Intolerance of Uncertainty and Eating Disorder Pathology in Anorexia Nervosa: Examining the Mediation Effect of Worry

Abstract

Due to the limited effectiveness of treatment for anorexia nervosa (AN), much research has been dedicated to finding transdiagnostic maintaining processes that may serve as targets for intervention. In light of this, the current study aims to investigate whether worry explains the effect of intolerance of uncertainty (IU) on eating disorder (ED) pathology in AN patients. Due to its unique relation with worry, the current study examined prospective IU (i.e., a subtype of IU) specifically. The current cross-sectional study is part of a larger study conducted by a highly specialized ED treatment facility in the Netherlands, and included participants who were 18 years and older, female, and had an AN diagnosis (N = 178). Participants completed self-report measures for prospective IU, worry and ED pathology at the facility. Results of the regression analyses showed that IU is positively associated with ED pathology, and that worry fully explains this relationship. However, the explanatory value of IU and worry for ED pathology scores was relatively low. Thus, their clinical relevance seems dubious. Nevertheless, the current study is the first to demonstrate an indirect association of IU and ED pathology in AN through worry, suggesting that (some) AN patients may benefit from intervention targeting such underlying transdiagnostic vulnerabilities.