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Intolerance of Uncertainty in OCD 

Intolerance of Uncertainty in OCD
Intolerance of Uncertainty in OCD

Ryan J. Jacoby

, and Jonathan S. Abramowitz

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date: 26 June 2022

Intolerance of uncertainty (IU) is a key cognitive construct in the maintenance of obsessive-compulsive disorder (OCD) symptoms. Whereas most individuals feel “certain-enough” that situations are relatively safe, those with OCD who have elevated IU have difficulty managing the feeling of not knowing “for sure” whether a feared outcome may occur. As a result, they engage in compulsive rituals (e.g., checking, reassurance seeking) with the aim of restoring a sense of certainty. Given the pervasiveness of uncertainty in daily life, these doubts and rituals can lead to heightened daily distress for individuals with OCD. Accordingly, the present chapter reviews the following: (a) a comprehensive definition of IU, (b) the conceptualization of IU as important in the development and maintenance of OCD across various symptom presentations, (c) the measurement of IU using both self-report and behavioral methods, and (d) recommendations for the consideration of IU in OCD treatment.

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