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Evaluation ViewAttendees 5

Transdiagnostic
Symposia

Symposium 46 - Pursuing the Unknown: Novel Insights for Measuring, Treating, and Understanding Intolerance of Uncertainty Across Transdiagnostic Samples

Friday, November 15, 2024
12:30 PM – 2:00 PM EST
Location: Congress C, Fourth Floor, Loews Hotel
CE: 1.5

Keywords: Common Factors, Anxiety, Cognitive Processes
Level of Familiarity: Basic to moderate
Recommended Readings: Sahib, A., Chen, J., Cárdenas, D., & Calear, A. L. (2023). Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review. Clinical Psychology Review, 102270.,  
Knowles, K. A., & Olatunji, B. O. (2023). Intolerance of uncertainty as a cognitive vulnerability for obsessive-compulsive disorder: A qualitative review. Clinical Psychology: Science and Practice.
,  
Rosser, B. A. (2019). Intolerance of uncertainty as a transdiagnostic mechanism of psychological difficulties: A systematic review of evidence pertaining to causality and temporal precedence. Cognitive therapy and research, 43(2), 438-463.
,  
Boswell, J. F., Thompson‐Hollands, J., Farchione, T. J., & Barlow, D. H. (2013). Intolerance of uncertainty: A common factor in the treatment of emotional disorders. Journal of clinical psychology, 69(6), 630-645.
,  
Hebert, E. A., & Dugas, M. J. (2019). Behavioral experiments for intolerance of uncertainty: Challenging the unknown in the treatment of generalized anxiety disorder. Cognitive and Behavioral Practice, 26(2), 421-436.

Intolerance of uncertainty—or a tendency to experience negative affective, psychological, and behavioral responses to uncertain information and outcomes—is commonly considered to be a risk factor for and clinical feature of many forms of psychopathology. Further highlighting its relevance to symptom maintenance and promise as an intervention target, research suggests that IU can be effectively targeted existing cognitive-behavioral treatments, and improvements in IU often relate to subsequent change in clinical symptoms. However, despite a robust and growing body of work on IU, there are several main gaps in our understanding of how this construct may promote symptom engagement and persistence. Most notably, there remain many questions regarding how IU may interact with other cognitive-affective processes to drive maladaptive behavior. Further, most existing work on IU has focused predominantly on specific diagnostic groups (e.g., Generalized Anxiety Disorder) and has used self-report, trait-based measurements, limiting the field’s understanding of how theoretical relationships with symptoms may play out in real-time and in clinical contexts.
Toward addressing these gaps, the current symposium will feature five talks that extend knowledge on how IU and its neurocognitive and affective correlates may influence clinical symptoms in at least one of three ways: (a) through exploring how uncertainty influences cognitive processes involved in the onset and/or maintenance of diverse clinical symptoms; (b) through use of new assessment or research methods for probing IU and its relation to clinical symptoms, and (c) through considering the ways in which IU may play a role in existing treatments. More specifically, our first talk will outline data test how IU may influence observed deficits in executive function within OCD and anxiety disorders. Next, the second talk will outline results from computational modeling analyses suggesting that individuals with OCD may engage in compulsive behavior to decrease uncertainty locally, and that this may compromise engagement in adaptive, goal-directed reward-based decision-making. Our third talk will feature behavioral data exploring differences in risk-taking under conditions of high and low ambiguity/uncertainty in a sample of patients with OCD, as well as how performance on this task relates to clinical symptom severity and trait-based IU. The fourth talk will outline data testing the utility of a cognitive task gauging IU in a sample with elevated eating disorder symptoms, as well as a behavioral induction of eating-specific uncertainty. The final talk will bring focus into the treatment domain through exploring whether changes in IU occur within existing treatments for hoarding disorder. Our discussant, who conducts work on transdiagnostic risk factors including IU, will end the symposium through exploring themes throughout each talk using a transdiagnostic lens and outlining important take-aways and areas for future research. Overall, our hope is to feature new research that helps to better characterize the role of IU within theoretical models of symptom maintenance across diverse patient populations and highlights diverse ways to assess this construct.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Summarize at least one recent finding regarding intolerance of uncertainty and clinical symptoms
  2. List at least two tasks that provide behavioral indicators of responses to uncertainty
  3. Explain how trait measurements of intolerance of uncertainty may or may not relate to performance on behavioral tasks gauging state uncertainty
  4. Describe at least two cognitive or affective processes that be altered by individual differences in intolerance of uncertainty
  5. Discuss similarities and differences regarding responses to uncertainty across different clinical populations

Presentations:

  • 12:30 PM – 2:00 PM EST
    (SYM 46) Ambiguity Limits Risk Taking for Both Patients with OCD and Non-psychiatric Controls

    Speaker: Ryan J. Jacoby, Ph.D. – Massachusetts General Hospital; Harvard Medical School

    Co-author: Caroline Armstrong, B.A. – Massachusetts General Hospital

    Co-author: Dalton Klare, M.A., M.S. (he/him/his) – Massachusetts General Hospital

    Co-author: Susanne S. Hoeppner, Ph.D., M.Ap.Stat. – Massachusetts General Hospital

    Co-author: Jennifer Lerner, PhD (she/her/hers) – Harvard Kennedy School

    Co-author: Sabine Wilhelm, Ph.D. (she/her/hers) – Harvard Medical School

  • 12:30 PM – 2:00 PM EST
    (SYM 46) Uncertainty-driven Information Seeking in Obsessive Compulsive Disorder

    Speaker: Christina L. Boisseau, Ph.D. (she/her/hers) – Northwestern University Feinberg School of Medicine

    Co-author: Andra Geana, Ph.D. – Providence College

    Co-author: Steven A. Rasmussen, M.D. – Brown University

    Co-author: Michael Frank, Ph.D. – Brown University

  • 12:30 PM – 2:00 PM EST
    (SYM 46) Intolerance of Uncertainty Improves After Treatment for Hoarding Disorder

    Speaker: Michael Wheaton, Ph.D. – Barnard College

    Co-author: Carolyn Rodriguez, M.D., Ph.D. – Stanford University

  • 12:30 PM – 2:00 PM EST
    (SYM 46) Intolerance of Uncertainty Is Associated with Sequence-specific Behavior in Obsessive Compulsive Spectrum and Anxiety Disorders

    Speaker: Gina M. Belli, M.S. (she/her/hers) – Northwestern University Feinberg School of Medicine

    Co-author: Hannah Doyle, B.S. – Brown University

    Co-author: Sarah L. Garnaat, PhD – Dartmouth University

    Co-author: Steven A. Rasmussen, M.D. – Brown University

    Co-author: Immanuela C. Obisie-Orlu, B.S. – Northwestern University

    Co-author: Yiqing Fan, M.A. – Northwestern University Feinberg School of Medicine

    Co-author: Theresa M. Desrochers, Ph.D. – Brown University

    Co-author: Christina L. Boisseau, Ph.D. (she/her/hers) – Northwestern University Feinberg School of Medicine

  • 12:30 PM – 2:00 PM EST
    (SYM 46) Exploring the Intersection of Intolerance of Uncertainty and Eating Disorders Through Behavioral Measures and Food Consumption

    Speaker: Kayla Costello, M.S. (she/her/hers) – University at Albany, State University of New York

    Co-author: C.Alix Timko, PhD – Children's Hospital of Philadelphia

    Co-author: Grace Haase, B.A. (she/her/hers) – Children's Hospital of Philadelphia

    Co-author: Julia M. Hormes, Ph.D. (she/her/hers) – University at Albany, State University of New York