Saulnier Kevin G, Allan Nicholas P, Raines Amanda M, Schmidt Norman B
Psychiatry. 2019 Spring;82(1):72-79. doi: 10.1080/00332747.2018.1560583. Epub 2019 Feb 7.
Depression is often modeled as a unidimensional construct despite evidence for distinct symptom dimensions (i.e., cognitive, affective, and somatic symptoms). Intolerance of uncertainty (IU; a cognitive bias that increases distress in uncertain situations) is a risk factor implicated in the development of depression. However, it is unclear how IU lower-order dimensions (i.e., inhibitory IU, the fear of future unpredictable events; prospective IU, avoidance due to fear of uncertain events) relate to depressive symptoms. The current study used confirmatory factor analysis and structural equation modeling to examine the relations between depressive symptoms and lower-order dimensions of IU in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). A two-factor model of depression, composed of Cognitive and Affective/Somatic factors, provided superior model fit compared to one- and three-factor solutions. A bifactor model of IU, composed of a general IU factor and specific Inhibitory IU and Prospective IU factors, provided superior model fit compared to one- and two-factor solutions. The general IU factor related to both Cognitive and Affective/Somatic factors. Inhibitory IU related to the Cognitive factor, but not the Affective/Somatic factor. Prospective IU was not related to Cognitive or Affective/Somatic factors. These findings elucidate the relations between IU and depression symptoms and have important theoretical implications regarding the etiology of depressive symptoms. In particular, inhibitory IU may be a novel target for intervention efforts in individuals presenting with depressive symptoms.
尽管有证据表明存在不同的症状维度(即认知、情感和躯体症状),但抑郁症通常被建模为一个单维结构。不确定性不耐受(IU;一种认知偏差,会在不确定情况下增加痛苦)是抑郁症发展中的一个危险因素。然而,尚不清楚IU的低阶维度(即抑制性IU,对未来不可预测事件的恐惧;前瞻性IU,因害怕不确定事件而回避)与抑郁症状之间的关系。本研究使用验证性因素分析和结构方程模型,在374名心理病理学水平较高的成年人样本(年龄M = 35.5岁,54.3%为女性)中,研究抑郁症状与IU低阶维度之间的关系(89.2%符合至少一种DSM-5诊断标准,25.6%为原发性抑郁症)。与单因素和三因素模型相比,由认知和情感/躯体因素组成的双因素抑郁症模型提供了更好的模型拟合。与单因素和双因素模型相比,由一般IU因素以及特定的抑制性IU和前瞻性IU因素组成的IU双因素模型提供了更好的模型拟合。一般IU因素与认知和情感/躯体因素均相关。抑制性IU与认知因素相关,但与情感/躯体因素无关。前瞻性IU与认知或情感/躯体因素均无关。这些发现阐明了IU与抑郁症状之间的关系,并对抑郁症状的病因具有重要的理论意义。特别是,抑制性IU可能是针对有抑郁症状个体进行干预的一个新靶点。