Examining the Relationship Between Prospective and Inhibitory Intolerance of Uncertainty, Obsessive Compulsive Disorder Symptoms and Treatment Outcome

Abstract

Objectives

Intolerance of uncertainty (IU) is a cognitive vulnerability factor that plays a role in obsessive compulsive disorder (OCD). Most research has looked at IU at an omnibus level. This paper aimed to investigate the two dimensions of IU, prospective and inhibitory IU, and their relation to overall OCD symptom severity, as well as the severity of obsessions and compulsions. Method: Fifty-nine individuals with OCD completed measures of OCD symptom severity and IU at pre- and post- group cognitive behavioral therapy (CBT).

Results

IU and OCD symptoms, and their dimensions, all reduced over the CBT treatment. At the start of treatment, only prospective IU was associated with compulsion symptom severity. In contrast, at the end of treatment, prospective and inhibitory IU were associated with compulsion symptom severity, and inhibitory IU was associated with obsession symptom severity. Baseline IU, prospective and inhibitory IU were not associated with post OCD symptom severity scores, when controlling for pre-treatment OCD severity levels. Change in prospective IU was associated with changes in OCD symptom severity, and change in compulsions, but not change in obsessions. The results cannot speak to causal or temporal predictions, or directionality of the relationship between IU and OCD.

Conclusion

These findings underscore the dynamic relationship between the IU dimensions and OCD symptoms, and highlights prospective IU as a potential important target in CBT for OCD to achieve reductions in compulsions and overall OCD symptom severity.