Anxiety Disorders 19 (2005) 699707

A psychometric analysis of the Intolerance of Uncertainty Scale among four racial groups
Peter J. Norton*
Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204-502, USA Received 19 May 2004; received in revised form 3 August 2004; accepted 16 August 2004

Abstract Recent psychometric analyses examining the cross-cultural validity of key anxiety measures have suggested that some, such as the Anxiety Sensitivity Index (ASI), may hold different psychometric characteristics among different racial or national groups. The Intolerance of Uncertainty Scale (IUS) is a self-report measure that, like the ASI, appears to assess a predispositional risk for developing some anxiety and mood disorders. Despite its validation in both a French and English version, the majority of the research conducted on the IUS has used predominantly Caucasian samples. Given this, the purpose of this research was to examine and compare the psychometric properties of the IUS among nonclinical participants of four racial groups: African American, Caucasian, Hispanic/Latino, and Southeast Asian. The data suggested generally strong, and highly similar, estimates of reliability and validity across the four racial groups. The factor structure of the IUS, however, was poorly interpretable among any of the groups. Implications for use of the IUS with different racial groups are discussed. # 2004 Elsevier Inc. All rights reserved.
Keywords: Psychometric analyses; Intolerance of uncertainty scale; Cross-cultural assessment

The increasing awareness of multicultural issues in modern psychology has led to a burgeoning recognition that psychometric characteristics of our research and clinical assessment tools must be examined within a multicultural context. Indeed, recent analyses have suggested that some commonly used may function
* Tel.: +1 713 743 8675; fax: +1 713 743 8633. E-mail address: Peter.Norton@mail.uh.edu. 0887-6185/$ see front matter # 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.janxdis.2004.08.002

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differently among different groups. The Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1992), for example, is a measure for which the psychometric characteristics have been extensively evaluated. However, recent psychometric evaluations of the ASI among individuals of different racial groups (e.g., Carter, Miller, Sbrocco, Suchday, & Lewis, 1999; Norton, De Coteau, Hope, & Anderson, 2004; Zvolensky, McNeil, Porter, & Stewart, 2001) and nationalities (e.g., Zvolensky et al., 2003) have generally suggested that the psychometric characteristics of the ASI vary considerably among various groups. These data underscore the need to evaluate cross-cultural applicability of assessment measures. Indeed, as Malgady (1996) articulates, perhaps the emphasis in crosscultural research should be on assuming differences until proven otherwise, as opposed to our traditional approach of assuming the null until rejected. Recent etiological models of anxiety and depression have suggested that anxiety sensitivity, the construct measured by the ASI, may act as a semi-specic risk factor for the development of panic disorder and hypochondriasis above-andbeyond the elevated general risk attributable to neuroticism (Norton, Sexton, Walker, & Norton, unpublished manuscript; Sexton, Norton, Walker, & Norton, 2003). These same studies suggested that another construct, intolerance of uncertainty, may also be a semi-specic risk for generalized anxiety and worry beyond the general non-specic risk attributable to neuroticism. Intolerance of uncertainty is characterized by a tendency to perceive ambiguous situations as threatening and, consequently, uncertainty is a source of fear or discomfort which contributes to the development of generalized anxiety and worry (Dugas, Gagnon, aume, Letarte, Dugas, & Ladouceur, Ladouceur, & Freeston, 1998; Freeston, Rhe 1994; Lachance, Ladouceur, & Dugas, 1999; Ladouceur, Gosselin, & Dugas, 2000a,b). To assess this intolerance of uncertainty construct, Freeston et al. (1994) developed the Intolerance of Uncertainty Scale (IUS), a self-report measure designed to measure this construct. Initial examinations of the psychometric characteristics of the IUS have been supportive of the measure. Freeston et al. (1994) reported a student sample mean of 43.8 (S.D. = 10.8). Their analyses suggested excellent internal consistency (a = .91) and 5-week test-retest reliability (r = .74). Validity was demonstrated with correlations with measures of worry beyond that accounted for by measures of anxiety and depression. Exploratory factor analysis suggested a ve-factor structure, with factors described as (1) beliefs that uncertainty is unacceptable and should be avoided, (2) being uncertain reects badly on a person, (3) uncertainty results in stress, (4) uncertainty results in frustration, and (5) uncertainty prevents action. Buhr and Dugas (2002) evaluated an English language version of the IUS and found comparable results. They reported a student sample mean of 54.78 (S.D. = 17.44), excellent internal consistency (a = .94), and strong 5-week test-retest reliability (r = .74). As with Freeston et al. (1994), validity was supported by correlations with measures of worry and anxiety, and the prediction of worry above-and-beyond measures of anxiety and depression. Unlike Freeston et al., however, Buhr and Dugas (2002) found stronger support for as four factor

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structure. They dened their factors as (1) uncertainty leads to the inability to act, (2) uncertainty is stressful and upsetting, (3) unexpected events are negative and should be avoided, and (4) being uncertain about the future is unfair. These reliability and validity data, while impressive, were derived from predominantly Caucasian samples (Buhr & Dugas, 2002; Freeston et al., 1994). Therefore, in order to continue the cross-cultural examination of key psychometric measures, this study examines the characteristics of the Intolerance aume, Letarte, of Uncertainty Scale (IUS; Buhr & Dugas, 2002; Freeston, Rhe Dugas, & Ladouceur, 1994) across a sample of participants of African, Caucasian, Hispanic, and Southeast Asian decent.

1. Methods 1.1. Participants and procedures Five-hundred and forty undergraduate students from the University of Houston consented to participate in a large questionnaire-based study. Participants were either tested en masse in a large classroom setting or were allowed to complete questionnaires on their own time and return them within 1 week. Of the total sample, 93 identied themselves as African American/Black (non-Hispanic), 149 as Caucasian/White (non-Hispanic), 113 as Hispanic/Latino(a), and 94 as Southeast Asian. Only participants of these four racial groups were included in the current study, and individuals who identied themselves as Multiracial were not included. As an admission requirement to the University of Houston, all students must have passed required high school English coursework or performed satisfactorily on the Test of English and a Foreign Language (TOEFL). Of these participants, 310 (69.0%) were women, 135 (30.1%) were men, and 4 (0.9%) did not report their sex. Participants ranged in age from 17 to 51 years of age (M = 21.65, S.D. = 4.93), and represented all years of undergraduate study (32.7% Freshman, 22.7% Sophomore; 23.4% Junior, 20.9% Senior or Post-Baccalaureate; 0.2% missing data). 1.2. Measures As part of a larger study, participants completed a demographics form and a large battery of self-report questionnaires. For the purposes of this study, data from the IUS, Generalized Anxiety Disorder Questionnaire-IV, Penn State Worry Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory were examined. 1.2.1. Intolerance of Uncertainty Scale (IUS) The Intolerance of Uncertainty Scale (Buhr & Dugas, 2002; Freeston et al., 1994) contains 27 items assessing emotional, cognitive and behavioral reactions

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to ambiguous situations, implications of being uncertain, and attempts to control the future (Dugas et al., 1994; p. 596). Items are scored on a 1 (not at all characteristic of me) to 5 (entirely characteristic of me) Likert-type scales, yielding possible scores from 27 to 135. Despite the reported multifactor structures, the IUS is most commonly summed as a total scale score (Antony, Orsillo, & Roemer, 2001). 1.2.2. Generalized Anxiety Disorder Questionnaire-IV (GADQ-IV; Newman et al., 2002) The GADQ-IV, a revision of the GAD-Q (Roemer, Borkovec, Posa, & Borkovec, 1995) is a 9-item self-report questionnaire that assesses generalized anxiety disorder criteria. It specically assesses the presence of excessive worry and its uncontrollability, number of excessive worry topics, associated symptoms, and the interference and distress associated with the worry. The GADQ-IV has shown excellent diagnostic sensitivity and specicity, as well as good test-retest reliability and both convergent and discriminant validity (Newman et al., 2002). 1.2.3. Penn State Worry Questionnaire (PSWQ; Meyer, Metzger, & Borkovec, 1990) The PSWQ is a 16-item self-report measure of the frequency and intensity of worry, the principal characteristic of generalized anxiety disorder. The PSWQ has repeatedly demonstrated strong psychometric properties in clinical and nonclinical samples (Meyer et al., 1990). 1.2.4. Beck Anxiety Inventory (BAI) The BAI is a 21-item self-report measure designed as a general measure of anxiety symptom severity (Beck, Epstein, Brown, & Steer, 1988; Beck & Steer, 1990). The BAI has demonstrated good psychometric properties with non-clinical college populations (see Creamer, Foran, & Bell, 1995). 1.2.5. Beck Depression Inventory-II (BDI; Beck, Steer, & Brown, 1996) The BDI is an extensively used 21-item measure of the somatic, cognitive and affective domains of depression. Dozois, Dobson, and Ahnberg (1998) report that the BDI possesses good reliability and validity.

2. Results 2.1. Scale summary Scores on the IUS ranged from 27 to 124, with a mean of 54.88 (S.D. = 18.71). No signicant difference by sex was observed on the total score (men: mean = 53.07, S.D. = 17.21; women: mean = 55.62, S.D. = 19.35), F(1,443) = 1.74, P = .188. Further, no differences in mean IUS scores were observed across racial

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groups (African American mean = 52.65, S.D. = 20.03; Caucasian mean = 54.15, S.D. = 17.75; Hispanic mean = 55.45, S.D. = 18.07; Southeast Asian mean = 57.53, S.D. = 19.54), F (3,445) = 1.183, P = .316. 2.2. Internal consistency Internal consistency of the IUS across the entire sample was very good (a = .945). Furthermore, alpha coefcients were quite similar across participants of African (a = .951), Caucasian (a = .942), Hispanic (a = .934), and Southeast Asian decent (a = .954). 2.3. Factor structure To be consistent with the analyses and results presented by Buhr and Dugas (2001), exploratory factor analysis using Principle Factor Analysis and a Promax rotation was used to identify the probable factor structure. Although a conrmatory approach might be desirable, the inconsistency between the factors structures extracted thus far suggests that such methods might be premature. The number of factors to retain was determined using the Kaiser rule (eigenvalue > 1; Kaiser, 1961), scree plot examination (Cattell, 1966), and factor structure interpretability. Using the Kaiser rule, a 5-factor structure was extracted for African American, Caucasian, and Southeast Asian participants, while a 6-factor solution emerged with Hispanic participants. Examination of the scree plots suggested 5-factor solutions were appropriate all four groups. However, the 5-factor solutions differed greatly from each other (mean Coefcient of Congruence between respective pairs = 0.20), as well as from those obtained by Buhr and Dugas (2002) and Freeston et al. (1994). In addition, the factor solutions showed extensive multi-vocal item loadings (average of ve items loading 0.30 or greater on multiple factors), and poor factor interpretability. Given Buhr and Dugas (2002) report of an interpretable 4-factor solution, exploratory factor analyses were recomputed constraining to four factor solutions. All rotated solutions converged but, again, the solutions differed greatly from each other (mean Coefcient of Congruence between respective pairs = 0.21), multi-vocality was widespread, and factors were poorly interpretability.1 2.4. Convergent validity IUS was strongly correlated with PSWQ and GADQ-IV for each group (Table 1). The magnitudes of the correlations were then compared across groups using the Fisher test of Z transformed independent-sample correlations. None of the corresponding correlations differed signicantly across racial groups (all Zs < 1.73).
1

Pattern matrices available from the author upon request.

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Table 1 Pearson correlations between IUS and measures of worry/generalized anxiety rIUS.PSWQ African American Caucasian Hispanic Southeast Asian .661 .617 .579 .658 rIUS.GADQ-IV .687 .629 .686 .512

All correlation coefcients signicant (P < .001).

The incremental validity of the IUS was next assessed to determine if the IAS signicantly related to measures of worry and generalized anxiety above and beyond that accounted for by general measures of anxiety and depression. First, for each racial group, a hierarchical multiple regression, was conducted with PSWQ as the criterion and BAI and BDI entered in the rst step. IUS was then entered in the second step. As shown in Table 2, the IUS signicantly predicted PSWQ scores beyond that already accounted for by BAI and BDI for each racial group. Second, identical regressions were conducted for each group, save that GADQ-IV was the criterion variable. As shown in Table 3, IUS predicted GADQIV above and beyond BAI and BDI for all groups except participants of Southeast Asian decent, rpartial = .186, P = .112.

3. Discussion Malgady (1996) appealed for a reconsideration of established decision-making rules when conducting cross-cultural mental health research. Most importantly,
Table 2 Step 2 of hierarchical regressions predicting the PSWQ Racial group African American Variable BDI BAI IUS BDI BAI IUS BDI BAI IUS BDI BAI IUS B 0.152 0.607 0.318 0.044 0.218 0.396 0.123 0.250 0.330 0.162 0.316 0.258 S.E. B 0.183 0.196 0.078 0.135 0.148 0.066 0.144 0.148 0.086 0.133 0.146 0.060 b 0.116 0.390 0.484 0.033 0.128 0.539 0.108 0.208 0.511 0.142 0.229 0.454 rPartial .097 .342 .431 .028 .128 .465 .092 .180 .385 .143 .247 .453 P .410 .003 <.001 .747 .143 <.001 .397 .095 <.001 .225 .034 <.001 Model r2 .480

Caucasian

.401

Hispanic/Latino

.353

Southeast Asian

.487

PSWQ: Penn State Worry Questionnaire; BAI: Beck Anxiety Inventory; BDI: Beck Depression Inventory; IUS: Intolerance of Uncertainty Scale.

P.J. Norton / Anxiety Disorders 19 (2005) 699707 Table 3 Step 2 of hierarchical regressions predicting the GADQ-IV Racial group African American Variable BDI BAI IUS BDI BAI IUS BDI BAI IUS BDI BAI IUS B 0.177 0.299 0.126 0.167 0.340 0.158 0.079 0.247 0.169 0.157 0.443 0.059 S.E. B 0.092 0.099 0.040 0.066 0.072 0.032 0.075 0.078 0.045 0.212 0.494 0.159 b 0.232 0.329 0.328 0.214 0.337 0.362 0.110 0.323 0.410 0.212 0.494 0.159 rPartial .220 .336 .351 .215 .379 .393 .114 .328 .379 .223 .505 .186 P .059 .003 .002 .013 .000 .000 .295 .002 .000 .056 .000 .112

705

Model r2 .614

Caucasian

.593

Hispanic/Latino

.570

Southeast Asian

.548

GADQ-IV: Generalized Anxiety Disorder Questionnaire-IV; BAI: Beck Anxiety Inventory; BDI: Beck Depression Inventory; IUS: Intolerance of Uncertainty Scale.

Malgady contends that incorrect retention [of the null hypothesis] (Type II error = disservice to minority clients) may be more serious than its incorrect rejection (Type I error = misdirection to the mental health service system) (1996; p. 73). Therefore, strong evidence should be required before assuming there are no differences across groups on assessment or treatment tools. Results presented here, however, do provide strong evidence of cross-racial uniformity for the IUS. Scores on the IUS were similarly internally consistent for each of the groups. Finally, the previously reported (Buhr & Dugas, 2002) zero-order and unique relationships between IUS and worry/generalized anxiety held consistent across all groups. Differences in the factor structures across groups in this study are, on the other hand, surprising. However, given the factor structure instability previously reported with different samples (e.g., Buhr & Dugas, 2002; Freeston et al., 1994), the structure differences observed here should not automatically be attributed to cultural or racial variables. Perhaps additional or modied items are necessary to obtain fuller coverage of theoretically derived factors of the intolerance of uncertainty construct. Conversely, the factor analysis may have picked up on irrelevant associations among the 27 items. If so, the very high alpha coefcients observed here and elsewhere (Buhr & Dugas, 2002; Freeston et al., 1994) suggests that the removal of misbehaving items would likely not impact scale reliability substantially. Should the IUS be revised in either way, similar cross-cultural examination of its factor structure would be warranted. It is also possible that intolerance of uncertainty is a one-dimensional construct, with the varied factor structures reecting idiosyncrasies within each sample. Several limitations exist within this study that may have inuenced the results. First, although representing a broad range of worry and generalized anxiety, the sample was recruited from an undergraduate population. Based on prevalence

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statistics, it can be estimated that a small percentage of the sample would meet criteria for generalized anxiety disorder. However, it still may be that the general uniformity of the psychometric estimates may relate to the predominantly nonclinical nature of the sample. Changes in the range of IUS scores obtained with clinical samples may lead to changes in the psychometric estimates of the measure, particularly coefcient alpha. Therefore, replication with clinical samples representing different racial groups could clarify this issue. Secondly, this study did not employ any measure of cultural identication or acculturation. Therefore, the extent to which the participants were representative of all individuals within these racial groups cannot be determined. A third limitation is that, as is far too common, individuals of multiracial decent were excluded from the analyses. Unfortunately, sample sizes for any specic multiracial prole were too small for analyses, and the extent to which multiracial participants should be considered a unique group, or a part of one or more racial groups, is unclear. Inclusion of measures of cultural identication may provide guidance. Finally, the simple categorization of participants into racial groups may mask variations among subpopulations within broader racial groups. For example, Norton et al. (2004) and Zvolensky et al. (2001) both examined the factor structure of the Anxiety Sensitivity Index among Native Americans. However, when participants with a broad range of tribal afliations were clustered together, the resulting factor structure was quite different than when examining a single tribal group. Future studies should attempt to move beyond simple categorizations, by incorporating more focused measures of racial, ethnic, and cultural identity. Limitations aside, results of this project provide fairly convincing evidence that the Intolerance of Uncertainty Scale behaves similarly across students of four different racial groups. In addition, these data may suggest that intolerance of uncertainty could be a fairly universal construct that is associated with generalized anxiety and worry. Whether this might indicate that treatment approaches targeting intolerance of uncertainty (e.g., Dugas et al., 2003; Ladouceur et al., 2000a,b) will be similarly efcacious with various racial and cultural groups remains an empirical question. References
Antony, M. M., Orsillo, S. M., & Roemer, L. (2001). Practitioners guide to empirically-based measures of anxiety. New York: Kluwer Academic/Plenum. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory manual. (2nd ed.). San Antonio, TX: Psychological Corporation. Buhr, K., & Dugas, M. J. (2002). The Intolerance of Uncertainty Scale: psychometric properties of the English version. Behaviour Research and Therapy, 40, 931945. Carter, M. M., Miller, O., Sbrocco, T., Suchday, S., & Lewis, E. L. (1999). Factor structure of the Anxiety Sensitivity Index among African American college students. Psychological Assessment, 11, 525533.

P.J. Norton / Anxiety Disorders 19 (2005) 699707

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Cattell, R.B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1, 245276. Creamer, M., Foran, J., & Bell, R. (1995). The Beck Anxiety Inventory in a non-clinical sample. Behaviour Research and Therapy, 33, 477485. Dozois, D. J. A. Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck Depression Inventory-II. Psychological Assessment, 10, 8389. Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: a preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215226. ger, E., Freeston, M. H., Langlois, F., Provencher, M. D., & Boisvert, J.Dugas, M. J., Ladouceur, R., Le M. (2003). Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up. Journal of Consulting and Clinical Psychology, 71, 821825. aume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people Freeston, M. H., Rhe worry? Personality and Individual Differences, 17, 791802. Kaiser, H.F. (1961). A note on Guttmans lower bound for the number of common factors. Multivariate Behavioral Research, 1, 249276. Lachance, S., Ladouceur, R., & Dugas, M. J. (1999). Elements dexplication de la tendance a sinquieter [Elements explaining the tendency to worry]. Applied Psychology: An International Review, 48, 187196. ger, E., Gagnon, F., & Thibodeau, N. (2000). Efcacy Ladouceur, R., Dugas, M. J., Freeston, M. H., Le of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial. Journal of Consulting and Clinical Psychology, 68, 957964. Ladouceur, R., Gosselin, P., & Dugas, M. J. (2000). Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry. Behaviour Research and Therapy, 38, 933 941. Malgady, R.G. (1996). The question of cultural bias in assessment and diagnosis of ethnic minority clients: lets reject the null hypothesis. Professional Psychology: Research and Practice, 27, 73 77. Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487495. Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T. et al. (2002). Preliminary reliability and validity of the generalized anxiety disorder questionnaire-IV: a revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33, 215 233. Norton, P. J., De Coteau, T. J., Hope, D. A., & Anderson, J. A. (2004). The factor structure of the Anxiety Sensitivity Index among Northern Plains Native Americans. Behaviour Research and Therapy, 42, 241247. Norton, P. J., Sexton, K. A., Walker, J. R., & Norton, G. R. (2003). Hierarchical model of vulnerabilities for anxiety: replication and extension with a clinical sample. Submitted for publication. Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index revised test manual. Worthington, OH: International Diagnostic Services. Roemer, L., Borkovec, M., Posa, S., & Borkovec, T. D. (1995). A self-report diagnostic measure of generalized anxiety disorders. Journal of Behavior Therapy and Experimental Psychiatry, 26, 345 350. Sexton, K. A., Norton, P. J., Walker, J. R., & Norton, G. R. (2003). A hierarchical model of generalized and specic vulnerabilities in anxiety. Cognitive Behaviour Therapy, 32, 8294. Zvolensky, M. J., Arrindell, W. A., Taylor, S., Bouvard, M., Cox, B. J., Stewart, S. H. et al. (2003). Anxiety sensitivity in six countries. Behaviour Research and Therapy, 41, 841859. Zvolensky, M. J., McNeil, D. W., Porter, C. A., & Stewart, S. H. (2001). Assessment of anxiety sensitivity in young American Indians and Alaska Natives. Behaviour Research and Therapy, 39, 477493.