Compulsively seeking certainty: Clarifying the association between intolerance of uncertainty and compulsion severity in OCD

Intolerance of uncertainty (IU), the dispositional tendency to fear the unknown, has clinical implications across a variety of disorders. While research has linked IU and OCD, relatively little is known about this association. Previous studies have focused on IU’s association with overall OCD severity and specific symptom dimensions, but we do not yet understand to what degree this cognitive vulnerability is associated with each of the two cardinal symptoms: obsessions and compulsions. Additionally, few studies have examined the established IU subtypes—prospective and inhibitory IU—as unique contributors to OCD severity. Given the ubiquity of uncertainty in daily life and the potential for IU to influence obsessive-compulsive processes, further investigation of this cognitive vulnerability in OCD is warranted. In a sample of patients diagnosed with OCD, partial correlations were conducted to determine the association between OCD severity (separately examining obsessions and compulsions) and IU (separately examining prospective and inhibitory IU). These analyses revealed positive correlations between IU and compulsion severity, specifically. And of the IU subtypes, this link was specifically associated with prospective IU. The results of this correlational study contribute to the literature on IU in OCD, suggesting prospective IU as a cognitive mechanism that may be involved in the maintenance of compulsions.