The Influence of Intolerance of Uncertainty on Decision-Making in Individuals with Eating Disorders

Abstract

Background and aim: Eating disorders are severe and often chronic psychiatric disorders influencing both physical and mental well-being (American Psychiatric Association, 2013). An important factor that has been related to the pathology of eating disorders is intolerance of uncertainty (IU; Sternheim, Startup, & Schmidt, 2015). Elevated IU may have important consequences, including impaired decision-making behavior (Thibodeau, Carleton, Gómez-Pérez, & Asmundson, 2013). Studies have found that individuals with eating disorders show impaired decision-making in uncertain situations (Bodell et al., 2014; Danner et al., 2012; Galimberti et al., 2013). The present study therefore examined whether IU influences decision-making in individuals with an eating disorder. Method: 202 patients with eating disorders (including anorexia nervosa restrictive type, anorexia nervosa binge-eating/purging type and bulimia nervosa) and 91 healthy control individuals completed the IUS-12 and the IGT. Results and discussion: Results showed that IU is higher in eating disorder patients than in healthy control individuals and that decision-making did not differ between both groups. Moreover, individuals with higher IU demonstrated more advantageous decision-making than individuals with lower IU. These findings suggest that IU is indeed an important factor influencing eating disorder pathology and has important consequences for decision-making. Patients may benefit from (adjunct) interventions targeting IU. More research is needed into the exact workings of the relation between IU and decision-making and how this affects eating disorder pathology.