Cognitive Processes in Adolescents with Generalised Anxiety Disorder: Exploring Intolerance of Uncertainty, Cognitive Avoidance, and Positive Beliefs About Worry

Intolerance of uncertainty, cognitive avoidance, and positive beliefs about worry feature in adult models of Generalised Anxiety Disorder (GAD); however, the nature of their role in this disorder in adolescents is less studied. We analysed self-report questionnaires to establish whether these cognitive processes are observed in 12-18 year-olds with GAD (n = 46) relative to those with other anxiety disorders (n = 18) and community controls (n = 38). The GAD group reported significantly higher intolerance of uncertainty and positive beliefs about worry relative to the anxiety control group, whilst levels of cognitive avoidance did not significantly differ between the two groups. Intolerance of uncertainty, but not cognitive avoidance or positive beliefs about worry, was significantly higher in the GAD group compared to the community group. Additionally, amongst adolescents with primary or secondary GAD, scores on these cognitive process variables did not predict significant variance in GAD symptoms. This study provides evidence for the relevance of intolerance of uncertainty to the maintenance of GAD in adolescence, and its specificity to this anxiety disorder. Avenues for further research into the mechanisms underlying GAD are discussed.