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Its not just the judgementsIts that I dont know: Intolerance of uncertaintyas a predictor of social anxiety

R. Nicholas Carleton, Kelsey C. Collimore, Gordon J.G. Asmundson *

Department of Psychology and the Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, Saskatchewan S4S 0A2, Canada

1. Introduction

Social anxiety (SA) refers to anxiety or apprehension experi-

enced in interpersonal or performance situations (Watson &

Friend, 1969). Individuals with high SA fear being negatively

evaluated by others (Rapee & Heimberg, 1997; Stein, Jang, &

Livesley, 1999), making a bad impression, or acting in a way that

might be embarrassing (Antony & Swinson, 2000). There is also

evidence that SA may result from fearing positive evaluation,

suggesting concern related to evaluation in general (Weeks,

Heimberg, & Rodebaugh, 2008; Weeks, Heimberg, Rodebaugh, &

Norton, 2008).

Researchers have shown that social anxiety disorder (SAD) is

related to and exacerbated by fears that other people can detectsymptoms of SA (e.g., blushing; Rector, Szacun-Shimizu, &

Leybman, 2007). Such fears are conceptualized within the anxiety

sensitivity (AS;Peterson & Reiss, 1992) construct, which denotes

the propensity to appraise anxiety-related somatic sensations,

cognitive changes, and social consequences based on expectations

of harmful consequences (Reiss & McNally, 1985; Taylor, 1999).

Substantial research has demonstrated a direct relationship

between the social subscale of the Anxiety Sensitivity Index

(ASI;Peterson & Reiss, 1992), and both SA and SAD (Anderson and

Hope, 2009; Asmundson & Stein, 1994; Ball, Otto, Pollack, Uccello,

& Rosenbaum, 1995) as well as indirect relationships with the ASI

somatic and cognitive subscales (Carleton et al., 2009).

The AS construct has been associated with intolerance of

uncertainty (IU) the tendency for a person to consider the

possibility of a negative event occurring as unacceptable and

threatening irrespective of the probability of its occurrence

(Carleton, Sharpe, & Asmundson, 2007) and may be causally

dependent on IU (Carleton, Sharpe, et al., 2007). For persons who

are intolerant of uncertainty, engaging in situations with uncertain

outcomesmay induce and perpetuate a heightened level of anxiety

(Dugas, Gosselin, & Landouceur, 2001). People with high IU aremore likely to interpret ambiguous information as threatening

(Heydayati, Dugas, Buhr, & Francis, 2003), therein exacerbating

their physiological arousal (Greco & Roger, 2001, 2003) which

serves to facilitate self-perpetuating cycles of fear (Barlow, 2002).

IU has been a useful construct in theory and research associated

with generalized anxiety disorder (GAD) and obsessive compulsive

disorder (Dugas et al., 2001; Holaway, Heimberg, & Coles, 2006);

however, it is now also drawing attention from researchers

investigating panic disorder (Dugas, Marchand, & Ladouceur, 2005;

Simmons, Matthews, Paulus, & Stein, 2008). In contrast, there is a

relative paucity of research directly investigating the relationship

Journal o f Anxiety Disorders 24 (2010) 189195

A R T I C L E I N F O

Article history:

Received 1 June 2009

Received in revised form 8 October 2009Accepted 19 October 2009

Keywords:

Intolerance of uncertainty

Social anxiety

Social phobia

Generalized anxiety disorder

A B S T R A C T

Interest in the role of intolerance of uncertainty (IU) the tendency for a person to consider the

possibility of a negative event occurring as unacceptable and threatening irrespective of the probability

of its occurrence in anxiety disorders has been increasing in recent research. IU has been implicated as

an important construct associated withgeneralizedanxiety disorder (GAD); however,a growing body of

research suggests that levels of IU are also high among individuals with other anxiety disorders. Despite

the increasing interest, few studies have examined the relationship between IU and social anxiety (SA).

The purpose of the present investigation was to further investigate the relationship between IU and SA.

Participants included 286 community members (71% women) from Canada who completed measures of

IU, SA, anxiety sensitivity, and fear of negative evaluation (FNE). Regression analyses revealed that the

inhibitory anxiety dimension of IU, the fear of socially observable anxiety symptoms dimension of

anxiety sensitivity, and the FNE were consistently significant predictors of SA symptoms. Unexpectedly,

IU and FNE were often comparable predictors of SA variance. Moreover, participants with SA symptoms

consistent with SAD exhibited levels of IU comparable to those reported by participants with worry

symptoms consistent with GAD. Comprehensive findings, implications, and directions for future

research are discussed.

2009 Elsevier Ltd. All rights reserved.

* Corresponding author. Tel.: +1 306 347 2415; fax: +1 306 337 3275.

E-mail address: gordon.asmundson@uregina.ca(Gordon J.G. Asmundson).

Contents lists available at ScienceDirect

Journal of Anxiety Disorders

0887-6185/$ see front matter 2009 Elsevier Ltd. All rights reserved.

doi:10.1016/j.janxdis.2009.10.007

mailto:gordon.asmundson@uregina.cahttp://www.sciencedirect.com/science/journal/08876185http://dx.doi.org/10.1016/j.janxdis.2009.10.007http://dx.doi.org/10.1016/j.janxdis.2009.10.007http://www.sciencedirect.com/science/journal/08876185mailto:gordon.asmundson@uregina.ca

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between IU and SA, including SAD. Researchers have found that IU

can predict changes in reported levels of SA (Riskind, Tzur,

Williams, Mann, & Shahar, 2007); however, the ability to tolerate

the uncertainty associated with social situations may be a critical

element in determining SA. For example, in persons with SAD,

uncertainty is often associated with SA before a social encounter

(e.g., catastrophizing about possible occurrences), during the social

encounter (e.g., catastrophizing about ambiguous stimuli), and/or

after the social encounter (e.g., catastrophizing about possible

consequences; Antony & Rowa, 2008).

The IU and SA relationship has also been directly demonstrated

as independent of the established relationships between SA, FNE,

and AS using data from a sample of Netherlands participants

(Boelen & Reijntjes, 2009). In that study, IU accounted for variance

in SA symptoms beyond negative affect, FNE, and AS. While novel

and highly coherent, Boelen and Reijntjess study included (1) only

one measure of SA, (2) used the Intolerance of Uncertainty Scale

(IUS; Freeston, Rheaume, Letarte, Dugas, & Ladouceur, 1994),

which can be psychometrically unstable (Carleton, Norton, &

Asmundson, 2007), (3) did not include a measure of positive

affectivity, and (4) used only the ASI total score.

The primary goal of the current study was to replicate the

previous finding of a relationship between IU and SA (Boelen &

Reijntjes, 2009) with data from a North American communitysample. A secondary goal was to extend those findings to include

measures of the various facets of SA (i.e., social interaction and

performance anxiety, social distress and avoidance), negative and

positive affect, as well as psychometrically stable measures of IU

and AS. More specifically, the dimensions of IU and AS were not

assessed in the previous study despite evidence that the

dimensions of each construct function in importantly distinct

ways (Collimore, McCabe, Carleton, & Asmundson, 2008; Gosselin

et al., 2008; Taylor, 1999). The final goal of this study was to

compare levels of IU across participants reporting symptoms

congruent with SAD (without co-occurring GAD), relative to GAD

(without comorbid SAD), or both (comorbid SAD and GAD),

thereby paralleling previous comparative analyses of GAD and

panic disorder with agoraphobia (Dugas et al., 2005).

2. Methods

2.1. Participants

Participants included community members (n= 286) from

Canada [82 men, 1854 years (Mage= 29.9; SD = 10.8) and 204

women, 1855 years (Mage = 29.8 SD = 10.7)], who completed

several self-report measures as part of a larger investigation that

was approved by the University Research Ethics Board. Partici-

pants were solicited with web-based advertising to participate in

research exploring fear. Web-based data collection has been

demonstrated to be a valid approach for questionnaire-based

research in North America that is comparable to other datacollection methods (Gosling, Vazire, Srivastava, & John, 2004) and

has been used in related investigations of fear constructs (Carleton

& Asmundson, 2009; Carleton, Norton, et al., 2007). Most

participants (70%) reported having at least some postsecondary

education, being employed or working at home (37% full-time, 19%

part-time, and 7% as homemakers) and being either part or full

time students (36%). Most participants identified their ethnicity as

Caucasian (88%), First Nations (2%), or Asian (2%). Approximately

half (52%) reported being single and 35% reported being married.

2.2. Measures

Anxiety Sensitivity Index-3(ASI-3;Taylor et al., 2007). The ASI-3

is an 18-item self-report measure assessing the tendency to fear

symptoms of anxiety based on the belief that they may have

harmful consequences (e.g., It scares me when I blush in front of

people). Items are rated on a 5-point Likert scale ranging from 0

(very little) to 4 (very much). Factor analyses supports a robust 3-

factor structure corresponding to the three dimensions of AS (fear

of somatic sensations, somatic; fear of cognitive dyscontrol,

cognitive, and fear of socially observable symptoms of anxiety,

social;Taylor, Koch, Woody, & McLean, 1996; Zinbarg, Barlow, &

Brown, 1997). The ASI-3 has demonstrated improved internal

consistency and factorial validity relative to the original ASI

(Peterson & Reiss,1992). The ASI-3 has also demonstrated evidence

for convergent, discriminant, and criterion validity (Taylor et al.,

2007). Measures of AS demonstrate unique incremental validity

beyond trait anxiety (Rapee & Medoro, 1994) and trait-level

negative affectivity/ neuroticism (Zvolensky, Kotov, Antipova,

Leen-Feldner, & Schmidt, 2005). The internal consistency was

acceptable for the total score (a = .92), the somatic subscale score

(a = .86), the cognitive subscale score (a = .89), and the social

subscale score (a = .84). The average inter-item correlation was

.40.

Brief Fear of Negative Evaluation scale, version 2 (BFNE-II;

Carleton, Collimore, & Asmundson, 2007; Carleton, McCreary,

Norton, & Asmundson, 2006). The BFNE-II is a 12-item revised

version of the Brief Fear of Negative Evaluation scale (BFNE;Leary,1983) used for measuring fears of negative evaluation (e.g., I am

afraid that others will not approve of me). The BFNE has been

correlated with the Social Avoidance and Distress Scale (SADS;

Watson & Friend, 1969); however, it more accurately depicts FNE

than it does SA (Miller, 1995). Revisions to the BFNE were made in

accordance with previously suggested changes (Taylor, 1993) to

remove a methodological issue stemming from four reverse-

worded items by revising those items to be straightforwardly

worded (Carleton, Collimore, et al., 2007; Carleton et al., 2006;

Weeks et al., 2005). Items are rated on a 5-point Likert scale

ranging from 0 (not at all characteristic of me) t o 4 (extremely

characteristic of me). The BFNE-II demonstrates excellent internal

consistency, correlates highly with the BFNE, and factor analyses

have supporteda unitary solution(Carleton, Collimore, et al., 2007;Carleton et al., 2006). The internal consistency was acceptable

(a = .98) and the average inter-item correlation was .76.

Generalized Anxiety Disorder Assessment (GAD-7; Spitzer,

Kroenke, Williams, & Lowe, 2006). The GAD-7 is a 7-item self-

report measure designed to assess GAD symptoms (e.g., Feeling

nervous, anxious or on edge). Items are rated on a 4-point Likert

scale ranging from 0 (not at all) to 3 (nearly every day). Use of the

total 7-item score typically provides sufficient sensitivity and

specificity for discerning clinical and nonclinical samples (i.e., a

cut-off score of 10 with reports of symptoms interfering with daily

activities can be used to distinguish persons reporting clinically

significant distress; Spitzer et al., 2006; Swinson, 2006). The

internal consistency was acceptable (a = .89) and the average

inter-item correlation was .54.Intolerance of Uncertainty Scale, Short Form (IUS-12;Carleton,

Norton, et al., 2007). The IUS-12 is a 12-item short-form of the

original 27-item Intolerance of Uncertainty Scale (Freeston et al.,

1994) that measures reactions to uncertainty, ambiguous situa-

tions, and the future (e.g., Unforeseen events upset me greatly).

Items are scored on a 5-point Likert scale ranging from 1 (not at all

characteristic of me) to 5 (entirely characteristic of me). The IUS-12

has a strong correlation with the original scale, r= .96, and has

been shown to have two factors, including prospective anxiety (7

items; e.g., I cant stand being taken by surprise) and inhibitory

anxiety (5 items; e.g., When its time to act, uncertainty paralyses

me), both with identically high internal consistencies, a = .85

(Carleton, Norton, et al., 2007). The internal consistency was

acceptable for the total score (a = .92), the prospective anxiety

R.N. Carleton et al./ Journal of Anxiety Disorders 24 (2010) 189195190

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subscale score (a = .87) and the inhibitory anxiety subscale score

(a = .90). The average inter-item correlation was .49.

Social Avoidance and Distress Scale (SADS; Watson & Friend,

1969). The SADS is a 28-item self-report measure assessing the

tendency to avoid or be distressed by social situations (e.g., I try to

avoid situations which force me to be very sociable). The original

scale presented respondents with true/false questions; however, in

line with previous research (High & Caplan, 2009) we used a 5-

point Likert scale ranging from 1 (not at all characteristic of me) t o 5

(entirely characteristic of me). The factor structure is generally

considered to be unitary (Watson & Friend, 1969). The internal

consistency was acceptable for the total score (a = .96) and the

average inter-item correlation was .45.

Social Interaction Phobia Scale(SIPS;Carleton et al., 2009). The

SIPS is a 14-item self-report measure designed to assess symptoms

specific to SAD (e.g., I have difficulty talking with other people).

Each item is measured on a 5-point Likertscale, ranging from 0 (not

at all) to 4 (extremely). Respondents indicate how much each item

bothered them during the past week. The items were derived as a

subset of items from the Social Interaction Anxiety and Social

Phobia Scales (Mattick & Clarke, 1998). The SIPS is designed to

measure three symptom dimensions (i.e., social interaction

anxiety, fear of overt evaluation, fear of attracting attention);

however, use of the total score provides optimal sensitivity andspecificity for discerning clinical and nonclinical samples (i.e., a

cut-off score of 21 can typically be used to distinguish persons

reporting clinically significant social distress). The internal

consistency was acceptable for the total score (a = .96) and the

average inter-item correlation was .63.

Positive and Negative Affect Schedule-Expanded Form (PANAS-X;

Watson & Clark, 1994; Watson, Clark, & Harkness, 1994). The

PANAS-X is a 60-item measure which assesses the extent to which

respondents have experienced each of 60 words and phrases that

describe differentfeelingsand emotions withinthe past few weeks

(e.g., cheerful or nervous). There is a strong convergence

between trait and state indices of affect when using the PANAS-X,

suggesting that the PANAS-X reflects trait levels of affect ( Watson

& Clark, 1994). Each item is measured on a 5-point Likert scale,ranging from 0 (very slightly/not at all) to 4 (extremely). There is

support for the construct validity of the PANAS-X scales,

particularly the convergence of the negative affect and positive

affect scales with measures of neuroticism and extraversion,

respectively (for a review, see Watson, 2000). The internal

consistency was acceptable for both the negative affect scale

(a = .91) and the positive affect scale (a = .89). The average scale

inter-item correlations were .50 for negative affect and .45 for the

positive affect.

2.3. Analyses

Response differences between women and men on each

subscale were assessed with t-tests. Pearson correlations werecalculated for each of the measured variables to provide

indications of directions for subsequent regression analyses.

Hierarchical regression analyses were performed with each of

the SADS total score and the SIPS total score as dependent

variables.Boelen and Reijntjes (2009)placed IU in the final step of

their hierarchical regression to evaluate whether it would account

for any additional variance beyond neuroticism/negative affectiv-

ity, FNE, and AS (total score), and their results supported IU as

accounting for significant variance beyond these measures;

however, IU, AS, and FNE have been posited to represent

fundamental underlying cognitive constructs (Reiss & McNally,

1985; Taylor, 1999), with IU as a potentially fundamental cognitive

construct underlying all anxiety disorders (Carleton, Sharpe, et al.,

2007). In contrast, negative affect and positive affect have been

posited as overarching emotional traits and states (Watson, 2000;

Watson & Clark, 1994; Watson et al., 1994).

Two series of regression analyses were performed. First, the IUS

total score was entered as block 1 of the independent variables,

with theASI-3totalscoreentered as block 2, the BFNE-II entered as

block 3, and the negative affect and positive affect subscales of the

PANAS-X entered as block 4. Second, the IUS-12 subscales were

entered as block 1 of the independent variables, with the ASI-3

subscalesentered as block 2, the BFNE-II entered as block 3, andthe

negative affect and positive affect subscales of the PANAS-X

entered as block 4. In this fashion, the regression model tested the

variance accounted for by each construct overall and each of the

construct dimensions in a linear fashion congruent with existing

theory. To be thorough, model results from the analyses wherein

the independent variables were entered in reverse order are also

presented in parentheses to delineate the variance IU predicts

beyond negative affect, positive affect, FNE, and the ASI-3

subscales.

The last analyses required that participants from the sample be

selected based on whether they reported symptoms consistent

with a probable diagnosis of SADor GAD, or both. Participantswere

selected using very conservative cutoff scores as recommended for

the SIPS (i.e., a cutoff score of 30; Carleton et al., 2009) and the

GAD-7 (i.e., a cut-off score of 15; Spitzer et al., 2006). This resultedin four groups of participants who reported (1) SA symptoms

consistent with people diagnosed with SAD (without clinically

significant GAD symptoms), (2) GAD symptoms consistent with

people diagnosed with GAD (without clinically significant SA

symptoms), (3) SA and GAD symptoms consistent with people

diagnosed with both SAD and GAD, and (4) SA and GAD symptom

levels lower than would be consistent with people diagnosed with

SAD or GAD. Thereafter, IU total and subscale scores were

compared across the four groups using analysis of variance

(ANOVA) and Scheffepost hoc comparisons to determine whether

differences existed in IU levels between persons with clinically

significant SAD, GAD, both disorders, or neither disorder.

3. Results

3.1. Descriptive statistics

Descriptive statistics for each dependent variable are presented

in Table 1. None of the indices of univariate skewness and kurtosis

in the clinical sample were sufficiently out of range to preclude the

planned analyses (Curran, West, & Finch, 1996; Tabachnick &

Fidell, 2001). Men and women were comparable on most subscales

(ps > .05); however, men reported higher scores on the PANAS-X

positive affect scale, t(284) = 2.65, p < .01, r2 = .02, while women

reported higher scores on the GAD-7, t(284) = 2.14,p < .05, r2 = .02.

In both cases the effect sizes were quite small (Cohen, 1988);

accordingly, men and women were not analyzed separately. The

correlation analyses suggested small to large relationshipsbetween each of the variables (Table 1).

3.2. Regression analyses

The regression results indicated a robust relationship between

the IUS-12 total score and the SIPS total score, independent of all

other independent variables and similar to the precedent results

from Boelen and Reijntjes (Table 2). The regression results also

indicated a robust relationship between the inhibitory anxiety

subscale of the IUS-12 and the SIPS total score, independent of

all other independent variables and comparable with the ASI-3

social subscale and the BFNE-II (Table 2). There were no

indications of problems with multicollinearity (i.e., all toler-

ances>

.30 and all variance inflation factors .30 and all

variance inflation factors< 4.00), problems with outliers, pro-

blems with normality, or problems with homoscedasticity

(Tabachnick & Fidell, 2001). In this case, the inhibitory anxiety

subscale of the IUS-12 accounted fora third of the variance in SADS

scores, which was less than with the SIPS, but still the largest

portion for the SADS. For the SADS, the absence of positive affect

(but not negative affect) was a statistically significant predictor of

SADS scores beyond IU, AS, and FNE. When the order of entry for

the independent variables was reversed, negative affect and

positive affect accounted for a fifth of the variance in SADS scores

(Table 2); however, IU, AS, and FNE each continued to contribute

statistically significant amounts to the variance accounted for. To

further explore the association with IU, a subsequent regressionwas performed (details not shown) wherein the BFNE-II was

entered as block 1, with the IUS-12 subscales in block 2, the ASI-3

subscales in block 3, and negative and positive affect in block 4.

Table 1

Descriptive statistics.

Correlations

M(SD) S(.14) K(.29) 1 2 3 4 5 6 7 8 9 10 11

1. IUS-12 total score 30.69 (11.07) .50 .46 1.00

2. IUS-12 prospective

anxiety subscale

1 9.45 (6.5 8) .25 .71 .94

3. IUS-12 inhibitory anxiety subscale 11.24 (5.32) .73 .41 .91 .73

4. ASI-3 total score 19.14 (14.38) .94 .26 .71 .60 .725. ASI-3 somatic subscale 5.39 (5.33) 1.04 .31 .50 .43 .52 .83

6. ASI-3 cognitive subscale 4.72 (5.41) 1.30 .87 .59 .50 .61 .86 .62

7. ASI-3 social subscale 9.03 (6.20) .57 .66 .69 .59 .71 .85 .53 .59

8. BFNE-II 23.77 (14.98) .03 1.29 .59 .50 .61 .65 .43 .49 .71

9. PANAS-X negative affect 23.60 (8.93) .60 .32 .60 .52 .61 .58 .41 .50 .55 .49

1 0. PANAS-X positive affe ct 2 7.77 (8.2 2) .14 .69 .29 .26 .29 .26 .20 .22 .23 .28 .25

11. SIPS total score 18.00 (14.56) .82 .17 .69 .59 .71 .68 .45 .54 .72 .68 .54 .28

12. SADS total score 52.84 (24.76) .14 .77 .54 .48 .54 .44 .23 .32 .54 .49 .35 .36 .78

NoteS: Skew (standard error); K: kurtosis (standard error). All correlations were statistically significant (p< .01); IUS-12: intolerance of uncertainy-12; ASI-3: anxiety

sensitivity index-3; BFNE-II: brief fear of negative evaluation scale-II; PANAS-X: positive and negative affect scale; SIPS: social interaction phobia scale; SADS: social

avoidance and distress scale.

Table 2

Regression results for SIPS.

Model step Constant Coefficient statistics Correlations Model step statistics (IVs in reversed order)

b t p r Part r DR2 DF p

Total scores

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Results indicated that the BFNE-II accounted for 24% of the

variance in SADS score, whereas in the previous analysis the

inhibitory anxiety subscale of the IUS-12 accounted for 30% of the

variance (seeTable 3).

3.3. Group comparisons

The results of the ANOVA indicated statistically significant

differences based on symptomgroupsfor the IUS-12 total score, F(3,

282) = 61.46, p < .001, eta2 = .40, the IUS-12 prospective anxiety

subscale score, F(3, 282) = 34.81,p < .001, eta2 = .27, andthe IUS-12

inhibitory anxiety subscale score F(3, 282) = 75.55, p < .001,

eta2 = .45. The substantially different sample sizes within each ofthe symptoms groups, while not prohibitive for ANOVA, does make

meeting theassumption of homogeneityof variance moreimportant

(Tabachnick & Fidell, 2001); however, even if violated, a correction

can be made using appropriately discriminating post hoc tests and

an increasingly stringent alpha (Judd, McClelland, & Culhane, 1995;

Tabachnick & Fidell,2001). Theassumption of homogeneity wasmet

forthe IUS-12 totalscore (p > .10) and prospective anxiety subscale

(p > .10). In contrast, there was a slight variance for the IUS-12

inhibitory anxiety subscale (p= .03). Nevertheless, use of Scheffe

post hoc tests and the large effect sizes suggest that the differences

are likely to be robust (Table 4). Overall, people with symptoms

consistent with both GAD and SAD reported higher IU levels than

people with symptoms consistent with either SAD or GAD alone

(who reported comparableIU levels),who inturn,reported higher IUlevels than people who reported symptoms that were consistent

with neither SAD nor GAD.

4. Discussion

The current study had three goals. The first was to replicate the

previously demonstrated relationship between IU and SA (Boelen

& Reijntjes, 2009) with data from a North American community

sample. The second goal was to extend those findings to include

measures of social interaction and performance anxiety, social

avoidance and distress, negative and positive affect, as well as

psychometrically stable measures and subscales of IU and AS. The

third and final goal paralleled previous research comparing IU

levels across GAD and panic disorder with agoraphobia samples

(Dugas et al., 2005) by comparing levels of IU across participants

reporting symptoms consistent with probable diagnoses of SAD,GAD, both disorders, or neither disorder.

The results of the correlation analyses demonstrated significant

interrelationships between all of the variables of interest and in

theoretically congruent directions (e.g., positive affect was

negatively correlated with SA,whereas FNE andSA were positively

correlated). These results are in accordance with growing research

indicating a relationship between SA, FNE (Weeks et al., 2005), AS

(Orsillo, Lilienfeld, & Heimberg, 1994), negative affect/ neuroticism

(Barlow, 2002), and IU (Boelen & Reijntjes, 2009). The current and

more specific analysis demonstrated that within AS and IU, the

subscales are differentially associated with SA, whether measured

as a function of social interaction and performance anxiety or

social avoidance and distress.

The first series of regression results supported a robustrelationship between IU and SA as measured by the SIPS and the

SADS, independent of all other variables andsimilar to theprecedent

Table 3

Regression results for SADS.

Model step Constant Coefficient statistics Correlations Model step statistics (IVs in reversed order)

b t p r Part r DR2 DF p

Total scores

5.54

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results from Boelen and Reijntjes (2009). The second series of

hierarchical regression analyses predicting either social interaction

and performance anxiety, or social avoidance and distress, provided

separate quantifications of the differential associations demon-

strated in the correlation analysis. IU inhibitory anxiety accounted

for more than half (51%) of the variance in social interaction and

performance anxiety, withthe ASI-3 social subscale and the BFNE-II

accounting for statistically significant, but smaller portions of

variance (i.e., 9% and 3%, respectively). In this case, negative affect

and positive affect were not statistically significant predictors of

social interaction and performance anxiety, together accounting for

less than 1% of the variance. When the order was reversed and

negative affect and positive affect were entered first, the constructs

accountedfor a statistically significantamount of thevariance(32%),

whichwas much lessthanIU accountedfor when it wasentered first.

Moreover, in thereverseorder analysis IU continuedto account for a

statistically significant amount of the variance (4%) above and

beyond negative affect, positive affect, FNE, and the AS fear of

socially observable anxiety symptoms.

IU inhibitory anxiety accounted for a third (30%) of the variance

in social avoidance and distress; however, this was notably less

than the variance accounted for in social interaction and

performance anxiety. The ASI-3 social subscale and BFNE-II again

accounted for statistically significant, but smaller, portions ofvariance (6% and 1%, respectively). In this case reduced positive

affect but not negative affect accounted for an additional

statistically significant portion of variance (4%). This suggests that

the absence of positive affect (Watson, 2000; Watson & Clark,

1994; Watson et al., 1994) may be related to social avoidance and

distress. When the order was reversed and negative affect and

positive affect were entered first, the constructs accounted for a

statistically significant amount of the variance (20%) that was less

than IU accounted forwhen it was entered first. Moreover, IU again

accounted for a statistically significant amount of the variance (4%)

above and beyond negative affect, positive affect, FNE, and the AS

fear of socially observable anxiety symptoms.

Overall, the results of the regression analyses support a robust,

independent relationship between SA and inhibitory anxietyassociated with IU. There was also evidence of a robust relationship

betweenSA andthe fearof socially observable anxietysymptoms,as

well as SA and fears of being negatively evaluated. There was no

evidence of a relationship between SA and worrying about future

uncertainty (i.e., prospective anxiety), fears of somaticsensations, or

fears of cognitive dyscontrol. In contrast to previous research

(Boelen & Reijntjes, 2009), the relationship between negative affect

and SA was equivocal at best because, although SA may result in

negative affect or the absence of positive affect, neither negative

affect nor positive affect predicted SA beyond cognitive constructs

such as IU,or ASI-3 social, or FNEin this sample. The results suggest

that the initially posited, tested, and theoretically congruent

(Carleton, Sharpe, et al., 2007; Taylor, 1999; Watson, 2000)

hierarchical ordering withIU as underlying andnegative affectandpositive affect as overarching constructs better reflects the social

interaction and performance anxiety data from this sample;

however, the directional influence of negative and positive affect

on social avoidance and distress remains unknown. Positive affect

mayserve a protectivefunctionagainst SA;alternatively,lowerfears

of the uncertainty of social situations, socially observable anxiety

symptoms, and fears of negative evaluation may facilitate the

development of positive affect.

The comparisons across the symptom groups suggest that there

are differences in IU levels between persons with a probable

diagnosis of SAD, GAD, neither, or both disorders. People reporting

SAD and GAD symptoms well below levels reported by people

meeting diagnostic criteria for either reported IU levels statistically

significantly lower than persons reporting symptoms congruent

with diagnoses of either or both SAD and GAD. People reporting

symptoms comparable to those reported by people diagnosed with

either SAD or GAD reported comparable levels of IU. This suggests

that differences wherein people with GAD reported higher IU

levels than people with panic disorder with agoraphobia (Dugas et

al., 2005) may not be pervasive across all anxiety disorders. People

reporting symptoms consistent with both SAD and GAD reported

statistically significantly higher levels of IU than all other groups.

These results contribute to a growing body of literature suggesting

that IU may be a fundamental component of several anxiety

disorders, and further evidence that IU may vary across anxiety

disorders, being more pertinent for some anxiety disorders relative

to others.

There are several limitations to the current study that provide

directions for future research. First, there was no diagnostic

information available for the current sample. There may be

important differences associated with people who have been

formally diagnosed with SAD or GAD and their responses to the

variables measured in the current study. Future researchers should

explore these variables across diagnosed clinical samples, particu-

larly persons with SAD. Moreover, future research should consider

including a measure of IU as a treatment outcome measure among

persons treated for SAD to determine whether reductions in SA

symptoms correspond with reductions in IU levels. Alternatively,researchers might explore whether targeted reductions in IU levels

result in reductions in SA symptoms, even in the absence of

treatments targeting SA. Second, the structure of the current

regression analyses suggests a linear hierarchical relationship

between IU, AS, FNE, negative and positive affect, and SA that

remains untested with longitudinal data. Although current theory

supports cognitive constructs as determinant bases for affective

constructs (Barlow, 2002), future researchers might attempt to

complete prospective studies to better determine causal relation-

ships, even if those relationships are reciprocal. Third, the Social

PhobiaInventory(SPIN; Connoret al.,2000) usedpreviously(Boelen

& Reijntjes, 2009) was notavailable in the current data. Accordingly,

it is possible that neuroticism is a significant component of a

dimensionofSAmeasuredbytheSPINbutnottheSIPSortheSADS.Itis also possible that negative affect and neuroticism are sufficiently

differentor that the measure of neuroticism used in the previous

study (i.e., the Shortened Eysenck Personality Questionnaire

Neuroticism subscale;Eysenck, Eysenck, & Barrett, 1985) and the

PANAS-X are sufficiently different that the relationship was not

replicablewith thecurrentdata. Based onprevious research withthe

PANAS-X (Watson, 2000), this possibility is unlikely; however,

future researchers might test this possibility before ruling out a

robust independent relationship between negative affect, neuroti-

cism, and SA.

Theresults of this study support a robustrelationship betweenIU

and SA that is independent of AS, FNE, negative affect, and positive

affect. Indeed, the inability to tolerate the uncertainty associated

with social situations may be a critical element in the developmentand maintenance of SAD. Although yet untested, treatments which

focus on increasing tolerance for the uncertainty inherent in social

situations may provide help in relieving SAD symptoms.

Acknowledgements

K.C. Collimore is supported by a Canadian Institutes of Health

Research doctoral grant (FRN # 85321).

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