The Impact of Emotion Regulation Improvements on Intolerance of Uncertainty During Emotion Regulation Therapy

Both intolerance of uncertainty (IU) and impoverished emotion regulation repertoires characterize generalized anxiety disorder (GAD). Across two treatment studies, we explored relationships between two emotion regulation skills, decentering and reappraisal, and IU during emotion regulation therapy (ERT). Participants were treatment-seeking individuals diagnosed with GAD. Study 1 included data from two open trials of ERT (N = 52), and Study 2 examined data from a randomized controlled trial of ERT (n = 28) versus a minimal attention control (n = 25). IU and emotion regulation skills were measured at pre-, mid-, and post-treatment. Mediation models explored indirect effects of emotion regulation skills on the relationship between time (Study 1) or group (Study 2) and intolerance of uncertainty. Results demonstrated improvements in emotion regulation skills and reductions in IU during ERT. Greater use of reappraisal and decentering was associated with reduced IU over time. Tests of indirect effects suggested that observed between-group differences in IU can be explained by changes in emotion regulation skills. The findings from these studies highlight the utility of non-IU-specific interventions to help individuals tolerate uncertainty. Exploring the impact of emotion regulation skills on IU could lead to improvements in treating GAD.