Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders
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This study aimed to replicate and extend a hierarchical model of vulnerability to worry, with neuroticism and extraversion as higher-order factors and negative metacognitions and intolerance of uncertainty as second-order factors. The model also included a transdiagnostic measure of repetitive negative thinking (RNT) and depression symptoms as outcome variables to determine whether relationships would extend beyond worry, which has traditionally been studied within the context of generalized anxiety disorder (GAD). Participants (N=99) were referrals to a specialist anxiety disorders clinic with a principal anxiety disorder who completed a battery of self-report questionnaires assessing neuroticism, extraversion, metacognitions, intolerance of uncertainty, worry, RNT, and depression symptoms. Mediational analyses using bootstrapping provided support for transdiagnostic and diagnosis-specific mediation effects. Negative metacognitions fully mediated the relationship between neuroticism and RNT for the whole sample and for subsamples with and without GAD. Intolerance of uncertainty mediated the relationship between neuroticism and worry (for the whole sample and for those with GAD) and between neuroticism and RNT (for those with GAD). Implications for theory, treatment, and nosology are discussed.
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Cognitive-behavioral therapy group has played a role in increasing distress tolerance.
“During research, McEvoy and Mahoney [9] found that the cognitive-behavioral therapy group has played a role in increasing distress tolerance.”
From Comparing the Effects of Islamic Spiritual Therapy and Stress Inoculation Training on Distress Tolerance and Anxiety of Patients With Stomach Cancer. (2023) · cites this paper as [9]
The Introduction reports that changes in intolerance of uncertainty were associated with improvements in worry and anxiety during CBT, citing intervention trials. But McEvoy and Mahoney’s own Procedure describes questionnaires completed at an initial assessment, not a CBT group intervention, and the paper does not report that a group increased distress tolerance. (LLM, conf=0.83)
Experimental — accuracy not yet measuredOur finding that changes in IU explained unique variance in RNT in all three groups, and symptoms in the social anxiety and worry/rumination groups, is consistent with previous studies.
“Our finding that changes in IU explained unique variance in RNT in all three groups, and symptoms in the social anxiety and worry and rumination groups, is consistent with previous studies (McEvoy & Mahoney, 2013;Sexton et al., 2003).”
From The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty (2016) · cites this paper as McEvoy & Mahoney, 2013
The Discussion (section 4.0; page unavailable) reports that IU mediated repetitive negative thinking and worry for patients with GAD, supporting a broad connection between IU and these outcomes. It also says IU did not mediate those outcomes for patients without GAD. The paper therefore supports the citing authors’ claim of consistency only in part: it does not establish a corresponding finding across all three groups or examine changes in IU. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- McEvoy, P. M., & Mahoney, A. E. J.
- Affiliations
- Centre for Clinical Interventions (AU)
- UNSW Sydney (AU)
- Corresponding author
- McEvoy, Peter M.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 27
- Issue
- 2
- Pages
- 216-224
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W1974079964
- Semantic Scholar
- 4ac4ad6a1e68a642cbef1fcbe089b4641a45789a
- Cited by
- 99
- References
- 86
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 7 · 2023: 12 · 2022: 13 · 2021: 9 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 4 · 2016: 10 · 2015: 4 · 2014: 5
- FWCI
- 8.56
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- eSpace (Curtin University) (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- intolerance of uncertainty, repetitive negative thinking, anxiety disorders, generalized anxiety disorder, neuroticism, extraversion, worry, depressive symptoms, metacognition
- MeSH terms
- Neuroticism, Adolescent, Adult, Anxiety Disorders, Depression, Extraversion, Psychological, Female, Humans, Male, Models, Psychological, Negativism, Surveys and Questionnaires, Thinking, Uncertainty, Self Report
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