Martin Fisher

Supervisor:

Dr Rosamond Watling

Intolerance of!
Uncertainty in!
Women with an Eating Disorder

Lab Technician: Richard Clarke

abstract: Intolerance of Uncertainty (IU) is a psychological construct that has been linked to eating disorders

(EDs). Objective: The aim was to investigate predictors of IU. Method: Measures identified levels of ED symptoms,
attachment insecurity, extroversion, openness to experience and IU in the participants (N = 148) with ED symptoms.
Results: Attachment insecurity and extroversion predicted IU but not openness to experience (R2 = .287) Discussion:
In the target sample, the more insecurely attached and less extraverted were the women, the greater their level of IU.

aim: To identify predictors of Intolerance of Uncertainty in women with eating disorder symptoms.

methods
&
measures

Online questionnaire:

253 participants from snowball sampling

Age range: 17 to 81 (M = 37.2, SD 14.1)

58% (148) exhibited ED symptoms

Multiple regression analysis

EDE-Q establishes eating behaviour e.g. Have you had a definite fear of losing control over eating?

IU Scale to measure levels of IU e.g. When it's time to act, uncertainty paralyses me.

NEO for extroversion, openness to experience e.g. Im a cheerful, high-spirited person.

ECR-R for attachment style e.g. I want to get close to my partner, but I keep pulling back.

DASS for levels of anxiety and depression e.g. Over the past week I felt life was meaningless.

(Fairburn, 2008; Buhr & Dugas, 2002; Costa & McCrae, 1989; Fraley, Waller & Brennan, 2000; Lovibond & Lovibond, 1995)

Uncertainty feels like the walls are caving in

Sternheim, Startup & Schmidt, 2011)

background

Eating Disorders (EDs):

EDs have the highest rate of mortality of all the

psychiatric illnesses. Latest figures estimate 725,000
sufferers, 50-75% with comorbid depression.

(PricewaterhouseCoopers LLP, 2015)

Intolerance of Uncertainty (IU):

Individuals with high levels of IU find uncertain situations

to be threatening, unfair and unacceptable, irrespective
of the probability of a negative event occurring.

(Carleton, Mulvogue, Thibodeau, McCabe, Antony & Asmundson, 2012)

Previous research:

IU may be an effective tool for early identification of

those at risk of developing an ED. Clear links have
already been established between IU and anorexia and
bulimia nervosa.

What is not yet known:

What are the predictors of IU?

Frank, Roblek, Shott, Jappe, Rollin, Hagman & Pryor, (2012)

Low
extroversion?

Insecure
attachment?

hypothesis

Insecure attachment

and low scores on two

personality factors

(openness to experience and

extroversion) will predict high IU
scores in women with ED symptoms.

Low
openness to
experience?

references

preliminary results

Early indications:

Data collection continues but a subset of 148 (58%) of

the women had EDE-Q >1.42 i.e. they exhibited ED
symptoms. Forced entry multiple regression analysis
of this subset indicated that extroversion (1 = -0.341 ,
p <.001) and insecure attachment (3 = 0.291 , p <.001)
are significant predictors of intolerance of uncertainty
(R2 = .287) but not openness to experience (2 =
-0.092, p >.05). The model accounted for 28.7% of
the variance in IU.
(Mond, Hay, Rodgers, Owen & Beumont, 2004)

discussion

Predictor variables

As predicted, the level of IU in the women who

exhibited ED symptoms corresponded with higher
levels of attachment insecurity and lower levels of
extroversion. Counter-intuitively, openness to
experience did not. This might be explained by the
snowball sampling method, which targeted online
communities where ED symptoms might be found, if
those who responded were more open than those who
did not respond.

Mediator variables

Further analysis may

determine if levels of anxiety
and depression, which were
also measured by the
questionnaire, might help
explain the results.

Buhr, K., & Dugas, M. J. (2002). The intolerance of uncertainty scale: Psychometric properties of the English version. Behaviour
research and therapy, 40(8), 931-945.

Carleton, R. N., Mulvogue, M. K., Thibodeau, M. A., McCabe, R. E., Antony, M. M., & Asmundson, G. J. (2012). Increasingly certain
about uncertainty: Intolerance of uncertainty across anxiety and depression. Journal of Anxiety Disorders, 26(3), 468-479.

Costa, P. T., & McCrae, R. R. (1989). The neo-PI/Neo-FFI manual supplement. Odessa, FL: Psychological Assessment Resources, 40.

Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.

Fraley, R. C., Waller, N. G., & Brennan, K. A. (2000). An item-response theory analysis of self-report measures of adult attachment.
Journal of Personality and Social Psychology , 78 , 350-365.

Frank, G. K., Roblek, T., Shott, M. E., Jappe, L. M., Rollin, M. D., Hagman, J. O., & Pryor, T. (2012). Heightened fear of uncertainty in
anorexia and bulimia nervosa. International Journal of Eating Disorders, 45(2), 227-232.

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress
Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy, 33(3), 335-343.

Mond, J. M., Hay, P. J., Rodgers, B., Owen, C., & Beumont, P. J. V. (2004). Validity of the Eating Disorder Examination Questionnaire
(EDE-Q) in screening for eating disorders in community samples. Behaviour research and therapy, 42(5), 551-567.

PriceWaterhouseCoopers (2015).The costs of eating disorders. Social, health and economic impacts. Available at http://www.beat.co.uk/assets/000/000/302/The_costs_of_eating_disorders_Final_original.pdf.

Sternheim, L., Startup, H., & Schmidt, U. (2011). An experimental exploration of behavioral and cognitiveemotional aspects of
intolerance of uncertainty in eating disorder patients. Journal of anxiety disorders, 25(6), 806-812.