Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic (preprint)

Background: Efforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertainty (IU), a transdiagnostic risk factor for anxiety, may be a particularly relevant vulnerability factor. Method: N = 641 adults with pre-pandemic anxiety reported their anxiety, intolerance of uncertainty, and other pandemic and mental health-related variables at least once and up to four times during the COVID-19 pandemic, with assessments beginning in Summer 2020 through Winter 2021. Analyses were preregistered on the Open Science Framework. Results: Higher intolerance of uncertainty at the first pandemic timepoint predicted more severe anxiety, but also a sharper decline in anxiety across timepoints. This finding was robust to the addition of pre-pandemic anxiety and demographic predictors as covariates. Younger age, lower self/parent education, and experience of COVID-19 illness at the first pandemic timepoint predicted more severe anxiety across timepoints, but did not predict anxiety trajectory. Conclusions: Differential levels of IU at the outset of the pandemic prospectively predicted more severe anxiety and a sharper decrease in anxiety over time. This finding was robust to the inclusion of covariates, including pre-pandemic anxiety and various demographic characteristics.

Mental Health and Clinical Psychological Science in the Time of COVID-19: Challenges, Opportunities, and a Call to Action (preprint)

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this paper, COVID-19 is conceptualized as a unique, compounding, multi-dimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond.