Measurement Invariance of Disorder-Specific and Transdiagnostic Measures of Repetitive Negative Thinking.

BACKGROUND: Repetitive negative thinking is conceptualized to be a transdiagnostic process linked to the development and maintenance of psychopathology. Prior research distinguishes between disorder-specific exemplars (worry, rumination) and transdiagnostic measures of repetitive negative thinking with differences across disorders reported. However, establishing the measurement invariance of these measures is necessary to support meaningful comparisons across clinical groups. METHOD: Bayesian structural equation modelling was used to assess the approximate invariance of the Ruminative Response Scale, Penn State Worry Questionnaire, and the Repetitive Thinking Questionnaire across individuals with a principal diagnosis of either depressive disorder, social anxiety disorder, or generalized anxiety disorder. RESULTS: All scales demonstrated approximate measurement invariance across the three disorder groups. The depressive disorder group reported a higher level of rumination than the generalized anxiety disorder group (Δµ = 0.25, 95% Credibility Interval [0.06, 0.45]), with no difference between the generalized anxiety disorder and social anxiety disorder groups. The depressive disorder and generalized anxiety disorder groups did not differ in their levels of trait repetitive negative thinking, but the social anxiety disorder group was markedly lower than the generalized anxiety disorder group (Δµ = -0.21 [-0.37, -0.05]). Similarly, levels of worry did not differ between the generalized anxiety disorder and depressive disorder group but were lower in the social anxiety disorder group than the generalized anxiety disorder group (Δµ = -0.23 [-0.41, -0.06]). CONCLUSIONS: The Ruminative Response Scale, Penn State Worry Questionnaire, and Repetitive Thinking Questionnaire are measuring trait repetitive negative thinking in a consistent manner across individuals with a principal diagnosis of depressive disorder, social anxiety disorder, or generalized anxiety disorder. This supports their use in transdiagnostic contexts and indicates that it is appropriate to directly compare the scores on these measures between diagnostic groups.

The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis.

Intolerance of uncertainty is a dispositional trait associated with a range of psychological disorders, but the influence of methodological factors on theses associations remains unknown. The first aim of this meta-analysis was to quantify the strengths of the association between IU and symptoms of generalised anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive compulsive disorder, depression, and eating disorders. The second aim was to assess the influence of methodological factors on these relationships, including clinical (vs. non-clinical) status, age group, sex, IU measure, and symptom measure. We extracted 181 studies (N participants = 52,402) reporting 335 independent effect sizes (Pearson's r). Overall, there was a moderate association between IU and symptoms (r = 0.51, 95% CI = 0.50-0.52), although heterogeneity was high (I2 = 83.50, p < .001). Some small but significant moderator effects emerged between and within disorders. Effect sizes were not impacted by sample size. The results indicate that IU has robust, moderate associations with a range of disorder symptoms, providing definitive evidence for the transdiagnostic nature of IU.

A bifactor model of intolerance of uncertainty in undergraduate and clinical samples: Do we need to reconsider the two-factor model?

The theorized role that intolerance of uncertainty (IU) plays in the acquisition, maintenance, and treatment of multiple emotional disorders underscores the importance of valid assessment tools. Research using the Intolerance of Uncertainty Scale-Short form (IUS-12) has conceptualized IU along 2 dimensions, namely, prospective IU and inhibitory IU. However, recent research has cast doubt on the separability of these dimensions. The aim of the current study was to evaluate the fit of competing measurement models of the IUS-12 in separate undergraduate (N = 506) and clinical (N = 524) samples. Unidimensional, correlated 2-factor, and bifactor models were tested using confirmatory factor analysis. The results of both studies supported a bifactor model consisting of a strong general IU factor. The general IU factor explained the majority of unique variance in the IUS-12, and suggested that a total score is generally appropriate for assessing IU. The general IU factor was most strongly and consistently associated with symptoms of multiple disorders. The inhibitory IU group factor was more weakly associated with most symptom measures in the clinical sample, but only with social phobia symptoms in the undergraduate sample. The prospective IU group factor was only separable from the general IU factor in the undergraduate sample, and did not explain unique variance in disorder symptoms. (PsycINFO Database Record

Pathways from uncertainty to anxiety: An evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms.

Uncertainty is central to anxiety-related pathology and intolerance of uncertainty (IU) appears to be a transdiagnostic risk and maintaining factor. The aim of the present study was to evaluate a hierarchical model to identify the unique contributions of trait and disorder-specific IU (i.e., uncertainty specific to generalised anxiety disorder, social anxiety, obsessive compulsive disorder, and panic disorder) to disorder-specific symptoms, beyond other disorder-specific cognitive vulnerabilities (i.e., negative metacognitive beliefs, fear of negative evaluation, inflated responsibility, and agoraphobic cognitions, respectively). Participants (N=506) completed a battery of online questionnaires. Structural equation modelling was used to evaluate model fit, as well as direct and indirect pathways. Trait and disorder-specific IU were significantly associated with multiple cognitive vulnerability factors and disorder symptoms. Indirect effects between trait IU and symptoms were observed through disorder-specific IU and cognitive vulnerabilities. The relative contribution of trait IU and disorder-specific IU to symptoms varied and theoretical and clinical implications are highlighted. Limitations include the cross-sectional design and reliance on self-report. Avenues for further research include a need for replication and extension of the model in different samples and using experimental and multi-method research methods.

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

The current paper presents a future research agenda for intolerance of uncertainty (IU), which is a transdiagnostic risk and maintaining factor for emotional disorders. In light of the accumulating interest and promising research on IU, it is timely to emphasize the theoretical and therapeutic significance of IU, as well as to highlight what remains unknown about IU across areas such as development, assessment, behavior, threat and risk, and relationships to cognitive vulnerability factors and emotional disorders. The present paper was designed to provide a synthesis of what is known and unknown about IU, and, in doing so, proposes broad and novel directions for future research to address the remaining uncertainties in the literature.

Evaluation of magical thinking: validation of the Illusory Beliefs Inventory.

Magical thinking has been related to obsessive-compulsive disorder; yet, little research has examined this construct in other anxiety disorders. The Illusory Beliefs Inventory (IBI) is a recently developed measure of magical thinking. The aim of this study was to investigate the psychometric properties of this new measure and to determine if magical thinking accounts for pathological worry beyond the well-researched constructs of intolerance of uncertainty (IU) and perfectionism. A sample of 502 participants completed an online survey. Confirmatory factor analysis identified a three-factor solution for the IBI, and the measure had good internal consistency (α = .92), test-retest reliability (r = .94) and discriminant validity. Magical thinking, IU, and perfectionism all predicted pathological worry; however, magical thinking accounted for less than 1% of unique variance in worry, suggesting that it is not strongly related to worry. Further investigation regarding the validity and clinical utility of the IBI is required.