Intolerance of Uncertainty and Depressive Symptoms in Female Freshmen: The Mediating Role of Cognitive and Behavioral Emotion-Regulation Strategies
DOI:
https://doi.org/10.24193/subbpsyped.2026.1.04Keywords:
intolerance of uncertainty, depressive symptoms, cognitive emotion regulation, behavioral emotion regulation, freshmenAbstract
Depression among university freshmen has become a serious public health problem; however, the underlying psychological factors and mechanisms remain insufficiently understood in this population. Intolerance of uncertainty (IU) has been considered a strong transdiagnostic risk factor for depression, yet few studies have investigated the pathways through which IU contributes to depressive symptoms in university freshmen. The present study explored whether adaptive and maladaptive cognitive and behavioral emotion regulation strategies mediate the relationship between global and dimensional IU (Prospective Anxiety and Inhibitory Anxiety) and depressive symptoms. A sample of 600 female Romanian freshmen completed self-report measures of IU, cognitive and behavioral emotion regulation strategies, and depressive symptomatology. Hypotheses were tested using PROCESS v5.0, model 4 (Hayes et al., 2025). Our results indicate that only maladaptive cognitive ER strategies mediated the relationship between IUS-Prospective Anxiety and depressive symptoms. In contrast, both deficits in adaptive regulation and increases in maladaptive regulation processes partially mediate the relationship between IUS-Inhibitory Anxiety and global IU and depressive symptoms. Thus, from a clinical point of view, early screening for global and dimensional IU and (mal)adaptive emotion regulation strategies in mental health programs targeting freshmen may help identify students with elevated risk of depression.
References
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
Aslan, I. H., Dorey, L., Grant, J. E., & Chamberlain, S. R. (2024). Emotion regulation across psychiatric disorders. CNS Spectrums, 29(3), 215-220. https://doi.org/10.1017/S1092852924000270
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. The Guilford Press.
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96. https://doi.org/10.1016/j.jad.2014.10.054
Bentler, P. M., & Wu, J. C. (2003). EQS structural equations program version 6.1. Multivariate Software.
Birrell, J., Meares, K., Wilkinson, A., & Freeston, M. (2011). Toward a definition of intolerance of uncertainty: A review of factor analytical studies of the Intolerance of Uncertainty Scale. Clinical Psychology Review, 31(7), 1198–1208. https://doi.org/10.1016/j.cpr.2011.07.009
Broadbent, J., & Poon, W. L. (2015). Self-regulated learning strategies and academic achievement in online higher education learning environments: A systematic review. The Internet and Higher Education, 27, 1–13. https://doi.org/10.1016/j.iheduc.2015.04.007
Bruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., Green, J. G., Nock, M. K., & Kessler, R. C. (2018). Mental health problems in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225, 97-103. https://doi.org/10.1016/j.jad.2017.07.044
Brzozowski, A., & Philip Crossey, B. (2024). Maladaptive emotion regulation strategies mediate the relationship between biased cognitions and depression. Journal of Behavioral and Cognitive Therapy, 34(1), 100485. https://doi.org/10.1016/j.jbct.2024.100485
Buhr, K., & Dugas, M.J. (2002). The Intolerance of Uncertainty Scale: Psychometric properties of the English version. Behaviour Research and Therapy, 40(8), 931–946. https://doi.org/10.1016/S0005-7967(01)00092-4
Cabras, C., & Mondo, M. (2017). Coping strategies, optimism, and life satisfaction among first-year university students in Italy: Gender and age differences. Higher Education, 75, 643-654. https://doi.org/10.1007/s10734-017-0161-x
Carleton, R. N. (2016). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30-43. https://doi.org/10.1016/j.janxdis.2016.02.007
Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007). Fearing the unknown: A short version of the Intolerance of Uncertainty Scale. Journal of Anxiety Disorders, 21(1), 105–117. https://doi.org/10.1016/j.janxdis.2006.03.014
Choudhary, K., Mason, G., Correa, A., Fotinos, K., Lokuge, S., Greifenberger, A., Toumeh, E., Clarissa, S., Epstein, I., Sternat, T., & Katzman, M. A. (2023). Intolerance of uncertainty, perfectionism, and coping as predictors of depression diagnosis and severity. Journal of Mood & Anxiety Disorders, 3, Article 100019. https://doi.org/10.1016/j.xjmad.2023.100
David, D., & Dobrean, A. (2012). Inventarul de Depresie Beck - (BDI - II). Romanian Psychological Testing Services.
Einstein, D. A. (2014). Extension of the transdiagnostic model to focus on intolerance of uncertainty: A review of the literature and implications for treatment. Clinical Psychology: Science and Practice, 21(3), 280–300. https://doi.org/10.1111/cpsp.12077
Fried, E.I., & Nesse, R.M. (2015). Depression sum-scores don’t add up: why analyzing specific depression symptoms is essential. BMC Medicine, 13, 72. https://doi.org/10.1186/s12916-015-0325-4
Garland, E. L., Hanley, A. W., Farb, N. A., & Froeliger, B. (2015). State mindfulness during meditation predicts enhanced cognitive reappraisal. Mindfulness, 6(2), 234–242. https://doi.org/10.1007/s12671-013-0250-6
Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 1311–1327. https://doi.org/10.1016/S0191-8869(00)00113-6
Garnefski, N., Kraaij, V., & Spinhoven, P. (2002). Manual for the use of the Cognitive Emotion Regulation Questionnaire. A questionnaire measuring cognitive coping strategies. DATEC.
Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clinical Psychology Review, 31(6), 923-33. https://doi.org/10.1016/j.cpr.2011.05.001
Graves, B. S., Hall, M. E., Dias-Karch, C., Haischer, M. H., & Apter, C. (2021). Gender differences in perceived stress and coping among college students. PloS One, 16(8), e0255634. https://doi.org/10.1371/journal.pone.0255634
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271
Grupe, D. W., & Nitschke, J. B. (2013). Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nature Reviews Neuroscience, 14(7), 488-501. https://doi.org/10.1038/nrn3524
Hale, W. J., Richmond, M., Bennett, J. M., Berzins, T. N., Fields, A., Weber, D. M., Beck, M. R., & Osman, A. (2016). Resolving uncertainty about the Intolerance of Uncertainty Scale–12: Application of modern psychometric strategies. Journal of Personality Assessment, 98(2), 200–208. https://doi.org/10.1080/00223891.2015.1070355
Hanson, M. (2024). College dropout rates. EducationData.org. https://educationdata.org/college-dropout-rates. Accessed on the 19th of March 2025.
Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (Vol. 3). The Guilford Press.
Hayes, A. F., Allison, P. D., & Alexander, S. M. (2025). Errors-in-variables regression as a viable approach to mediation analysis with random error-tainted measurements: Estimation, effectiveness, and an easy-to-use implementation. Behavior Research Methods, 57, 323. https://doi.org/10.3758/s13428-025-02783-3
Heumann, E., Palacio Siebe, A. V., Stock, C., & Heinrichs, K. (2024). Depressive symptoms among higher education students in Germany - A systematic review and meta-analysis. Public Health Review, 45, 1606983. https://doi.org/10.3389/phrs.2024.1606983
Ibáñez-Cubillas, P., López-Rodríguez, S., Martínez-Sánchez, I., & Álvarez Rodríguez, J. (2023). Multicausal analysis of the dropout of university students from teacher training studies in Andalusia. Frontiers in Education, 8. https://doi.org/10.3389/feduc.2023.1111620
IBM Corp. (2017). IBM SPSS Statistics for Windows (Version 25.0) [Computer software]. IBM Corp.
Ibrahim, A. K., Kelly, S. J., Adams, C. E., & Glazebrook, C. A. (2013). A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research, 47(3), 391-400. https://doi.org/10.1016/j.jpsychires.2012.11.015
Joormann, J., & Stanton, C. H. (2016). Examining emotion regulation in depression: A review and future directions. Behavior Research and Therapy, 86, 35–49. https://doi.org/10.1016/j.brat.2016.07.007
Kállay, É., & Cheie, L. (2023). “Can I still blame my parents?” Links between perceived parenting, cognitive emotion regulation strategies, and adolescent mental health. Current Psychology, 42, 27259–27274. https://doi.org/10.1007/s12144-022-03721-8
Kállay, É., & Rus, C. L. (in review). The Behavioral Emotion Regulation Questionnaire: Evidence of Validity and Reliability in Romanian Context. Journal of Rational-Emotive & Cognitive-Behavior Therapy.
Kállay, É., & Visu-Petra, L. (2014). Indicators of cognitive and emotional functioning in first-year master students in conference interpreting: A focus on individual differences. Cognition, Brain, Behavior. An Interdisciplinary Journal, 18(3), 209-228.
King, R. B., & dela Rosa, E. D. (2019). Are your emotions under your control or not? Implicit theories of emotion predict well-being via cognitive reappraisal. Personal and Individual Differences, 138, 177–182. https://doi.org/10.1016/j.paid.2018.09.040
Knowles, K. A., Cole, D. A., Cox, R. C., & Olatunji, B. O. (2022). Time-varying and time-invariant dimensions in intolerance of uncertainty: Specificity in the prediction of obsessive-compulsive symptoms. Behavior Therapy, 53(4), 686-700. https://doi.org/10.1016/j.beth.2022.01.012
Kraaij, V., & Garnefski, N. (2019). The Behavioral Emotion Regulation Questionnaire: Development, psychometric properties and relationships with emotional problems and the Cognitive Emotion Regulation Questionnaire. Personality and Individual Differences, 137, 56–61. https://doi.org/10.1016/j.paid.2018.07.036
Kuehner, C. (2017). Why is depression more common among women than among men? Lancet Psychiatry, 4(2), 146-158. https://doi.org/10.1016/S2215-0366(16)30263-2
Li, Y., Wang, A., Wu Y., Han, N., & Huang, H. (2021). Impact of the COVID-19 Pandemic on the mental health of college students: A systematic review and meta-analysis. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.669119
Lipson, S. K., Lattie, E. G., & Eisenberg, D. (2019). Increased rates of mental health service utilization by U.S. college students: 10-year population-level trends (2007-2017). Psychiatric Services, 70(1), 60-63. https://doi.org/10.1176/appi.ps.201800332
Lorenzo-Quiles, O., Galdón-López, S., & Lendínez-Turón, A. (2023). Factors contributing to university dropout: A review. Frontiers in Education, 8, 1159864. https://doi.org/10.3389/feduc.2023.1159864
McEvoy, P. M., & Mahoney, A. E. J. (2011). Achieving certainty about the structure of intolerance of uncertainty in a treatment-seeking sample with anxiety and depression. Journal of Anxiety Disorders, 25(1), 112–122. https://doi.org/10.1016/j.janxdis.2010.08.010
McKee, B. (2024). Fees for no degrees: Analysis of drop out and completion rates of domestic and international university students. IPA Press.
Morriss, J., Goh, K., Hirsch, C. R., & Dodd, H. F. (2023). Intolerance of uncertainty heightens negative emotional states and dampens positive emotional states. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1147970
Nekić, M., & Mamić, S. (2019). Intolerance of uncertainty and mindfulness as determinants of anxiety and depression in female students. Behavioral Sciences, 9(12), 135. https://doi.org/10.3390/bs9120135.
Neugebauer, M., & Daniel, A. (2022). Higher education non-completion, employers, and labor market integration: Experimental evidence. Social Science Research, 105, 102696. https://doi.org/10.1016/j.ssresearch.2022.102696
Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking Rumination. Perspectives on Psychological Science, 3(5), 400-24. https://doi.org/10.1111/j.1745-6924.2008.00088.x
Panjwani, A. A., Applebaum, A. J., Revenson, T. A., Erblich, J., & Rosenfeld, B. (2024). Intolerance of uncertainty, experiential avoidance, and trust in physician: A moderated mediation analysis of emotional distress in advanced cancer. Journal of Behavioral Medicine, 47(1), 71–81. https://doi.org/10.1007/s10865-023-00419-5
Pascoe, M. C., Hetrick, S. E., & Parker, A. G. (2020). The impact of stress on students in secondary school and higher education. International Journal of Adolescence and Youth, 25(1), 104–112. https://doi.org/10.1080/02673843.2019.1596823
Perte, A., & Tincas, I. (2010). CERQ - Manualul de utilizare a Chestionarului de coping cognitiv - emotional. Adaptarea si standardizarea CERQ pe populatia din România. ASCR Press.
Rutkowska, A., Cieślik, B., Tomaszczyk, A., & Szczepańska-Gieracha, J. (2022). Mental health conditions among e-learning students during the COVID-19 Pandemic. Frontiers in Public Health, 10, 871934. https://doi.org/10.3389/fpubh.2022.871934
Sabates, R., Zhao, Y. V., Mitchell, R., & Ilie, S. (2021). Understanding the external social benefits of education in Ethiopia: A contextual analysis using young lives. Journal of Education Finance, 47(1), 45–70. https://doi.org/10.17863/CAM.57081
Sahib, A., Chen, J., Cárdenas, D., & Calear, A. L. (2023). Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review. Clinical Psychology Review, 101, 102270. https://doi.org/10.1016/j.cpr.2023.102270
Sahib, A., Chen, J., Cárdenas, D., Calear, A. L., & Wilson, C. (2024). Emotion regulation mediates the relation between intolerance of uncertainty and emotion difficulties: A longitudinal investigation. Journal of Affective Disorders, 1(364),194-204. https://doi.org/10.1016/j.jad.2024.08.056
Saulnier, K. G., Allan, N. P., Raines, A. M., & Schmidt, N. B. (2019). Depression and intolerance of uncertainty: Relations between uncertainty subfactors and depression dimensions. Psychiatry, 82(1), 72-79. https://doi.org/10.1080/00332747.2018.1560583e
Shihata, S., McEvoy, P. M., & Mullan, B. A. (2017). Pathways from uncertainty to anxiety: An evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms. Journal of Anxiety Disorders, 45, 72–79. https://doi.org/10.1016/j.janxdis.2016.12.001
Shihata, S., McEvoy, P. M., & Mullan, B. A. (2018). A bifactor model of intolerance of uncertainty in undergraduate and clinical samples: Do we need to reconsider the two-factor model? Psychological Assessment, 30(7), 893–903. https://doi.org/10.1037/pas0000540
Shihata, S., McEvoy, P. M., Mullan, B. A., & Carleton, R. N. (2016). Intolerance of uncertainty in emotional disorders: What uncertainties remain? Journal of Anxiety Disorders, 41, 115–124. https://doi.org/10.1016/j.janxdis.2016.05.001
Shu, J., Ochsner, K. N., & Phelps, E. A. (2022). Trait intolerance of uncertainty is associated with decreased reappraisal capacity and increased suppression tendency. Affective Science, 3(3), 528–538. https://doi.org/10.1007/s42761-022-00115-8
The Lancet (2022). An age of uncertainty: Mental health in young people. The Lancet, 400(10350), 539. https://doi.org/10.1016/S0140-6736(22)01572-0
Wan, P., Hu, J., Su, C., & Li, Q. (2024). Impact of intolerance of uncertainty on depression in college students during the COVID-19 pandemic: Coping strategies as mediators. Inquiry, 61, 469580241273119. https://doi.org/10.1177/00469580241273119
Waterhouse, P., Samra, R., & Lucassen, M. (2022). Distance education students' satisfaction: Do work and family roles matter? Distance Education, 43(1), 56–77. https://doi.org/10.1080/01587919.2021.2020622
Williams, H., & Roberts, N. (2023). ‘I just think it’s really awkward’: Transitioning to Higher Education and the implications for student retention. Higher Education: The International Journal of Higher Education Research, 85, 1125-1141. https://doi.org/10.1007/s10734-022-00881-1
Yau, H. K., & Cheng, A. L. F. (2014). An empirical study into gender differences in the relationships among academic, social and psychological adjustments of university support. Journal of Further and Higher Education, 38(2), 268–282. https://doi.org/10.1080/0309877X.2012.722197
Ye, H., Chen, C., Chen, S., Jiang, N., Cai, Z., Liu, Y., Li, Y., Huang, Y., Yu, W., You, R., Liao, H., & Fan, F. (2025). Profiles of intolerance of uncertainty among 108,540 adolescents: Associations with sociodemographic variables and mental health. Child Psychiatry and Human Development, 56(3), 715–727. https://doi.org/10.1007/s10578-023-01603-z
Zhao, S., Zhang, Y., Yu, C., Zhang, H., Xie, M., Chen, P., & Lin, D. (2023). Trajectories of perceived stress among students in transition to college: Mindset antecedents and adjustment outcomes. Journal of Youth and Adolescence, 52(9), 1873-1886. https://doi.org/10.1007/s10964-023-01788-5
Zlomke, K. R., & Jeter, K. M. (2014). Stress and worry: Examining intolerance of uncertainty's moderating effect. Anxiety Stress Coping, 27(2), 202-215. https://doi.org/10.1080/10615806.2013.835400
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