Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic

• DOI: 10.1016/j.janxdis.2024.102910
• Publication Date: 2024-08-03T22:34:58Z
• Authors: Rosanna Breaux; Kristin Naragon-G...; Benjamin A. Katz; Lisa R. Starr; Jeremy G. Stewart; Bethany A. Teachman; Katie L. Burkhouse; M. Kathleen Caulf...; Christine B. Cha; Samuel E. Cooper; Edwin Dalmaijer; Katie Kriegshauser; Susan Kusmierski; Cecile D. Ladouceur; Gordon J.G. Asmun...; Darlene M. Davis ...; Eiko I. Fried; Ilana Gratch; Philip C. Kendall; Shmuel Lissek; Adrienne Manbeck; Tyler C. McFayden; Rebecca B. Price; Kathryn Roecklein; Aidan G.C. Wright; Iftah Yovel; Lauren S. Hallion
• Keywords: Pandemic; 2019-20 coronavirus outbreak; Vulnerability

Background: Efforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertainty (IU), a transdiagnostic risk factor for anxiety, may be a particularly relevant vulnerability factor.Method: N = 641 adults with pre-pandemic anxiety reported their anxiety, intolerance of uncertainty, and other pandemic and mental health-related variables at least once and up to four times during the COVID-19 pandemic, with assessments beginning in Summer 2020 through Winter 2021. Analyses were preregistered on the Open Science Framework.Results: Higher intolerance of uncertainty at the first pandemic timepoint predicted more severe anxiety, but also a sharper decline in anxiety across timepoints. This finding was robust to the addition of pre-pandemic anxiety and demographic predictors as covariates. Younger age, lower self/parent education, and experience of COVID-19 illness at the first pandemic timepoint predicted more severe anxiety across timepoints, but did not predict anxiety trajectory.Conclusions: Differential levels of IU at the outset of the pandemic prospectively predicted more severe anxiety and a sharper decrease in anxiety over time. This finding was robust to the inclusion of covariates, including pre-pandemic anxiety and various demographic characteristics.