Intolerance of Uncertainty as a Transdiagnostic Mechanism of Psychological Difficulties: A Systematic Review of Evidence Pertaining to Causality and Temporal Precedence

Abstract

Intolerance of uncertainty (IU) is proposed to be a transdiagnostic causal mechanism of psychological difficulties. The systematic review sought to evaluate the status of evidence pertaining to IU's proposed causal influence upon symptoms of psychological conditions. The review collated evidence from studies involving experimental manipulation and assessment of temporal precedence to ensure direct assessment of causality. The search strategy and eligibility screening identified 12 articles, detailing 15 eligible studies (experimental manipulations: n = 10; temporal precedence studies: n = 5). Available evidence comprised symptoms of anxiety-and mood-related conditions, including obsessive-compulsive disorder (OCD). The greatest support for IU as a causal mechanism was evident for anxiety-related difficulties and, to a lesser extent, negative affect; limited support was found for OCD-related difficulties. However, notable inconsistency across study findings for all difficulty types precludes absolute conclusions. Implications and recommendations are discussed.

Changes in Alcohol Use During the COVID-19 Pandemic: Impact of the Lockdown Conditions and Mental Health Factors

“…Moreover, intolerance of uncertainty, which is highly correlated with depression (Carleton et al 2012 ; Gentes and Ruscio 2011 ) and anxiety (Boswell et al 2013 ; Rosser 2019 ), is also associated with the frequency of alcohol use. However, in contrast to studies which suggest that intolerance of uncertainty is likely to be positively correlated with drinking alcohol to cope or conform (Kraemer et al 2015 ; Oglesby et al 2015 ) or to diminish aversive reactivity to ambiguous threats (Gorka et al 2016 ), our results show that the frequency of use is negatively correlated with intolerance of uncertainty.…”

“…One of the distressing features of the emerging pandemic is that as long as the precise cause and evolution are unknown, this uncertainty in itself can increase the level of psychosocial morbidity (Carleton et al 2012 ; Freeston et al 2020 ; Mertens et al 2020 ; Sankar et al 2017 ; Sim and Chua 2004 ). Intolerance of uncertainty, namely the difficulty of not knowing , is associated with other mental health problems (Glowacz and Schmits 2020 , including generalized anxiety disorder (Boswell et al 2013 ; Rosser 2019 ) and depression (Carleton et al 2012 ; Gentes and Ruscio 2011 ). Moreover, intolerance of uncertainty has been shown to be positively correlated with drinking alcohol to cope or conform (Kraemer et al 2015 ; Oglesby et al 2015 ).…”

Psychological impact of the COVID-19 pandemic: Negative and positive effects in Spanish population during the mandatory national quarantine

“…We can therefore emphasize the special role of intolerance of uncertainty and media exposure. The influence of intolerance of uncertainty as a vulnerability factor could be understood from its transdiagnostic nature (Sandín, Chorot and Valiente, 2012) with capacity to influence the etiopathogenesis of emotional disorders, and especially anxiety disorders (Pineda, 2018;Rosser, 2019). With respect to the pernicious effect of excessive exposure to information on coronavirus through different media, our data are in line with preliminary evidence published by Gao et al (2020) and Roy et al (2020), who clarified its negative influence on anxiety, preoccupation and sleep problems.…”

Anxiety disorders, climate change, and the challenges ahead: Introduction to the special issue

“…Accordingly, people who have a great deal of difficulty tolerating uncertainty will find climate change to be particularly stressful. The intolerance of uncertainty is a personality trait that is a vulnerability factor for a variety of types of anxiety-related pathology ( Rosser, 2019 ). Other personality traits that might provide to be vulnerability factors for climate-related anxiety are likely to be many of the same traits that are vulnerability factors for pandemic-related anxiety.…”