Exploring the Interplay Between Intolerance of Uncertainty, Resilience and Psychopathological Correlates in Anorexia Nervosa

Intolerance of uncertainty (IU) and resilience are two psychological constructs that can influence the onset, maintenance and prognosis of individuals with anorexia nervosa (AN). Existing literature in various contexts suggests that resilience is inversely associated with IU and may mediate the relationship between IU and affective symptoms. This study aimed to explore the interplay between these variables in AN by comparing a group of affected individuals with healthy controls (HCs). The cross-sectional study included 108 patients with AN accessing a specialized eating disorders centre and 121 HCs. Participants completed questionnaires measuring IU, resilience, eating and body-related psychopathology and anxious and depressive symptoms. The groups were compared with non-parametric tests, although correlation and bootstrapped mediation analyses were used to analyse the relationships among variables. Individuals with AN showed higher IU and lower resilience compared to HCs. IU scores positively correlated with all psychopathology measures across both groups and were negatively associated with resilience; resilience negatively correlated with anxiety and depression in both groups and with eating psychopathology only in the control group. Resilience partially mediated the relationship between IU and anxiety/depression in both groups. This study paves the way for a line of research focused on these psychological constructs in AN: Enhancing resilience resources in therapeutic settings may help address the emotional burden associated with high levels of IU, particularly regarding non-ED symptoms.