Intolerance of uncertainty (IU), the tendency to find uncertainty distressing, is an important transdiagnostic dimension in mental health disorders. Higher self-reported IU has been linked to poorer threat extinction training (i.e., the updating of threat to safe associations), a key process that is targeted in exposure-based therapies. However, it remains to be seen whether IU-related effects during threat extinction training are reliably and specifically driven by the IU construct or a particular subcomponent of the IU construct over other self-reported measures of anxiety. A meta-analysis of studies from different laboratories (experiment n = 18; sample n = 1006) was conducted on associations between different variants of self-reported IU (i.e., 27-item, 12-item, inhibitory and prospective subscales), trait anxiety and threat extinction training via skin conductance response. The specificity of IU and threat extinction training was assessed against measures of trait anxiety. All of the self-reported variants of IU, but not trait anxiety, were associated with threat extinction training via skin conductance response (i.e., continued responding to the old threat cue). Specificity was observed for the majority of self-reported variants of IU over of trait anxiety. The findings suggest that the IU construct broadly accounts for difficulties in threat extinction training and is specific over other measures of self-reported anxiety. These findings demonstrate the robustness and specificity of IU-related effects during threat extinction training and highlight potential opportunities for translational work to target uncertainty in therapies that rely on threat extinction principles such as exposure therapy.

Individuals who score high in self-reported Intolerance of Uncertainty (IU) display difficulties updating threat associations to safe associations. Here we sought to determine whether individuals who score high in IU can learn and retain new safety associations if given more exposure. We recorded skin conductance response, pupil dilation and expectancy ratings during an associative threat learning task with acquisition, same-day extinction and next-day extinction phases. Participants (n = 144) were assigned to either a regular exposure (32 trials of same-day and next-day extinction) or extended exposure condition (48 trials of same-day and next-day extinction). We failed to replicate previous work showing that IU is associated with poorer safety-learning indexed via SCR. We found preliminary evidence for promoted safety-retention in individuals with higher Inhibitory IU in the extended exposure condition, relative to individuals with higher Inhibitory IU in the regular exposure condition, indexed via SCR. These findings further our current understanding of the role of IU in safety-learning and -retention, informing models of IU and exposure-based treatments.

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Background Difficulty updating threat associations to safe associations has been observed in individuals who score high in self-reported Intolerance of Uncertainty (IU). Here we sought to determine whether an instruction based on fundamental principles of Cognitive Behavioural Therapy could promote safety learning in individuals with higher levels of IU, whilst controlling for self-reported trait anxiety (STICSA). Methods We measured skin conductance response, pupil dilation and expectancy ratings during an associative threat learning task in which participants either received a cognitive behavioural instruction or no instruction prior to threat extinction (n = 92). Results Analyses revealed that both self-reported IU and STICSA similarly predicted differences in skin conductance response. Only individuals with lower IU/STICSA in the cognitive behavioural instruction condition displayed successful safety learning via skin conductance response. Conclusions These initial results provide some insight into how simple cognitive behavioural instructions combined with exposure are applied differently in individuals with varying levels of self-reported anxiety. The results further our understanding of the role of basic cognitive behavioural principles and self-reported anxiety in safety learning.