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Investigating the construct validity of intolerance of uncertainty and its unique relationship with worry
Abstract
Although recent findings suggest that intolerance of uncertainty is a fundamental construct involved in excessive worry, additional research is required to further establish the construct validity of intolerance of uncertainty and demonstrate its unique contribution to the understanding of worry. The present study examined the relationships among measures of worry, intolerance of uncertainty, intolerance of ambiguity, perfectionism, and perceived control in a sample of 197 university students. The findings indicated that intolerance of uncertainty moderately overlaps with earlier conceptualizations of intolerance of ambiguity; however, worry was more highly related to intolerance of uncertainty than to intolerance of ambiguity. Intolerance of uncertainty also emerged as the most salient predictor of worry compared to other cognitive processes such as perfectionism and perceived control. Worry and intolerance of uncertainty continued to be significantly related after controlling for intolerance of ambiguity, perfectionism, and perceived control, which implies that intolerance of uncertainty shares a unique association with worry that is not accounted for by these other cognitive factors. Overall, the findings provide evidence of construct validity and underscore the role of intolerance of uncertainty in the conceptualization of worry.
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In the citing paper
“considering evidence that intolerance of uncertainty is positively related to psychological inflexibility and negatively related to post-traumatic growth32,45,62”
In the citing paper
“is proposed to be a key maintaining factor in chronic worry (Buhr and Dugas, 2006; Dugas et al ., 2004; Freeston et al .,1994)”
From Effectiveness and predictors of group cognitive behaviour therapy outcome for generalised anxiety disorder in an out-patient hospital setting (2024) · cites this paper as Buhr and Dugas, 2006
In the citing paper
“IU is proposed to be one of the key factors that exacerbates and maintains chronic worry (Buhr and Dugas, 2006; Dugas et al ., 2004).”
From Effectiveness and predictors of group cognitive behaviour therapy outcome for generalised anxiety disorder in an out-patient hospital setting (2024) · cites this paper as Buhr and Dugas, 2006
In the citing paper
“Despite the transdiagnostic nature of IU (for a review, see Carleton, 2012), the relationship between IU and GAD is not accounted for by shared variance with other anxiety disorders, mood disorders, negative affect, perfectionism or need for control (Buhr & Dugas, 2006; Norton et al., 2005).”
From Behavioral Experiments for Intolerance of Uncertainty: A Randomized Clinical Trial for Adults With Generalized Anxiety Disorder (2022) · cites this paper as Buhr & Dugas, 2006
In the citing paper
“Worry and IU continued to be significantly correlated after controlling for intolerance for ambiguity, perfectionism, and perceived control (Buhr & Dugas, 2006).”
From Extension of the Transdiagnostic Model to Focus on Intolerance of Uncertainty: A Review of the Literature and Implications for Treatment (2014) · cites this paper as Buhr & Dugas, 2006
In the citing paper
“IU has been linked to the development and maintenance of worry and Generalised Anxiety Disorder (GAD) (Buhr and Dugas 2006, 2009, 2012; Dugas et al. 1997, 2005; Freeston et al. 1994)”
From Towards a Treatment for Intolerance of Uncertainty for Autistic Adults: A Single Case Experimental Design Study. (2018) · cites this paper as Buhr and Dugas 2006
In the citing paper
“People with a high intolerance of uncertainty see uncertain situations as stressful and sad.[53]”
From Psychological Distress of Breast Cancer Survivors During the COVID-19 Pandemic and Related Factors: A Controlled Study. (2023) · cites this paper as [53]
In the citing paper
“Numerous studies suggest IU is a cognitive vulnerability factor for worry (e.g.Buhr & Dugas, 2006; Koerner & Dugas, 2008).”
From Applicability of the intolerance of uncertainty model to Generalized Anxiety Disorder symptoms in young people (2021) · cites this paper as Buhr & Dugas, 2006
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“A concept related to worry is Intolerance of Uncertainty (IU; Buhr & Dugas, 2006).”
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“Since there is evidence that higher IU is associated with a lower sense of control (Buhr and Dugas, 2006; Song and Li, 2019), it is reasonable to speculate that individuals with high neuroticism have lower tolerance toward the uncertain situation, which further leads to a lower sense of control (because of insufficien…”
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“Intolerance of uncertainty is the most prominent cause of worry (Buhr & Dugas, 2006) and is a risk factor for clinical anxiety disorders (Carleton, 2012).”
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“Tolerance of uncertainty refers to an individual’s habitual response when faced with uncertain situations (Buhr & Dugas, 2006).”
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“…of uncertainty was selected because over 25 years of research supports its theoretical and clinical significance in GAD (for a review, see Robichaud et al., 2019) and because it is consistently a strong predictor of the severity of worry and GAD (e.g., Buhr & Dugas, 2006; Dugas et al., 2007).”
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“This measure demonstrates excellent internal consistency (Cronbach’s a¼ .94) and good test–retest reliability (r¼ .74; Buhr & Dugas, 2006).”
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“This cognitive model has been validated in multiple cross-sectional (e.g., Buhr & Dugas, 2006) and experimental studies (e.g., Ladouceur, Gosselin, & Dugas, 2000), and has led to a successful empirically-supported cognitive-behavioural intervention that targets beliefs about uncertainty in…”
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“Findings are consistent with Buhr and Dugas (2006) who also observed IU to be a larger predictor of worry than perfectionism.”
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“For instance, intolerance to ambiguity has been found to be related to anxiety (Bardi et al., 2009) and worry (Buhr & Dugas, 2006; Dugas et al., 1997).”
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“Theoreti-cally, intolerance of uncertainty is considered a trait that challenges individuals’ resilience to the unknown and negatively affects their risk perception (Buhr & Dugas, 2006; Jensen et al., 2014; Uzun & Arslan, 2025).”
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“The Intolerance of Uncertainty Scale (IUS) [49] measured the participants’ reactions, attitudes, and beliefs about future events, ambiguity, and uncertainty.”
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“( Buhr & Dugas, 2006; Carleton, 2016).”
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“Individuals with low tolerance for uncertainty tend to perceive the threat as a source of discomfort and to react negatively to it [30].”
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“Furthermore, Buhr and Dugas (2006) showed a negative correlation between intolerance for ambiguity and the age of students, which may indi cate that TA changes with life experience.”
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“Nature connectedness can directly reduce IGD and also mitigate intolerance of uncertainty and desire thinking.”
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“…as in self-concealment (Flett & Hewitt, 2002; Kawamura & Frost, 2004; Masuda et al., 2011; Mendoza et al., 2018), IU is also linked with social anxiety, perfectionism, fear of disapproval by others, and cognitive avoidance (Boelen & Reijntjes, 2009; Buhr & Dugas, 2006; Shikatani et al., 2016).”
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“…evidence that intolerance of uncertainty is positively related to psychological inflexibility and negatively related to post-traumatic growth 32,45,62 , we assumed that intolerance of uncertainty has a mediating role on the relationship between psychological inflexibility and post-traumatic…”
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“The significant reduction in IU is encouraging as IU is proposed to be one of the key factors that exacerbates and maintains chronic worry (Buhr and Dugas, 2006; Dugas et al ., 2004).”
Kraemer, K. M., O'Bryan, E. M., Johnson, A. L., & McLeish, A. C. (2017) · Substance Abuse · doi:10.1080/08897077.2017.1340394 · Cited by 4
“, thoughts, emotions, body sensations) without judgment may be the most important mindfulness skill in terms of IU, because it undercuts maladaptive cognitive processes, such as worry, that are used as a strategy for managing the negative affectivity associated with uncertainty.(19,63) Indeed, acceptance of, as oppose…”
BackgroundLi, N., Xie, J., Guo, Z., & Yang, Y. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1756689 · Cited by 4
“Empirical evidence indicates that intolerance of uncertainty serves as a core cognitive variable in anxiety disorders and is a significant positive predictor of anxiety levels (Buhr and Dugas, 2006).”
Marquis‐Brideau, C., Bernier, A., Béliveau, M., & Dirks, M. A. (2022) · Advances in child development and behavior · doi:10.1016/bs.acdb.2022.10.007 · Cited by 4
İrak, D. U., Dede, B., & Demir, N. (2024) · SAGE Open · doi:10.1177/21582440241251478 · Cited by 4
“Since the development and maintenance of anxiety has been shown to be highly correlated with IU (Buhr & Dugas, 2006; Ladouceur et al., 2000), awareness and IU show extremely similar relationships (Kraemer et al., 2016).”
Carsten, H. P., Härpfer, K., Malbec, M., Wieser, M. J., & Riesel, A. (2024) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2024.112480 · Cited by 5
Krautz, A. E. (2021) · Journal of Multilingual and Multicultural Development · doi:10.1080/01434632.2021.1879091 · Cited by 4
“In relation to age, in line with previous research by, e.g. Dewaele (2016) and Buhr and Dugas (2006), it is expected that older participants will report feeling di ff erent more frequently.”
BackgroundResultDo perfectionists show negative, repetitive thoughts facing uncertain situations?
Kummer, K., Mattes, A., & Stähl, J. (2023) · Current Psychology · doi:10.1007/s12144-023-04409-3 · Cited by 7
“IU is also described as a key component in the development and maintenance of worry and accordingly associated with worrying (Buhr & Dugas, 2006; Jong-Meyer et al., 2009).”
Simos, G., & Nisyraiou, A. (2023) · Psychiatry International · doi:10.3390/psychiatryint4020010 · Cited by 8
Carlson, K. W., Smolker, H. R., Smith, L. L., Snyder, H. R., Hankin, B. L., & Banich, M. T. (2025) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-024-01262-0 · Cited by 6
“Intolerance of Uncertainty (IU), or distress felt when encountering situations with unknown outcomes, is considered a transdiagnostic feature across internalizing disorders, occurring in generalized anxiety disorder (GAD), major depressive disorder (MDD), and obsessive-compulsive disorder (OCD), amongst others (Gentes…”
InfluentialPedović, I., Ćirović, N., & Stošić, M. (2022) · Current Psychology · doi:10.1007/s12144-021-02612-8 · Cited by 8
“Buhr and Dugas (2006) and Lauriola et al.”
BackgroundThe extent of and motivation for disaster information seeking behavior via social networking sites
Alajmi, B. M., & Khalil, O. E. M. (2022) · Journal of Electronic Resources Librarianship · doi:10.1080/1941126x.2022.2099026 · Cited by 4
“…(Tapanes et al., 2009), technological knowledge renewal effectiveness (Rong & Grover, 2009), tolerance of uncertainty and perceived mastery (Buhr & Dugas, 2006), and information processing (need for cognition) (Wolfradt et al., 1999), However, high TA correlates negatively with threat…”
BackgroundResultJhang, Y.-T., & Liang, C. (2023) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2023.101842 · Cited by 4
Perfectionism, Intolerance of Uncertainty, and Fear of Childbirth in Pregnant and Non-pregnant Women
Kuljanac, A., Brekalo, M., & Radoš, S. N. (2023) · Clínica y Salud · doi:10.5093/clysa2023a17 · Cited by 7
“In contrast, individuals with negative perfectionism think they did not perform at an optimum level, so they set unrealistic goals (Buhr & Dugas, 2006).”
BackgroundInfluentialElizabeth A. Hebert, J. M. S., & Dugas, M. J. (2017) · Sage eBooks · doi:10.4135/9781483365817.n761 · Cited by 4
Self-citationWatts, R., Cossar, J., & Ferreira, N. (2021) · Mediterranean Journal of Clinical Psychology · doi:10.13129/2282-1619/mjcp-2978 · Cited by 3
“Numerous studies suggest IU is a cognitive vulnerability factor for worry (e.g. Buhr & Dugas, 2006; Koerner & Dugas, 2008).”
BackgroundGuo, Q., Zhu, R., Zhou, H., Wang, D., & Zhang, X. (2025) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2025.103048 · Cited by 3
Ou, C. H. K., Chen, G., Giesbrecht, G. F., Keys, E., Lebel, C. A., & Tomfohr‐Madsen, L. M. (2025) · Depression and Anxiety · doi:10.1155/da/6663877 · Cited by 4
“It is also closely associated with symptoms of generalized anxiety disorder [41].”
An investigation of relationships between cognitive factors associated with worry
Voon, D., & Phillips, L. (2015) · Journal of Experimental Psychopathology · doi:10.5127/jep.037013 · Cited by 3
“…a significant amount of variance in worry scores over and above that of a number of other constructs such as perfectionism and perceived control (Buhr & Dugas, 2006), and predicts worry levels particularly in circumstances where individuals feel uncertain or doubtful (de Bruin, Rassin, & Muris,…”
BackgroundAre Obsessive Beliefs Specific to Obsessive-Compulsive Symptoms?
우충환, Kwon, S., & 신민섭 (2010) · The Korean Journal of Clinical Psychology · doi:10.15842/kjcp.2010.29.1.003 · Cited by 3
Perfectionistic Concerns are Detrimental to Skill Learning for Minimally Invasive Surgery
Kleinrensink, V. E. E., Lange, J. F., & Kleinrensink, G. (2020) · Journal of surgical education · doi:10.1016/j.jsurg.2020.08.022 · Cited by 3
Brown, M. A. (2009) · Texas ScholarWorks (Texas Digital Library) · Cited by 3
Suh, K., & 양승애 (2012) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2012.17.3.010 · Cited by 3
Woo, J., & Hyun, M. (2020) · Korean Journal of Stress Research · doi:10.17547/kjsr.2020.28.4.195 · Cited by 3
A lower order structural examination of the neuroticism/negative emotionality domain
Naragon‐Gainey, K. (2011) · doi:10.17077/etd.03774mjg · Cited by 3
“…that GAD symptoms and worry are also strongly related to maladaptive perfectionism scales (rs = .39 to .62, mean = .49; Boelen & Reijntjes, 2009; Buhr & Dugas, 2006; Santanello & Gardner, 2007; Stöber & Joormann, 2001a), with elevated scores compared to normal controls (d = .67; Sica et al.,…”
BackgroundInfluentialFunction, Threat and Closure in the Fear of CrimePreprint
Jackson, J. (2012) · SSRN Electronic Journal · doi:10.2139/ssrn.2027721 · Cited by 3
Understanding worry and mindfulness through psycholinguistics.
Bortoleto, E. M. C. G. (2019) · doi:10.18297/etd/3328 · Cited by 3
Fracalanza, K. (2021) · doi:10.32920/ryerson.14657616.v1 · Cited by 4
Parlar‐Yazıcı, A., Norman, A., & Bacon, A. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.12872 · Cited by 2
“IU can dominate one's life (Buhr & Dugas, 2006), and exploring it qualitatively can deepen understanding of anxiety mechanisms, inform interventions and clarify coping processes.”
Le traitement de l'anxiété généralisée : plus on en sait, moins on en fait.
Dugas, M. J. (2018) · Canadian Psychology / Psychologie Canadienne · doi:10.1037/cap0000144 · Cited by 2
Self-citationNisyraiou, A., Simou, M., & Simos, G. (2024) · Psychiatry International · doi:10.3390/psychiatryint5010009 · Cited by 2
“Research suggests that IU is a transdiagnostic cognitive bias [55] that plays a role in the symptoms of several psychiatric disorders, including both Generalized Anxiety Disorder [56–58] and obsessive–compulsive disorder (OCD; [16,59]).”
BackgroundMeng, X., & Lin, F. (2025) · Social Indicators Research · doi:10.1007/s11205-025-03689-5 · Cited by 2
“Since worry, like fear, stems from feelings of uncertainty (Buhr & Dugas, 2006; Lazarus, 1991) and promotes risk-avoidant behaviors (Lerner & Keltner, 2000), we anticipate a similar moderating effect for worry.”
Metadata
- Authors
- Buhr, K., & Dugas, M. J.
- Affiliations
- Concordia University (CA)
- Corresponding author
- Dugas, Michel J.
- ORCID
- Dugas, Michel J.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2006
- Volume
- 20
- Issue
- 2
- Pages
- 222-236
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W1978488323
- Semantic Scholar
- 1284dc569568791a0bb63d5c8f0f64bf36c254ff
- Cited by
- 421
- References
- 50
- Citations by year
- 2026: 11 · 2025: 23 · 2024: 22 · 2023: 25 · 2022: 35 · 2021: 47 · 2020: 22 · 2019: 26 · 2018: 23 · 2017: 23 · 2016: 26 · 2015: 18 · 2014: 32 · 2013: 19 · 2012: 17
- FWCI
- 6.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- intolerance of uncertainty, worry, construct validity, intolerance of ambiguity, perfectionism, perceived control, university students, anxiety
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Anxiety, Culture, Defense Mechanisms, Female, Humans, Internal-External Control, Male, Psychometrics, Reference Values, Statistics as Topic, Students, Reproducibility of Results, Uncertainty
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