“But it might be a heart attack”: Intolerance of uncertainty and panic disorder symptoms

Carleton, R. Nicholas; Duranceau, Sophie; Freeston, Mark H.; Boelen, Paul A.; McCabe, Randi E.; Antony, Martin M.

doi:10.1016/j.janxdis.2014.04.006

Cited by 105 publications

(66 citation statements)

References 70 publications

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“…However, our results provided evidence of both direct and indirect effects for both prospective and inhibitory IU on health anxiety through AS. A similar relationship has been observed between IU, AS, and panic disorder symptoms (Carleton et al, 2014). For example, we speculate that uncertainty about future health problems may also increase AS, facilitating attention towards physical symptoms (e.g., heart rate), worry, and maladaptive avoidance behaviours, all of which facilitate health anxiety.…”

Section: Discussionsupporting

confidence: 79%

Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth

Wright

Lebell

Carleton

2016

Journal of Anxiety Disorders

Self Cite

101

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Section: Discussionsupporting

confidence: 79%

Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth

Wright

Lebell

Carleton

2016

Journal of Anxiety Disorders

Self Cite

101

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“…Indeed, in a state of chronic uncertainty and stagnated error reduction, it may be adaptive to take an inferential leap on the basis of insufficient data, adopting a model that explains away somatosensory prediction errors and paradoxically reduces the overall level of threat; in other words, it may be better to know that you are ill than to be unsure whether you are (i.e., "better the devil you know"). Whilst disambiguation may serve a short term goal of reduced aversive feedback, however, it sustains a high error rate in the long run; the result is chronic negative affect and further attempts at disambiguation, expressed as chronic worry about the state (Carleton et al, 2014) and the creation of a vicious circle that ultimately leads to chronic MUS and somatoform disorders.…”

Section: Threat and Negative Affect (Na)mentioning

confidence: 99%

Symptoms and the body: Taking the inferential leap

Bergh

Witthöft

Petersen

et al. 2017

Neuroscience & Biobehavioral Reviews

403

354

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a b s t r a c tThe relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of "medically unexplained" or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it. We then use the framework of predictive coding to propose a new and more comprehensive model of the body-symptom relationship that integrates existing concepts within a unifying framework that addresses many of the shortcomings of current theory. We describe the conditions under which a close correspondence between the experience of symptoms and objective physiology might be expected, and when they are likely to diverge. We conclude by exploring some theoretical and clinical implications of this new account.

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“…Physical symptoms and other patient attributes may also interact with uncertainty intolerance. 14 However, to date, the impact of intolerance of uncertainty among men undergoing AS of prostate cancer is unexplored.…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Intolerance of Uncertainty and Anxiety in Men on Active Surveillance for Prostate Cancer

et al. 2016

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Purpose Anxiety may serve as a major barrier to participation in AS. Intolerance of uncertainty—the tendency to perceive the potential for negative events as threatening—has been linked to cancer-related worry. Accordingly, we explored prospectively the relationship of intolerance of uncertainty with anxiety along with other clinical factors among men managed with AS for prostate cancer. Materials and Methods From 2011–2014, 119 men with D’Amico low-risk prostate cancer participating in active surveillance completed the HADS, MAX-PC, IUS, and IPSS surveys. We evaluated the relationship between anxiety and IUS score after adjusting for patient characteristics, cancer information, and IPSS score using bivariable and multivariable analyses. Results A number of men reported clinically significant anxiety on the generalized (n=18, 15.1%) and prostate-cancer-specific (n=17, 14.3%) scales. In bivariable analyses, men with moderate/severe urinary symptoms and higher IUS scores reported more generalized and prostate-cancer-specific anxiety than men with mild urinary symptoms and lower IUS scores, respectively (p≤0.008). Men with depressive symptoms (p=0.024) or family history of prostate cancer (p=0.006) experienced greater generalized anxiety. In multivariable analysis, IUS score was significantly associated with generalized (OR 1.22, 95% CI 1.09–1.38) and prostate-cancerspecific anxiety (OR 1.29, 95% CI 1.13–1.49) while moderate/severe urinary symptoms were associated with prostate-cancer-specific anxiety (OR 6.89, 95% CI 1.33–35.68). Conclusions Intolerance of uncertainty and urinary symptoms may promote anxiety among men on AS for prostate cancer. Patient education, management of lower urinary tract symptoms, and behavioral interventions may lessen anxiety related to uncertainty intolerance and help maintain patient engagement in AS.

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“But it might be a heart attack”: Intolerance of uncertainty and panic disorder symptoms

Cited by 105 publications

References 70 publications

Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth

Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth

Symptoms and the body: Taking the inferential leap

The Relationship between Intolerance of Uncertainty and Anxiety in Men on Active Surveillance for Prostate Cancer

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