(PS2-96) Understanding the Moderating Role of Intolerance of Uncertainty in Obsessive-compulsive Symptoms and Distress

Considerable research has focused on obsessive beliefs and their role in understanding obsessive-compulsive (OC) symptoms (Steketee et al., 1998). However, there is a gap in understanding how these beliefs independently contribute to OC symptomatology. Intolerance of uncertainty (IU) has attracted particular interest as a transdiagnostic construct due to its potential to intensify distress associated with OC symptoms (Tolin et al., 2003). Yet the specific mechanisms through which IU affects the association between OC symptoms and general distress remain relatively unexplored. Addressing this gap is critical for refining targeted treatment interventions aimed at alleviating distress related to OC symptomatology. In order to provide insight into the nuanced associations between cognitive processes and OC pathology, this study seeks to examine the moderating effect of IU on the association between OC symptoms and general distress.

 A diverse sample of undergraduates (N = 4,040) completed a series of online questionnaires. 46% of participants self-identified as White, 23% as Black, 7% as Asian, and 21% as Hispanic. Students completed three main assessment tools: the Intolerance of Uncertainty Scale (IUS; Buhr & Dugas, 2002), the Obsessive Compulsive Inventory – Revised (OCI-R; Foa, 2002), and the Mood and Anxiety Symptom Questionnaire (MASQ; Watson & Clark, 1991). The variables of primary interest were intolerance of uncertainty, OC symptoms, and distress symptoms as evaluated by the MASQ General Distress: Anxious Symptoms (GDA) subscale.

 Moderation analyses were conducted using Model 1 of the PROCESS macro (Hayes, 2012). The overall model examined the moderating effect of IUS on the relationship between OCI-R total score and MASQ GDA—and was significant (F_(3,3574) = 649.1518, p < .001). Both OCI-R (β = .1350, SE = .0280, p < .001) and IUS (β = .1243, SE = .0082, p < .001) significantly predicted MASQ GDA. The interaction between OCI-R and IUS symptoms also was significant (β = .0008, SE = .0004, t₍₃₅₇₄₎ = 2.2381, p < .05). Conditional effects analysis revealed the impact of OCI-R symptoms on MASQ GDA varied depending on the level of IUS score. Specifically, the effect was stronger at higher levels on the IUS (β = .2027, SE = .0116, t₍₃₅₇₈₎ = 17.4111, p < .001) compared to lower levels (β = .1664, SE = .0160, t₍₃₅₇₈₎ = 10.4072, p < .001).

 The current findings indicate that IU moderates the association between OC symptoms and distress, and underscore the importance of considering cognitive beliefs in OC conceptualization and ultimately, treatment. As recommended by Grayson (2010), tailored interventions targeting IU may offer effective options for alleviating distress. Future research should aim to delve deeper into the mechanisms underlying the interaction between IU and OC symptoms. Approaches could involve conducting longitudinal studies to explore how IU influences the development and exacerbation of OC symptoms over time, or the use of experimental designs to investigate the cognitive processes implicated in this interaction. Finally, studies should aim to further examine whether the association between OC and distress remains when examining other cognitive vulnerabilities, such as anxiety sensitivity.