Volume 24, Issue 4 (Winter 2019)                   IJPCP 2019, 24(4): 400-415 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Abdolpour G, Nasiri M, Mafakheri M, Mansouri K, Abdi R. Structural Equation Modeling of Intolerance of Uncertainty and Symptoms of Depression and General Anxiety Disorder: Investigation of the Mediating Role of Rumination. IJPCP. 2019; 24 (4) :400-415
URL: http://ijpcp.iums.ac.ir/article-1-2822-en.html
1- PhD. in Clinical Psychology, Department of Psychology, Faculty of Humanities, University of Shahed, Tehran, Iran. , g.marand@yahoo.com
2- PhD. in Health Psychology, Department of Clinical Psychology, Faculty of Psychology and Education, University of Kharazmi, Tehran, Iran.
3- MSc. in Psychology, Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
4- PhD. in Psychology, Department of Psychology, Faculty of Psychology and Education, Azarbaijan Shahid Madani University, Tabriz, Iran.
Abstract:   (242 Views)
Objectives Generalized anxiety disorder and depression, one of the common problems in childhood and adulthood is associated with many problems in the field of health. This study aimed to investigate the mediating role of rumination in the relationship among Intolerance of Uncertainty (IU) and symptoms of depression and General Anxiety Disorder (GAD).
Methods In this descriptive correlational study, a sample of 250 students from Iran University of Medical Sciences were selected using cluster sampling method. The participants responded to intolerance of uncertainty scale and rumination scale, Generalized Anxiety Disorder Questionnaire Inventory-revised (GAD-Q-IV), and Beck depression inventory. The obtained data were analyzed using Structural Equation Modeling (SEM). For statistical analysis, SPSS V. 22 and LISREL 85.9 were used to classify, process, and analyze the data and to investigate the hypotheses of the research.
Results The evaluation of hypothetical model with fit indexes demonstrated that the hypothetical model fits the measurement model (CFI=0.98, NFI=0.96, and RMSEA=0.060).
Structural relations analysis also indicated intolerance of uncertainty indirectly through rumination over depression and directly and indirectly general anxiety disorder.
Conclusion Thus, based on the current research findings, rumination has a mediating role in relationship between intolerance of uncertainty and symptoms of depression and general anxiety disorder. Considering these dimensions, the employed mechanisms can be useful in developing efficacious preventive and therapeutic interventions for depression.
Full-Text [PDF 3266 kb]   (199 Downloads) |   |   Full-Text (HTML)  (64 Views)  
Type of Study: Original Research | Subject: Psychiatry and Psychology
Received: 2018/03/4 | Accepted: 2018/08/7

References
1. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Philadelphia: Lippincott Williams & Wilkins; 2011.
2. Shihata S, McEvoy PM, Mullan BA. Pathways from uncertainty to anxiety: An evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms. Journal of Anxiety Disorders. 2017; 45:72-9. [DOI: 10.1016/j.janxdis.2016.12.001] [PMID] [DOI:10.1016/j.janxdis.2016.12.001]
3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental disorders (DSM-5). Washington: American Psychiatric Association; 2013.
4. Kessler R, Walters E, Wittchen HU. Epidemiology. In: Heimberg RG, Turk CL, Mennin DS, editors. Generalized Anxiety Disorder: Advances in Research and Practice. New York: Guilford Press; 2004.
5. Ehsanmanesh M. [Epidemiology of mental disorders in Iran (Persian)]. Iranian Journal of Psychiatry & Clinical Psychology. 2001; 6(4):54-70.
6. Omidi A, Tabatabai A, Sazvar A, Akkashe G. [Epidemiology of mental disorders in urbanized areas of Natanz (Persian)]. Iranian Journal of Psychiatry & Clinical Psychology. 2003; 8(4):32-8.
7. Brain C. Advance psychology: Application, issues and perspective. Cheltenham: Nelson Thorenes; 2002.
8. Al Hamzawi AO, Bruffaerts R, Bromet EJ, AlKhafaji AM, Kessler RC. The epidemiology of major depressive episode in the Iraqi general population. PLOS One. 2015; 10(7):e0131937. [DOI:10.1371/journal.pone.0131937] [PMID] [PMCID]
9. Boelen PA, Reijntjes A. Intolerance of uncertainty and social anxiety. Journal of Anxiety Disorders. 2009; 23(1):130-5. [DOI:10.1016/j.janxdis.2008.04.007] [PMID]
10. Agheli F, Hasanzadeh R, Ghasemian D. [Compare of intolerance of uncertainty among obsessive-compulsive disorder, generalized anxiety disorder and healthy subjects (Persian)]. Journal of Novel Applied Sciences. 2013; 2(2):896-9.
11. Buhr K, Dugas MJ. Investigating the construct validity of intolerance of uncertainty and its unique relationship with worry. Journal of Anxiety Disorders. 2006; 20(2):222-36. [DOI:10.1016/j.janxdis.2004.12.004] [PMID]
12. Dugas MJ, Robichaud M. Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice. New York: Routledge; 2007.
13. Freeston MH, Rhéaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Personality and Individual Differences. 1994; 17(6):791-802. [DOI:10.1016/0191-8869(94)90048-5] [DOI:10.1016/0191-8869(94)90048-5]
14. Holaway RM, Heimberg RG, Coles ME. A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. Journal of Anxiety Disorders. 2006; 20(2):158-74. [DOI:10.1016/j.janxdis.2005.01.002] [PMID]
15. Dugas MJ, Buhr K, Ladouceur R. The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In: Heimberg RG, Turk CL, Mennin DS, editors. Generalized Anxiety Disorder: Advances in Research and Practice. New York: Guilford Press; 2003. [PMCID]
16. Heimberg RG, Turk CL, Mennin DS. Generalized anxiety disorder: Advances in research and practice. New York: Guilford Press; 2004.
17. de Jong Meyer R, Beck B, Riede K. Relationships between rumination, worry, intolerance of uncertainty and metacognitive beliefs. Personality and Individual Differences. 2009; 46(4):547-51. [DOI:10.1016/j.paid.2008.12.010] [DOI:10.1016/j.paid.2008.12.010]
18. Ward A, Lyubomirsky S, Sousa L, Nolen Hoeksema S. Can't quite commit: Rumination and uncertainty. Personality and Social Psychology Bulletin. 2003; 29(1):96-107. [DOI:10.1177/0146167202238375] [DOI:10.1177/0146167202238375]
19. Hartley S, Haddock G, e Sa DV, Emsley R, Barrowclough C. An experience sampling study of worry and rumination in psychosis. Psychological Medicine. 2014; 44(8):1605-14. [DOI:10.1017/S0033291713002080] [PMID] [DOI:10.1017/S0033291713002080]
20. Wolkenstein L, Zwick JC, Hautzinger M, Joormann J. Cognitive emotion regulation in euthymic bipolar disorder. Journal of Affective Disorders. 2014; 160:92-7. [DOI:10.1016/j.jad.2013.12.022 ] [PMID] [DOI:10.1016/j.jad.2013.12.022]
21. Nolen Hoeksema S, Davis CG. Thanks for sharing that: Ruminators and their social support networks. Journal of Personality and Social Psychology. 1999; 77(4):801. [DOI:10.1037/0022-3514.77.4.801] [PMID] [DOI:10.1037/0022-3514.77.4.801]
22. Nolen Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology. 2000; 109(3):504-11. [DOI:10.1037/0021-843X.109.3.504] [DOI:10.1037/0021-843X.109.3.504]
23. Mansouri A, Farnam AR, Bakhshipour Rodsari A, Mahmood-Aliloo M. [Comparisons between rumination in Individual with major depresion disorder, obsessive-compulsive disorder. General Anxiety Disorder and normal persons (Persian)]. Journal of Sabzevar University of Medical Sciences. 2010; 4:26-9.
24. Pearson M, Brewin CR, Rhodes J, McCarron C. Frequency and nature of rumination in chronic depression: A preliminary study. Cognitive Behaviour Therapy. 2008; 37(3):160-8. [DOI:10.1080/16506070801919224] [PMID] [DOI:10.1080/16506070801919224]
25. Papageorgiou C, Wells A. Positive beliefs about depressive rumination: Development and preliminary validation of a self-report scale. Behaviour Therapy. 2001; 32(1):13-26. [DOI:10.1016/S0005-7894(01)80041-1]
26. Watkins E, Baracaia S. Why do people ruminate in dysphoric moods? Personality and Individual Differences. 2001; 30(5):723-34. [DOI:10.1016/S0191-8869(00)00053-2]
27. Dugas MJ, schewartz A, Francis K. Intolerance of uncertainty, worry, and depression. Cognitive Therapy and Research. 2004; 28(6):835-42. [DOI:10.1007/s10608-004-0669-0] [DOI:10.1007/s10608-004-0669-0]
28. Ladouceur R, Gosselin P, Dugas MJ. Experimental manipulation of intolerance of uncertainty: A study of a theoretical model of worry. Behaviour Research and Therapy. 2000; 38(9):933-41. [DOI:10.1016/S0005-7967(99)00133-3]
29. Grenier S, Ladouceur R. [Manipulation de Intolerance al Incertitude et Inquietudes (French)]. Revue Comedienne Dessciences du Comportment. 2004; 36(1):56-65.
30. Kendler KS. Major depression and generalised anxiety disorder: same genes, (partly) different environments-revisited. Focus. 2004; 168(3):68-425.
31. Buhr K, Dugas MJ. The intolerance of uncertainty scale: Psychometric properties of the English version. Behaviour Research and Therapy. 2002; 40(8):931-45. [DOI:10.1016/S0005-7967(01)00092-4]
32. Sexton KA, Norton PJ, Walker JR, Norton GR. Hierarchical model of generalized and specific vulnerabilities in anxiety. Cognitive Behaviour Therapy. 2003; 32(2):82-94. [DOI:10.1080/16506070302321] [PMID]
33. Muris P, Roelofs J, Meesters C, Boomsma P. Rumination and worry in nonclinical adolescents. Cognitive Therapy and Research. 2004; 28(4):539-54. [DOI:10.1023/B:COTR.0000045563.66060.3e]
34. Kraemer HC, Stice E, Kazdin A, Offord D, Kupfer D. How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry. 2001; 158(6):848-56. [DOI:10.1176/appi.ajp.158.6.848] [DOI:10.1176/appi.ajp.158.6.848]
35. Frazier PA, Tix AP, Barron KE. Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology. 2004; 51(1):115-34. [DOI:10.1037/0022-0167.51.1.115] [DOI:10.1037/0022-0167.51.1.115]
36. Spasojević J, Alloy LB. Rumination as a common mechanism relating depressive risk factors to depression. Emotion. 2001;1(1):25-37. [DOI:10.1037/1528-3542.1.1.25] [PMID] [DOI:10.1037/1528-3542.1.1.25]
37. Kline RB. Principles and practice of structural equation modeling. New York: Guilford; 2010.
38. Newman MG, Zuellig AR, Kachin KE, Constantino MJ, Przeworski A, Erickson T, et al. Preliminary reliability and validity of the generalized anxiety disorder questionnaire-IV: A revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy. 2002; 33(2):215-33. [DOI:10.1016/S0005-7894(02)80026-0] [DOI:10.1016/S0005-7894(02)80026-0]
39. Abdi R, Bakhshipour Roodsari A, Mahmood Alilou M, Farnam A. [Efficacy evaluation of unified transdiagnostic treatment in Patients with generalized anxiety disorder (Persian)]. International Journal of Behavioral Sciences. 2014; 11(5):245-51.
40. Abolghasemi A, Narimani M. [Psychological tests (Persian)]. Ardebil: Bagh-e Rezvan; 2006.
41. Bagherinejhad M, Salehi J, Tabatabayi M. [Relationship between rumination and depression in Sample of iranian students (Persian)]. Journal of Educational Psychology. 2010; 11(1):21-38.
42. Jöreskog KG, Sörbom D. LISREL 8.80 for Windows [Computer software]. Lincolnwood: Scientific Software International, Inc; 2006.
43. Anderson JC, Gerbing DW. Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin. 1988; 103(3):411-23. [DOI:10.1037/0033-2909.103.3.411]
44. Chou CP, Bentler PM. Estimates and tests in structural equation modeling. In Hoyle RH, editors. Structural Equation Modeling: Concepts, Issues and Applications. Thousand Oaks, California: Sage; 1995.
45. Kline RB. Principles and practice of structural equation modeling. New York: Guilford; 2001.
46. Bentler PM. EQS structural equations program manual. San Fernando Valley, Los Angeles: Encino; 1995.
47. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods. 2008; 40(3):879-91. [PMID] [DOI:10.3758/BRM.40.3.879] [PMID]
48. Lyubomirsky S, Nolen Hoeksema S. Effects of self-focused rumination on negative thinking and interpersonal problem solving. Journal of Personality and Social Psychology. 1995; 69(1):176-90. [DOI:10.1037/0022-3514.69.1.176] [DOI:10.1037/0022-3514.69.1.176]
49. Davis RN, Nolen Hoeksema S. Cognitive inflexibility among ruminators and nonruminators. Cognitive Therapy and Research. 2000; 24(6):699-711. [DOI:10.1023/A:1005591412406]
50. Joormann J. Differential effects of rumination and dysphoria on the inhibition of irrelevant emotional material: Ev idence from a negative priming task. Cognitive Therapy and Research. 2006; 30(2):149-60. [DOI:10.1007/s10608-006-9035-8] [DOI:10.1007/s10608-006-9035-8]
51. Moulds ML, Kandris E, Starr S, Wong ACM. The relation hip between rumination, avoidance and depression in a non-clinical sample. Behaviour Research and Therapy. 2007; 45(2):251-61. [DOI:10.1016/j.brat.2006.03.003] [PMID] [DOI:10.1016/j.brat.2006.03.003]
52. Dobson KS, Dozois DJA. Risk factors in depression. New York: Elsevier; 2008.
53. Riskind JH, Alloy LB. The Cognitive Vulnerability to Depression (CVD) Project: Current fndings and future directions. In Alloy LB, Rishkind JH, editors. Cognitive Vulnerability to Emotional Disorders. New Jersey: Paulist Press; 2006.
54. Lyubomirsky S, Kasri F, Zehm K. Dysphoric rumination impairs concentration on academic tasks. Cognitive Therapy and Research. 2003; 27(3):309-30. [DOI:10.1023/A:1023918517378]
55. Mahmood Aliloo M, Shahjoyi T, Hashemi Z. [Comparision intolerance of uncertainty, cognitive avoidance, negative attitude to problem and positive believes about worry between individual with general anxiety disorder and normal individuals (Persian)]. Journal of Psychology. 2010; 5(20):20-32.
56. Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology. 1991; 100(4):569-582. [DOI:10.1037/0021-843X.100.4.569] [PMID] [DOI:10.1037/0021-843X.100.4.569]
57. Roberts JE, Gilboa E, Gotlib IH. Ruminative response style and vulnerability to episodes of dysphoria: Gender, neuroticism, and episode duration. Cognitive Therapy and Research. 1998; 22(4):401-23. [DOI:10.1023/A:1018713313894]
58. Cox BJ, Enns MW, Taylor S. The effect of rumination as a mediator of elevated anxiety sensitivity in major depression. Cognitive Therapy and Research. 2001; 25(5):525-34. [DOI:10.1023/A:1005580518671]
59. Billings AG, Moos RH. Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology. 1984; 46(4):877-91. [DOI:10.1037/0022-3514.46.4.877] [PMID] [DOI:10.1037/0022-3514.46.4.877]
60. Nolen Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspectives on Psychological Science. 2008; 3(5):400-24. [DOI:10.1111/j.1745-6924.2008.00088.x] [PMID] [DOI:10.1111/j.1745-6924.2008.00088.x]
61. Marroquín BM, Fontes M, Scilletta A, Miranda R. Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms. Cognition and Emotion. 2010; 24(8):1446-55. [DOI:10.1080/02699930903510212] [DOI:10.1080/02699930903510212]
62. Dugas MJ, RobichaudM. Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice. Abingdon: Taylor & Francis; 2007.

Add your comments about this article : Your username or Email:
CAPTCHA code

Send email to the article author


© 2019 All Rights Reserved | Iranian Journal of Psychiatry and Clinical Psychology

Designed & Developed by : Yektaweb