefs about uncertainty, and cognitive inflexibility, which involves difficulty shifting focus, have both been associated with heightened ED psychopathology. Furthermore, there is an association between intolerance of uncertainty and cognitive inflexibility. However, it remains unclear whether individuals with elevated levels of both intolerance of uncertainty and cognitive flexibility exhibit greater ED psychopathology. Therefore, this study aimed to investigate whether cognitive inflexibility moderates the relationship between intolerance of uncertainty and ED psychopathology. Participants were N=692 college students, predominantly White (46.4%) and female (58.6%), from a northeastern university, with a mean age of 18.74 (SD = 1.56).  Participants completed the Eating Pathology Symptoms Inventory (EPSI) to assess ED psychopathology, the Intolerance of Uncertainty short form (IUS-12) to measure intolerance of uncertainty, and the Acceptance and Action Questionnaire-II (AAQ-II) to gauge cognitive flexibility. Linear regression models were employed to determine whether cognitive inflexibility moderated the relationship between intolerance of uncertainty and ED psychopathology. Results revealed that higher scores on both IUS-12 (b=.26, SE=.06, p < .001) and AAQ-II (b=.39, SE=.08, p < .001) were associated with elevated EPSI binge scores. Furthermore, AAQ-II scores moderated the relationship between IUS-12 and EPSI binge scores (b= -.01, SE=.002, p = .009), such that there were higher levels of binge eating when IU was low and AAQ-II was higher. Higher IUS scores were also associated with increased EPSI cognitive restraint scores (b=.08, SE=.03, p = .01), whereas AAQ-II was not associated with EPSI cognitive restraint scores (b = .04, SE =.04, p= .31) and it did not moderate the relationship between IUS-12 and EPSI cognitive restraint scores (b=.001, SE=.001, p = .06). Finally, higher scores on both IUS-12 (b=.18, SE=.05, p < .001) and AAQ-II (b=.24, SE=.07, p = .001) were associated with elevated EPSI restriction scores. However, AAQ-II did not moderate the relationship between IUS-12 and EPSI restriction scores (b= -.002, SE=.001, p = .22). In summary, findings continue to highlight it is important to assess for both intolerance of uncertainty and cognitive inflexibility in individuals with eating disorder psychopathology. In addition, the findings suggest that individuals with lower levels of intolerance of uncertainty and high levels of cognitive inflexibility may exhibit more severe binge eating psychopathology. However, the relationships between intolerance of uncertainty and cognitive restraint and restriction do not depend on cognitive flexibility. Given these findings, it is important to continue to assess for both intolerance of uncertainty and cognitive inflexibility, in those who might be at risk for an eating disorder.