(PS2-65) Inferential Confusion and Intolerance of Uncertainty Interact to Predict OC Symptoms

Intolerance of uncertainty (IU) is a transdiagnostic cognitive vulnerability linked to obsessive-compulsive (OC) symptoms. Inferential confusion (IC) refers to dysfunctional reasoning which overvalues hypothetical possibilities and devalues sensory information. The inference-based approach (IBA) proposes that IC generates obsessional doubts which cause OC symptoms (O’Connor et al., 2009). Whereas no prior research has studied both constructs together, we propose that IU and IC are conceptually related. Namely, doubt generated by IC may be more threatening and persistent when IU is high, making OC symptoms more likely. High IU may be more likely to lead to OC symptoms when IC provides reasons for uncertainty about specific possibilities. In this way, IC was proposed as a condition under which IU increases risk specifically for OC symptoms rather than for other psychopathology.

Undergraduate participants (N = 257; 40% White, 24% Black, 22% Latino/a, 5% Asian, 9% multiracial) completed a battery including the Inferential Confusion Questionnaire-Extended Version (ICQ-EV), Intolerance of Uncertainty Scale (IUS-12), Dimensional Obsessive-Compulsive Scale (DOCS), and Depression, Anxiety, Stress Scales (DASS-21). Correlations and regressions were conducted in R; a moderation model was tested with the PROCESS Macro.

The IUS-12 and ICQ-EV were considerably correlated (r = .63, p < .001) but not to the extent that violated multicollinearity assumptions. Regression found significant main effects of both IUS-12 (β = .24, p</span> < .001) and ICQ-EV (β = .34, p < .001) for predicting DOCS total score (R² = .42, F_{(3, 223)} = 53.12, p < .001) while controlling for DASS-21 Depression (β = .14, p = .01). The moderation model tested IUS-12 as focal predictor, ICQ-EV as moderator, and DOCS total score as outcome. The addition of the interaction effect significantly improved model fit, ΔR² = .014, ΔF_{(1, 222)} = 4.32, p = .04. Simple slopes showed the association between IUS-12 and DOCS total score strengthened as ICQ-EV increased. Of note, their association was no longer significant (p > .05) when ICQ-EV fell .62 SDs or more below the mean. This suggests that, whereas IU broadly was predictive of OC symptoms, this association was stronger for higher levels of IC and did not hold beyond a threshold level of low IC.

Results support that IU and IC may interact in the pathogenesis of OC symptoms. This preliminarily suggests IC as a potential condition under which the transdiagnostic vulnerability of IU may be related to OCD specifically. A possible interpretation is that IU alone increases distress about uncertainty, which generally increases internalizing symptoms. However, when people with high IU also are prone to mistaking their subjective reasoning for objective truth (as in IC), they are more likely to seek certainty from faulty internal inferences which are biased toward threat, thus resulting in OC symptoms. Experimental research is needed to determine whether manipulation of IU has a causal effect on IC, as this would imply mediation rather than moderation. Researchers studying clinical interventions that target IC or IU separately should consider examining both constructs concurrently to clarify mechanisms of change that contribute to OC symptom reduction.