(PS14-5) Intolerance of Uncertainty Is Associated with Disordered Eating Behaviors and Mood Symptoms in Pregnancy

Background: A growing body of evidence points to intolerance of uncertainty as a transdiagnostic risk factor for diverse psychopathologies, most notably the anxiety and eating disorders. Pregnancy is a time of significant change and uncertainty as well as a period of heightened vulnerability for the development and exacerbation of eating disorders and mood symptoms. To date, little is known about the extent to which findings regarding links between IU and psychopathology generalize to pregnant populations. This study sought to examine the psychometric performance of the 27-item Intolerance of Uncertainty Scale (IUS) in pregnant people and to explore the relationship between IU and disordered eating behaviors and mood symptoms in pregnancy.

Methods: Participants (n = 269) were recruited via the online research participation platform Prolific. Eligibility criteria included 18+ years old, currently pregnant, and residing in the United States. Participants provided demographic information and completed the IUS, the Prenatal Eating Behaviors Screening tool (PEBS), a 12-item measure of disordered eating behaviors specifically in pregnancy (Cronbach’s α = .89), and the Edinburgh Perinatal Depression Scale (EPDS), a 10-item measure of perinatal depressive symptoms (α = .90).

Results: Participants were on average 30 years old (M = 30.42, SD = 5.60). At the time of survey completion, 27.1% were in the first trimester of pregnancy, 40.1% were in the second trimester, and 32.7% were in the third trimester. A third of respondents (33.1%, n = 89) indicated being nulliparous (i.e., had not been pregnant previously). A total of 14 respondents (5.3%) scored above the PEBS cutoff of 39 suggesting the likely presence of a clinically significant eating disorder; 91 respondents (34.0%) scored above the EPDS cutoff of 13 suggesting the likely presence of clinically significant depressive symptoms.

In confirmatory factor analysis, data fit adequately with the established two-factor structure of the IUS quantifying beliefs that “uncertainty has negative behavioral and self-referent implications” (factor 1; α = .95) and perceptions that “uncertainty is unfair and spoils everything” (factor 2; α = .94). There was a significant multivariate main effect of the likely presence of an eating disorder on combined IUS subscale scores (p < .001, η_p² = .07), with respondents meeting criteria for an ED scoring significantly higher on IUS factor 1. In linear regression analysis, controlling for age, weeks gestation, and parity, IU accounted for about 15% of the variance in PEBS scores. There was also a significant multivariate main effect of the likely presence of major depression on combined IUS subscale scores (p < .001, η_p² = .22), with respondents meeting criteria for depression scoring significantly higher on both IUS subscales. In linear regression analysis, IU accounted for about 38% of the variance in EPDS scores.

Discussion: Findings suggest that the IUS is an appropriate tool for quantifying intolerance of uncertainty specifically in pregnant people and add to a growing body of evidence pointing to IU as an important transdiagnostic risk and/or maintaining factor for eating and mood disorders in diverse populations.