Depression and Intolerance of Uncertainty: Relations between Uncertainty Subfactors and Depression Dimensions

Psychiatry. 2019 Spring;82(1):72-79. doi: 10.1080/00332747.2018.1560583. Epub 2019 Feb 7.


Depression is often modeled as a unidimensional construct despite evidence for distinct symptom dimensions (i.e., cognitive, affective, and somatic symptoms). Intolerance of uncertainty (IU; a cognitive bias that increases distress in uncertain situations) is a risk factor implicated in the development of depression. However, it is unclear how IU lower-order dimensions (i.e., inhibitory IU, the fear of future unpredictable events; prospective IU, avoidance due to fear of uncertain events) relate to depressive symptoms. The current study used confirmatory factor analysis and structural equation modeling to examine the relations between depressive symptoms and lower-order dimensions of IU in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). A two-factor model of depression, composed of Cognitive and Affective/Somatic factors, provided superior model fit compared to one- and three-factor solutions. A bifactor model of IU, composed of a general IU factor and specific Inhibitory IU and Prospective IU factors, provided superior model fit compared to one- and two-factor solutions. The general IU factor related to both Cognitive and Affective/Somatic factors. Inhibitory IU related to the Cognitive factor, but not the Affective/Somatic factor. Prospective IU was not related to Cognitive or Affective/Somatic factors. These findings elucidate the relations between IU and depression symptoms and have important theoretical implications regarding the etiology of depressive symptoms. In particular, inhibitory IU may be a novel target for intervention efforts in individuals presenting with depressive symptoms.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Depression / physiopathology*
  • Depressive Disorder / physiopathology*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Models, Theoretical*
  • Risk Factors
  • Uncertainty*