We used structural equation modeling to assess the role of impaired emotional awareness and clarity (Impaired Awareness/Clarity) and inability to control behaviors when experiencing emotional distress (Inability to Control Behaviors) as an account for the relationship between intolerance of uncertainty (IU) and negative affect (NA) in individuals with Substance Use Disorders (SUDs) and healthy controls (HCs) used for comparison.

One-hundred and thirty-one individuals with SUDs (42.75% female; mean age = 39.74 ± 11.83) and 131 sex-matched HCs (mean age = 40.02 ± 12.34) entered the study. Participants completed questionnaires assessing the constructs of interest. Single-group analyses aimed to identify a baseline model for each group and test the hypothesized direct/indirect relations’ overall significance. Then, a multigroup analysis tested the invariance of model parameters between SUD and HC groups.

The model in which IU had both direct and indirect relationships with NA through Impaired Awareness/Clarity and Inability to Control Behaviors was a good fit to the data. The indirect relationship of IU with NA through Inability to Control Behaviors was significant and moderate-sized. The relationship involving Impaired Awareness/Clarity and Inability to Control Behaviors was small-sized and significant in single group analysis only. The multigroup analysis supported the association of IU with NA through Inability to Control Behaviors in the SUD group.

Overall, our study highlights the crucial role of the Inability to Control Behaviors in SUDs and suggests that its association with IU might fuel NA in this population.

我们使用结构方程模型来评估情绪意识和清晰度受损（意识/清晰度受损）和在遇到情绪困扰时无法控制行为（无法控制行为）的作用，以此来解释不确定性（IU）和不容忍之间的关系。患有物质使用障碍（SUD）和健康对照（HCs）的个体的负面影响（NA）进行比较。

一百三十一名患有SUD的个体（女性为42.75％；平均年龄= 39.74±11.83）和131个与性别匹配的HCs（平均年龄= 40.02±12.34）进入了研究。参与者完成了问卷调查，评估了感兴趣的结构。单组分析旨在为每个组确定基线模型，并测试假设的直接/间接关系的整体意义。然后，多组分析测试了SUD和HC组之间模型参数的不变性。

通过受损的意识/清晰度和无法控制行为，IU与NA既有直接关系又有间接关系的模型非常适合数据。通过无法控制行为，IU与NA的间接关系显着且中等。意识/清晰度受损和无法控制行为的关系很小，仅在单组分析中有意义。多组分析通过无法控制SUD组中的行为来支持IU与NA的关联。

总体而言，我们的研究突出了无法控制SUD中行为的关键作用，并表明其与IU的关联可能助长了该人群的NA。