Intolerance of uncertainty is associated with heightened arousal during extinction learning and retention: Preliminary evidence from a clinical sample with anxiety and obsessive-compulsive disorders

Background: Uncertainty-related distress is considered a hallmark of anxiety and obsessive compulsive disorders (OCD). Previous research in community samples has demonstrated that individuals with high Intolerance of Uncertainty (IU), the tendency to find uncertainty aversive, display altered threat extinction learning and retention. Methods: Here, we conducted an exploratory secondary analysis of an existing dataset (Steinman et al., 2022) to examine the extent to which IU in a clinical sample with anxiety and OCD predicts threat extinction learning and retention. Participants with an anxiety disorder and/or OCD completed a differential threat learning task across two days (n = 27). Skin conductance response (SCR) was used as an index of conditioned responding. Results: No significant effects of self-reported IU were observed for differential SCR during any of the experimental phases. However, higher self-reported IU, while controlling for trait anxiety, was specifically associated with greater SCR overall during same-day extinction training, next-day extinction training, and next-day reinstatement test. Conclusions: Such findings provide preliminary evidence that higher IU within clinical samples with anxiety and/or OCD may be associated with heightened arousal under uncertainty, and highlight IU as a promising treatment target for anxiety and OCD.