The role of aversiveness in the relationship between intolerance of uncertainty and inflexible avoidance

The relationship between P-IU and inflexible avoidance was MODERATED by the participants’ ratings of outcome aversiveness: Specifically, the significant association between P-IU and insensitivity to outcome devaluation was found to be conditional upon high aversiveness ratings (see Table 1 and Figure 4): The interaction P-IU x Outcome aversiveness was significant: b= 0.005 [.001, .010] The role of aversiveness in the relationship between intolerance of uncertainty and inflexible avoidance g Amanda Flores1, Francisco J. López1, Bram Vervliet2& Pedro L. Cobos1 1Universidad de Málaga and Instituto de Investigación Biomédica de Málaga (IBIMA) 2Center for Excellence on Generalization, University of Leuven, and Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital The study of avoidance behaviour is considered relevant to improve our understanding of anxiety disorders, which are commonly characterized by the presence of undue avoidance behaviours (Endrass et al., 2011; Gillan et al., 2014). On the other hand, Dugas et al. (2001) defined intolerance of uncertainty as “the excessive tendency of an individual to consider it unacceptable that a negative event may occur, however small the probability of its occurrence”. One of its two factors, Prospective Intolerance of Uncertainty, has been defined as a factor leading to excessive responding in uncertain situations (Kraemer et al., 2014, Oglesby et al., 2013). Thus, uncertain avoidance situations may be taken as a relevant scenario to examine the role of intolerance of uncertainty as a factor that facilitates excessive and inflexible avoidance behavior. Flores et al. (2018)found evidence that Prospective Intolerance of Uncertainty (P-IU) is associated with inflexible avoidance behaviour. Specifically, healthy participants learned in a free-operant discriminative task to avoid an aversive sound, and were tested in extinction to measure the sensitivity of avoidance responses to the devaluation of the sound aversiveness. The results showed that an increase in P-IU was positively associated with insensitivity to outcome devaluation. This association was still significant even when trait anxiety was controlled for. These results suggested that P-IU may be a vulnerability factor for inflexible avoidance. Results We replicated Flores et al. (2018):It seems that prospective intolerance of uncertainty predisposes to the acquisition of inflexible avoidance behaviour in uncertain situations. Interestingly, new information was found: the relationship between P-IU and inflexible avoidance was moderated by the participants’ ratings of outcome aversiveness. Specifically, the significant association between P-IU and insensitivity to outcome devaluation was found to be conditional upon high aversiveness ratings. In other words, intolerant of uncertainty people are easily engaged in inflexible avoidance only if aversiveness is high enough. Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: Investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25,551–558. Endrass, T., Kloft, L., Kaufmann, C., & Kathmann, N. (2011), Approach and avoidance learning in obsessive–compulsive disorder. Depression & Anxiety, 28,166–172. Flores, A., López, F.J., Vervliet, B. & Cobos, P.L. (2018). Intolerance of uncertainty as a vulnerability factor for excessive and inflexible avoidance behavior. Behavioral Research and Therapy, 104,34-43. Freeston, M. H., Rheaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17,791–802. Gillan, C. M., Morein-Zamir, S., Urcelay, G. P., Sule, A., Voon, V., Apergis-Schoute, A. M., Fineberg, N. A., Sahakian, B. J., & Robbins, T. W. (2014). Enhanced avoidance habits in obsessive-compulsive disorder. Biological Psychiatry, 75,631–638. González Rodríguez, M., Cubas León, R., Rovella, A.T., & Darias Herrera, M. (2006). Spanish adaptation of the Intolerance of Uncertainty Scale: Cognitive processes, anxiety, and depression. Psicología y Salud, 16,219-233. Kraemer, K. M., McLei, A. C., & O'Bryan, E. M. (2014). The role of intolerance of uncertainty in terms of alcohol use motives among college students. Addictive Behavior, 42, 162-166. Oglesby, M. E., Medley, A. N., Norr, A. N., Capron, D. W., Korte, K. J., & Schmidt, N. B. (2013). Intolerance of uncertainty as a vulnerability factor for hoarding behaviors. Journal of Affective Disorders, 145,227–231. [email protected] After a Pavlovian phase (Phase 1), we used a free-operant discriminated avoidance procedure (Phase 2). Participants pressed two different keyboard keys to avoid a highly aversive noise (the US) presented to either the right or left ear. After a Devaluation phase (Phase 3) where we reduced the noise volume presented to one of the ears, participants went through a Test phase (Phase 4) where the noise was never administered (see Figures 1 and 2). Figure 1. Design and phases of the Experiment. -P-IU was measured with the Spanish adaptations of the Intolerance of Uncertainty Scale: IUS (Freeston et al.,1994; adaptation: González Rodríguez et al., 2006). -Inflexible avoidance was inferred from insensitivity to the reduction in the sound volume made in the Devaluation phase. A sensitive performance would entail less avoidance responses to A than to Bin the Test phase. An insensitive performance would entail similar avoidance responses to Aand B. Insensitivity to devaluation was calculated as: number of responses to CSA +1 (number of responses to CSA + 1) + number of responses to CSB -Outcome aversiveness ratings were asked after the Pavlovian phase. They were given on a 0 (Non aversive at all)to 9 (Extremely aversive) rating scale. Interval in which the US could appear (8-12 seconds) The noise could be avoided by pressing the correct key within 1 second before the noise was programmed to appear Method N = 79 CSC Introduction Objective To replicate Flores et al. (2018)’s results: To study avoidance behaviour using a reinforcer devaluation procedure to evaluate the extent to which P-IU is related to insensitivity to devaluation. Prospective intolerance of uncertainty (P-IU) Inflexible avoidance (insensitivity to devaluation) Outcome aversiveness Figure 2. Procedure of the Experiment, specifically the instrumental learning phase. Pavlovian learning phase was similar but without the possibility to respond, and the Test phase without the noise (although participants were not explicitly informed about this). Conclusions CSA CSB CSC CSA CSB CSC CSA CSB This research was supported by Grant PSI2014-56061 of the Spanish Ministerio de Economía y Competitividad, by a Marie Curie International Outgoing Fellowship within the 7th European Community Framework Programme to BV, and by the Plan Propio de Investigación de la Universidad de Málaga, Programa de Fortalecimiento de las Capacidades en I+D+I en las Universidades 2014-20150, Fondos FEDER, to AF . Table 1. Output of the PROCESS package implemented with SPSS for moderation analysis. Relationships between P-IU and insensitivity to outcome devaluation moderated by aversiveness ratings (low, medium and high) can be observed. Figure 4. Relationship between P-IU and Insensitivity to devaluation in the three levels of outcome aversiveness ratings (low, medium and high) . Outcome aversiveness ratings: Low Medium High Figure 3. Diagram of the conceptual moderation model for our results.