4 - (SYM 46) Intolerance of Uncertainty Is Associated with Sequence-specific Behavior in Obsessive Compulsive Spectrum and Anxiety Disorders

Background: Intolerance of uncertainty (IUS) has been shown to be a transdiagnostic cognitive vulnerability factor that contributes to the development and maintenance of obsessive-compulsive (OC) spectrum and anxiety disorders (Carleton et al., 2012; Castriotta et al.. 2019; Pinciotti et al. 2021). However, the link between this clinical phenomenon and the observed executive functioning deficits in these populations (Giomi et al., 2021; Snyder et al., 2014) remains poorly understood.  For example, the ritualistic and ruminative behavior characteristic of these disorders can be conceptualized as both the inability to handle uncertainty and as failures in the ability to exert the sequential control necessary for goal directed behavior. Thus, the purpose of this study was to examine the relationship between IUS and sequential processing in individuals with OC spectrum and anxiety disorders.

Method: 127 clinical participants and 45 healthy controls (HCs) were recruited as part of a larger study on dimensional endophenotypes of OC spectrum and anxiety disorders. Participants completed the intolerance of uncertainty questionnaire (Carleton et al., 2007) and a sequencing task designed to assess hierarchical sequential control (Desrochers et al., 2015). Briefly, participants internally monitored a four-item sequence while making simple judgements about image color and shape on each trial. Sequences were presented in simple (requiring only one task switch), and complex (requiring two task switches) formats. Correlations and ANCOVAs were conducted to examine differences in sequential processing in individuals with OC spectrum and anxiety disorders relative to HCs and relate these differences to self-reported IUS.

Results: Overall, OC spectrum and anxiety disorder participants had a slower response time on the task compared to HCs. Higher IUS was associated with less response time difference on simple and complex sequences in clinical participants (r = -.23, p =.03). Supplementary analyses demonstrated a significant interaction between sequence type (simple vs. complex) when the clinical group was split into high vs. low IUS groups, F(1,77) = 4.24 p = .043. 

Conclusion:   In the OC spectrum and anxiety disorder participants, those with higher IUS show a greater degree of caution on simple sequences and are less able to take advantage of the difference between simple and complex sequences.