Analogue Generalized Anxiety Disorder Research Articles

Is meta-worry relevant to interpersonal problems? Testing the metacognitive model of generalized anxiety disorder in an analogue- and a clinical sample of GAD

ABSTRACT Interpersonal problems are common in individuals with generalized anxiety disorder (GAD) and improved interpersonal functioning is an important goal in treatment. In the metacognitive model of worry and generalized anxiety disorder, emotional distress and psychological dysfunction are related to two distinct types of worry. Particular emphasis is put on meta-worry which refers to “worry about worrying” or appraisal of worrying as threatening in itself. Meta-worry impairs effective mental regulation and might therefore be an important predisposition to self-regulate via others and thereof interpersonal problems. In the current study, we tested the prediction that meta-worry is uniquely associated with interpersonal problems in two samples. The first consisted of 135 individuals with analogue GAD and the second of 56 individuals with a diagnosis of GAD. Using hierarchical linear regressions controlling for anxiety, depression and worry, meta-worry showed a unique relationship with interpersonal problems in both samples. These findings indicate that meta-worry may be relevant to formulate and treat interpersonal problems in individuals with GAD.

Intolerance of Uncertainty, Negative Reinforcement Alcohol Use Motives, and Hazardous Drinking in College Students with Clinically Elevated Worry

Background: Hazardous drinking has remained high for college students in recent years, and individuals who endorse drinking to cope with emotional distress or to conform socially report higher levels of alcohol use. Intolerance of uncertainty, a core process underlying generalized anxiety disorder, has been linked to negative reinforcement drinking motives; however, no research, to date, has examined the role of intolerance of uncertainty in terms of alcohol use motives and hazardous drinking among individuals with generalized anxiety disorder. Objective: The current study was designed to examine the relationships between intolerance of uncertainty, coping and conformity alcohol use motives, and hazardous drinking in an analogue generalized anxiety disorder sample. Methods: Participants were 323 college students (Mage = 19.25, SD = 2.23, Range = 18–40) who endorsed past-year alcohol use and clinically elevated levels of worry. Self-report measures were completed online for course credit. Results: Partially consistent with our hypotheses, uncertainty paralysis predicted greater levels of coping motives, but not conformity motives. Desire for predictability did not predict either drinking motive. Mediation analyses revealed that there was a significant indirect effect of uncertainty paralysis on more hazardous drinking through greater coping motives. Conclusion: Overall, these findings highlight the potential utility of targeting behavioral inhibition due to uncertainty to reduce unhealthy coping via alcohol use and subsequent hazardous alcohol use.

An empirical test of the metacognitive model of generalized anxiety disorder.

The metacognitive model of generalized anxiety disorder (GAD) places worrying, meta-worry ("worry about worry") and corresponding underlying metacognitive beliefs (i.e., beliefs about worry) as central in the maintenance of symptoms. Previous research has demonstrated significant relationships between these factors and symptoms, but no study has tested the statistical fit of this influential model including its hypothesized components and the suggested paths between them. The aim of the current study was therefore to evaluate the fit of the metacognitive model of GAD. A total of 312 participants constituting an analogue GAD sample were included in a cross-sectional study and completed self-report measures of anxiety and depression symptoms and scales relevant to the metacognitive model. Metacognitions, worry, and meta-worry in their hypothesized order provided a good model fit and explained significant and substantial variance in symptoms. These results provide further support for the metacognitive model of GAD and demonstrates separate and unique contributions from worry and meta-worry to generalized anxiety symptoms of which meta-worry was the most influential.

The Interplay Between Expected Psychological Responses to Exercise and Physical Activity in Analogue Generalized Anxiety Disorder: a Cross-sectional Study.

Expectations for psychological responses to exercise are not well characterized, particularly in people at risk for anxiety-related illnesses. Given the substantial evidence for salutary effects of exercise on anxiety symptoms and emerging recognition for expectations as a critical mechanism of placebo/nocebo effects, this study explored the interplay between expectations and physical activity in young adults with and without analogue generalized anxiety disorder. Participants (N=470, 23.2±4.8 years, 63% female) completed a physical activity and mood survey, including a 7-day physical activity recall questionnaire, and a 20-item questionnaire designed to measure positive and negative expectations for psychological and perceptual responses to exercise, particularly expectations for symptoms in the generalized anxiety disorder symptom profile. Analogue generalized anxiety disorder status was determined using the Generalized Anxiety Disorder subscale of the Psychiatric Diagnostic Screening Questionnaire. For select outcomes, expected exercise-induced changes significantly differed according to analogue generalized anxiety disorder (whole-body pain, sleep quality, psychological well-being, stress, relaxation) and active versus inactive (anxious mood, depressed mood, concentration, physical function, psychological well-being, relaxation) status. However, these findings did not survive corrections for multiple comparisons and the magnitude of these differences was small, approximating 0.25 standard deviations. Expectations for anxious (Spearman's ρ=-0.14, p≤0.002) and depressed mood (ρ=-0.15, p≤0.002), and psychological well-being (ρ=0.15, p≤0.001) were significantly associated with higher physical activity levels. Exercise expectations for anxious mood explained a significant, but small (+1.5%, p≤0.03), amount of variance in physical activity. Expectations for exercise-induced improvements did not significantly differ between young adults based on analogue generalized anxiety disorder or physical activity status.

The effects of acute resistance exercise among young adults: A randomized controlled trial

Background The effects of a single bout of resistance exercise (RE) on state anxiety and worry symptoms are understudied. Further, how resistance exercise training (RET) changes response to acute RE is unknown.Methods Sixty-two untrained young adults (mean age (y):26.6; RET n = 27, Wait-list (WL): n = 35, 62.9% female) were randomized to an eight-week, ecologically-valid, guidelines-based RET condition, or eight-week WL control condition. Two acute RE trials were nested within the design at week one and eight, to determine RE response, and change in RE response following RET. The RET condition completed a twice-weekly RET intervention. The WL condition completed 30-minute bouts of quiet-rest at week one and eight. Two-condition (RE/quiet-rest) x two-time (pre/post) x two-session (weeks one/eight) RM-ANCOVAs examined differences between acute RE and quiet-rest pre-post and between acute sessions. Sub-analyses were conducted among young adults with analogue-Generalized Anxiety Disorder (AGAD). Primary outcomes were anxiety and worry symptoms.Results Compliance was 99% (Rate of perceived exertion (6–20) = 14±1, Muscle soreness (1–10)=4 ± 2), with no adverse events. There were no significant three-way interactions for anxiety symptoms or worry symptoms (all p ≥ 0.51) among the total sample or AGAD sample. The magnitude of change in outcomes at each session for both samples were small and non-significant (Hedges’ d = -0.26 to 0.23).Limitations Post-condition assessment of primary outcomes was only conducted at a single time point.Conclusion RE did not elicit significant reductions in state anxiety or worry symptoms ten minutes post-RE. RET did not change response to acute RE. Clinicians should encourage RET for maximum anxiolytic benefits.

Expected Psychological Responses To Exercise Vary Based On Physical Activity And Analogue Generalized Anxiety Disorder

Expected Psychological Responses To Exercise Vary Based On Physical Activity And Analogue Generalized Anxiety Disorder

Physical activity and analogue anxiety disorder symptoms and status: Mediating influence of social physique anxiety

BackgroundAssociations between physical activity (PA) and subclinical anxiety disorder symptoms and status, and potential mediating effect of social physique anxiety (SPA), remain understudied. We examined associations between PA and analogue Generalized Anxiety Disorder (AGAD), analogue Social Anxiety Disorder (ASAD), and analogue Panic Disorder (APD) symptoms and status, the mediating effect of SPA, and sex-related differences. MethodsParticipants (n = 470, 23.2 ± 4.8 years, 298 female) completed the Psychiatric Diagnostic Screening Questionnaire, seven-day PA recall, and Social Physique Anxiety Scale. ANCOVA examined differences in SPA and anxiety disorder symptoms between PA levels. Logistic regression examined associations between PA and analogue anxiety disorder status. Mediation analyses estimated the effect of change in PA on analogue anxiety disorder odds when SPA was at its mean. ResultsAGAD, ASAD, and APD prevalence was 38.1%, 60.0%, and 15.1%, respectively. AGAD and ASAD symptoms, but not APD symptoms, were significantly lower among higher PA levels. PA was associated with lower odds of AGAD, ASAD, and APD; findings were not significant after adjustment. The pure indirect effect of SPA significantly accounted for 58.2% and 47.9% of the total effect of PA on AGAD and ASAD, respectively; findings were not significant after adjusting for depression. Females showed greater odds of AGAD, ASAD, and APD; mediation findings did not differ based on gender. LimitationsCross-sectional design, self-reported exposure and outcomes, and sample size are potential limitations. ConclusionSymptoms and odds of AGAD and ASAD status were lower among young adults with greater PA; SPA partially mediated associations and warrants experimental investigation.

Resistance exercise training among young adults with analogue generalized anxiety disorder

IntroductionThe objective of this randomized controlled trial (RCT) was to quantify the effects of eight weeks of World Health Organization and American College of Sports Medicine guidelines-based resistance exercise training (RET) among participants meeting criteria for subclinical, or analogue-GAD (AGAD) MethodsForty-four participants (mean age (y): 25.4.6±4.9.2) were randomized to either an eight-week, fully-supervised, one-on-one RET intervention or wait-list control. AGAD status was determined using validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire-GAD subscale (≥6) and Penn State Worry Questionnaire (≥45). Remission, based on change in AGAD status, was assessed post-intervention, and quantified with number needed to treat (NNT). Primary analyses focused on participants missing outcome data at ≤1 time point (RET: n=12, Wait-list: n=15). RM-ANCOVA examined differences between RET and wait-list across time. Simple effects analysis decomposed significant interactions. Hedges’ d quantified magnitude of differences in change between conditions over time. ResultsAttendance was 81% and compliance to the RET was 77%. Participants significantly increased strength (all d≥1.24, p≤0.006) with no adverse events. RET improved AGAD status (NNT=3, 95%CI: 2 to 7). Significant group X time interactions were found for worry (F(3,66) = 3.12, p≤0.043; d=0.93, 95%CI: 0.13 to 1.73) and anxiety symptoms (F(3,57.84)=2.91, ε=0.88, p≤0.045; d=0.71, 95%CI: -0.08 to 1.49). RET significantly reduced worry (mean difference=-6.49, p≤0.045) and anxiety symptoms (mean difference=-10.50, p≤0.001). LimitationsLimitations include a small sample size, and lack of attention-matched control condition. ConclusionRET significantly improved AGAD severity, and elicited large, clinically meaningful improvements in worry and anxiety symptoms among young adults with AGAD.

Resistance exercise training for anxiety and worry symptoms among young adults: a randomized controlled trial

This trial quantified the effects of ecologically-valid resistance exercise training (RET) on anxiety and worry symptoms among young adults. Young adults not meeting criteria for subclinical, or analogue Generalized Anxiety Disorder (AGAD) were randomized to an eight-week RET intervention, or eight-week wait-list. AGAD status was determined using validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire-Generalized Anxiety Disorder subscale (≥ 6) and Penn State Worry Questionnaire (≥ 45). The primary outcome was anxiety symptoms measured with the Trait Anxiety subscale of the State-Trait Anxiety Inventory. The RET was designed according to World Health Organization and American College of Sports Medicine guidelines. RM-ANCOVA examined differences between RET and wait-list over time. Significant interactions were decomposed with simple effects analysis. Hedges’ d effect sizes quantified magnitude of differences in change between RET and wait-list. Twenty-eight participants (64% female) fully engaged in the trial (mean age: 26.0 ± 6.2y, RET: n = 14; Wait-list: n = 14). A significant group X time interaction was found for anxiety symptoms (F(3,66) = 3.60, p ≤ 0.019; d = 0.85, 95%CI: 0.06 to 1.63). RET significantly reduced anxiety symptoms from baseline to post-intervention (mean difference = − 7.89, p ≤ 0.001). No significant interaction was found for worry (F(3,69) = 0.79, p ≥ 0.50; d = − 0.22, 95%CI: − 0.96 to 0.53). Ecologically-valid RET significantly improves anxiety symptoms among young adults.Trial Registration: Clinicaltrials.gov Identifier: NCT04116944, 07/10/2019.

Associations Between Physical Activity, Generalized Anxiety Disorder, And Social Physique Anxiety Among Young Adults

Social Physique Anxiety (SPA) has been associated with physical activity (PA) behaviors and anxiety disorder symptoms. However, little is known about the potential influence of SPA on associations between PA and Generalized Anxiety Disorder (GAD). PURPOSE: This study quantified associations between PA, GAD and SPA among young adults (N=470, 23.2±4.8y; 63.4% female) and explored SPA as a mediator of the association between PA and GAD. METHODS: Seven-day PA Recall determined estimated expenditure (kcal/wk) and classified inactive, moderately active, and highly active PA dose categories. The Psychiatric Diagnostic Screening Questionnaire GAD subscale assessed GAD symptom severity; a score of ≥6 indicated analogue GAD (AGAD) status. The Social Physique Anxiety Scale assessed SPA. Independent t-tests examined baseline differences based on gender and AGAD status. Cohen’s d quantified the magnitude of difference. Logistic regression quantified odds of AGAD based on PA dose, adjusting for age, gender, and smoking status. Simple mediation analyses examined mediation of the continuous PA-GAD symptom association by SPA. RESULTS: Females reported less PA (p≤0.002, d=0.31) and greater SPA (p≤0.001, d=-0.63) and GAD symptom severity (p≤0.001, d=-0.51). AGAD reported greater SPA (p≤0.001, d=0.92). Compared to inactive, odds of AGAD were 28.3% (OR=0.72, 95%CI: [0.43, 1.20], p≥0.21) and 42.5% (OR=0.58, [0.35, 0.94], p≤0.03) lower among moderately active and highly active, respectively. In adjusted models, compared to inactive, odds were 29.3% (OR= 0.71, [0.42, 1.20], p≥0.21) and 36.9% (OR=0.63, [0.38, 1.06], p≥0.08) lower among moderately active and highly active, respectively. Regression models of PA on GAD symptoms (β=-0.01, p≤0.04), SPA on PA (β=-0.02, p≤0.03), and SPA on GAD symptoms (β=0.14, p≤0.001) were significant. When regressed together, SPA was (β=0.14, p≤0.001), but PA was not (β=-0.003, p≤0.27), statistically significant, supporting mediation. CONCLUSION: PA may lower odds of GAD, but findings were not significant after adjusting for covariates. SPA, a modifiable factor that was higher among females and those with AGAD, mediated the association between PA and GAD. Future research should examine these relationships longitudinally and explore SPA experimentally.

The Effects Of Ecologically-Valid Resistance Exercise Training Among Young Adults With Analogue Generalized Anxiety Disorder

The Effects Of Ecologically-Valid Resistance Exercise Training Among Young Adults With Analogue Generalized Anxiety Disorder

Acute and chronic effects of resistance exercise training among young adults with and without analogue Generalized Anxiety Disorder: A protocol for pilot randomized controlled trials

ObjectivesRecent meta-analyses support the chronic anxiolytic effects of resistance exercise training (RET) among women with diagnosed Generalized Anxiety Disorder (GAD). However, the effects of RET among those with subclinical, or analogue, GAD (AGAD) is unknown. The purpose of the pilot randomized controlled trial (RCT) detailed in this protocol was to quantify the acute and chronic effects of RET on signs and symptoms of GAD among young adults with and without AGAD. MethodsThis protocol details the full methods of two parallel, RCTs of an eight-week RET intervention compared to a wait-list control condition among young adults with and without AGAD. AGAD status was determined using validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire GAD subscale (≥6) and the Penn State Worry Questionnaire (≥45). The ecologically-valid RET was designed according to World Health Organization and American College of Sports Medicine guidelines. The primary outcome was AGAD status, assessed pre- and post-intervention. Secondary outcomes were assessed weekly. Two acute RET trials were nested within the design at pre- and post-intervention to determine response and change in response to a single bout of RET. ConclusionsThis pilot RCT examines the effect of an ecologically-valid RET intervention among young adults with subclinical levels of GAD. Given that GAD most often emerges during young adulthood, and young adults who display elevated subclinical symptoms are more likely to develop clinically significant psychopathology, investigating the effects of RET among individuals with emerging signs and symptoms of an anxiety disorder is particularly important. Trial registrationClinicalTrials.gov Identifier: NCT04116944.

Acute effects of Pilates on mood states among young adult males

BackgroundEvidence supports positive effects of acute exercise on mood states. Non-traditional exercise modalities, including Pilates, remain understudied, particularly among males. This study examined mood state responses to a single Pilates bout among young adult males, and explored if responses differed according to analogue Generalized Anxiety Disorder (AGAD) or depression status, or physical activity level. MethodsEighty-seven young adult males completed 30-min of mat-based Pilates. Outcomes included state anxiety, worry, feelings of tension, depressed mood, anger, energy and fatigue, and total mood disturbance (TMD). Paired samples t-tests compared pre- and post-session means within the group; magnitude of change was quantified with standardized mean differences. Two condition X two time repeated measures ANOVA examined outcome differences according to AGAD and depression status, and physical activity level. ResultsAcute Pilates significantly reduced state anxiety, feelings of fatigue, and TMD, and significantly increased feelings of energy (allp ≤ 0.007). Small-to-moderate effect sizes were found for state anxiety, feelings of energy and fatigue, and TMD (all d = 0.22-0.51). Pilates resulted in significant improvements in state anxiety, feelings of fatigue and energy, and TMD among participants with AGAD (n = 28) (all d = 0.10-0.32, p < 0.007) and depressed (n=41) participants (all d = 0.01-0.19, p < 0.008). ConclusionsNotwithstanding potential limitations, including the absence of a control group and a lack of follow-up beyond immediate effects, this is the first report to support potential positive mood state responses to an acute bout of Pilates among young adult males. Findings varied based on analogue GAD and depression statuses, and physical activity level.

Affect variability and emotional reactivity in generalized anxiety disorder

Background and objectivesResearch indicates that greater variability in affect and emotion over time is associated with depression and anxiety. However, it remains unclear whether individuals with generalized anxiety disorder (GAD) experience greater affect variability due to individual differences or differences in the stimuli they encounter. The current study investigated whether individuals with analogue GAD demonstrate greater affect variability in response to a standardized set of stimuli. Methods: Participants were 134 (95 female) undergraduate participants with analogue GAD (endorsing DSM-IV criteria A, B, C, and E on the GAD-Q-IV; n = 66) or with no symptoms of GAD (n = 68). Participants reported affective reactions (positive affect, negative affect, affective arousal, and affective dominance) to each of nine sets of standardized images varying in valence (positive, neutral, or negative) and arousal (low, medium, or high). Results: In a logistic regression model controlling for baseline measurements, higher variability of affective arousal across the nine sets of images uniquely predicted analogue GAD status, whereas variability in positive affect, negative affect, and affective dominance did not. Additional analyses revealed that lower mean affective arousal also uniquely predicted analogue GAD. Limitations: Limitations include using self-report measures to determine analogue GAD status; using a short laboratory session for the assessment of affect variability; and potential repeated testing effects. Conclusions: These findings suggest that individuals with GAD symptoms experience higher levels of affective arousal variability, even when the stimuli presented are held constant. Assessing variability in affective arousal may be helpful in both conceptualizing and treating individuals with GAD symptoms.

The Effectiveness of Acute Resistance Exercise Training among Young Adults with Analogue Generalized Anxiety Disorder

The Effectiveness of Acute Resistance Exercise Training among Young Adults with Analogue Generalized Anxiety Disorder

Acute Exercise Effects among Young Adults with Analogue Generalized Anxiety Disorder.

This study replicated initial findings of positive effects of acute vigorous-intensity aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young adult women with analogue GAD, examined responses among young adult men with analogue GAD, and explored sex-related differences and moderation by physical activity level, trait anxiety, depression, and poor sleep status. Thirty-five young adults (21.4 ± 2.3 yr; 19 males; 16 females) with Penn State Worry Questionnaire scores ≥45 (60 ± 8) completed two counterbalanced 30-min conditions: treadmill running at ~71.2% ± 0.04% HR reserve and seated quiet rest. Outcomes included worry, worry engagement, absence of worry, state anxiety, and feelings of energy and fatigue. No outcome or moderator differed at baseline between sexes. Exercise significantly improved state anxiety (P < 0.04; d = 0.27) and feelings of energy (P < 0.001; d = 1.09). Small nonsignificant improvements were found for worry (d = 0.22), worry engagement (d = 0.18), and feelings of fatigue (d = 0.21). The magnitude of improvements in worry, worry engagement, absence of worry, and feelings of energy were stronger among females. Significant large, potentially clinically meaningful increases in feelings of energy were found among women (d = 1.35) and men (d = 0.92). A nonsignificant, but potentially clinically meaningful, moderate reduction in worry (d = 0.53) was found among women. High-trait anxiety and poor sleep quality were supported as moderators. Findings replicated positive effects of acute aerobic exercise among young adult women with analogue GAD, and extended to support for positive effects among young adult men with analogue GAD.

Heightened reward learning under stress in generalized anxiety disorder: a predictor of depression resistance?

Stress-induced anhedonia is associated with depression vulnerability (Bogdan & Pizzagalli, 2006). We investigated stress-induced deficits in reward learning in a depression-vulnerable group with analogue generalized anxiety disorder (GAD, n = 34), and never-depressed healthy controls (n = 41). Utilizing a computerized signal detection task, reward learning was assessed under stressor and neutral conditions. Controls displayed intact reward learning in the neutral condition, and the expected stress-induced blunting. The GAD group as a whole also showed intact reward learning in the neutral condition. When GAD subjects were analyzed as a function of prior depression history, never-depressed GAD subjects showed heightened reward learning in the stressor condition. Better reward learning under stress among GAD subjects predicted lower depression symptoms 1 month later. Robust reward learning under stress may indicate depression resistance among anxious individuals.

Exploring the Relationship Between Childhood Abuse and Analogue Generalized Anxiety Disorder: The Mediating Role of Emotion Dysregulation

Despite emerging evidence for the central role of emotion dysregulation in generalized anxiety disorder (GAD), little is known about the factors that may increase the risk for this dysregulation. One factor that may be worth investigating is childhood abuse, previously found to be associated with both emotion dysregulation and GAD. To begin to explore the interrelationships among these phenomena, the present study examined the mediating role of emotion dysregulation in the relationship between various forms of childhood abuse (i.e., physical, sexual, and emotional abuse) and analogue GAD status in a sample of 396 undergraduates. Findings provided evidence for the mediating role of emotion dysregulation in the relationship between emotional abuse in particular and analogue GAD.

The Impact of Pretrauma Analogue GAD and Posttraumatic Emotional Reactivity Following Exposure to the September 11 Terrorist Attacks: A Longitudinal Study

The relation between analogue generalized anxiety disorder (GAD) assessed the day before the events of September 11, 2001 (9/11) and long-term outcome was examined in 44 young adults who were directly exposed the following day to the terrorist attacks in New York City. After controlling for high exposure to the attacks, preattack analogue GAD was associated with greater social and work disability, loss of psychosocial resources, anxiety and mood symptoms, and worry, but not symptoms of posttraumatic stress, assessed 12 months after 9/11. Fear and avoidance of emotions assessed 4 months after 9/11 statistically mediated the relation between preattack analogue GAD and social and work disability, loss of psychosocial support, mood and anxiety symptoms, and worry at 12-month follow-up. Avoidance of emotions 4 months after 9/11 also mediated the relation between preattack analogue GAD and posttraumatic stress symptoms 12 months after 9/11.

A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder

Intolerance of uncertainty has been defined as the unwillingness to tolerate the possibility that negative events may occur in the future, no matter how low the probability [Personality Individual Differences 17 (1994), 791–802]. Previous research suggests that intolerance of uncertainty may be more specific to worry and generalized anxiety disorder (GAD) than to other anxiety disorders [e.g., Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143–163). New York: Guilford Press]. However, Tolin et al. [J. Anxiety Disorders 17 (2003), 233–242] argued that intolerance of uncertainty may also play a central role in obsessive-compulsive disorder (OCD). Therefore, the current study compared intolerance of uncertainty in individuals with analogue GAD and/or OCD. Intolerance of uncertainty was strongly related to pathological worry, GAD symptoms, and OCD symptoms; however, neither worry nor GAD was found to be more strongly associated with intolerance of uncertainty than OCD. Further, individuals with analogue GAD or OCD reported more intolerance of uncertainty than controls, but they did not differ significantly from each other. These findings suggest that intolerance of uncertainty may be a central theme in a number of the anxiety disorders.