The impact of psychological treatment on intolerance of uncertainty in generalized anxiety disorder: A systematic review and meta-analysis |
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| Affiliation: | 1. Graduate School of Health, University of Technology Sydney, Australia;2. School of Psychology, The University of Sydney, Australia;1. Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA;2. School of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA;3. School of Medicine, Louisiana State University, New Orleans, LA 70112, USA;4. Southeast Louisiana Veterans Healthcare System, 2400 Canal Street, New Orleans, LA 70119, USA;5. Department of Psychological & Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX 77843, USA;6. Department of Psychology, University of Nevada Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA;7. Department of Psychology, Ohio University, Porter 200, Athens, OH 45701, USA;1. The Cairnmillar Institute, Australia;2. Université de Sherbrooke, Sherbrooke, Québec, Canada;3. Université Laval, Québec, Canada;1. Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, the Netherlands;2. Amsterdam UMC, Department of Child and Adolescent Psychiatry, the Netherlands;3. Levvel, Academic Center for Child and Adolescent Psychiatry, the Netherlands;4. University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands;5. Accare Child Study Center, Groningen, the Netherlands;1. Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada;2. Department of Psychology, Faculty of Arts, University of New Brunswick, 38 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada;3. Department of Psychology, Faculty of Science, St. Francis Xavier University, 2323 Notre Dame Ave., Antigonish, Nova Scotia B2G 2W5, Canada;4. Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veteran’s Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada;1. University of North Carolina at Chapel Hill, United States;2. Rogers Memorial Hospital, United States;1. Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands;2. Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil;3. Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands;4. Department of Psychology, University of Montana, Missoula, MT, United States;5. ARQ National Psychotrauma Centre, Diemen, the Netherlands |
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| Abstract: | Research has demonstrated a strong link between intolerance of uncertainty and generalized anxiety disorder (GAD). The current systematic review and meta-analysis aimed to evaluate how effective evidence-based psychological treatments are at reducing intolerance of uncertainty for adults with GAD. An extensive literature search identified 26 eligible studies, with a total of 1199 participants with GAD. Psychological treatments (k = 32 treatment groups) yielded large significant within-group effect size from pre- to post-treatment and pre-treatment to follow-up for intolerance of uncertainty (g = 0.88; g = 1.05), as well as related symptoms including worry (g = 1.32; g = 1.45), anxiety (g = 0.94; g = 1.04) and depression (g = 0.96; g = 1.00). Psychological treatment also yielded a large significant between-group effect on intolerance of uncertainty (g = 1.35). Subgroups analysis found that CBT that directly targeted intolerance of uncertainty (CBT-IU) throughout treatment was significantly more effective than general CBT at reducing intolerance of uncertainty (p < 0.01) and worry (p < 0.01) from pre- to post treatment, however, this result was not maintained at follow-up. Meta-regression analyses supported this finding as increases in the amount of time spent directly targeting intolerance of uncertainty, significantly increased the effect size for both intolerance of uncertainty (z = 2.01, p < 0.01) and worry (z = 2.23, p < 0.01). Overall, these findings indicate that psychological treatments are effective at reducing IU, and related symptom measures of GAD. |
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| Keywords: | Intolerance of uncertainty Anxiety Worry GAD Treatment |
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