Intolerance of uncertainty affects the behavioral and neural mechanisms of higher generalization.

Intolerance of uncertainty (IU) is associated with several anxiety disorders. In this study, we employed rewards and losses as unconditioned positive and negative stimuli, respectively, to explore the effects of an individual's IU level on positive and negative generalizations using magnetic resonance imaging technology. Following instrumental learning, 48 participants (24 high IU; 24 low IU) were invited to complete positive and negative generalization tasks; their behavioral responses and neural activities were recorded by functional magnetic resonance imaging. The behavior results demonstrated that participants with high IUs exhibited higher generalizations to both positive and negative cues as compared with participants having low IUs. Neuroimaging results demonstrated that they exhibited higher activation levels in the right anterior insula and the default mode network (i.e. precuneus and posterior cingulate gyrus), as well as related reward circuits (i.e. caudate and right putamen). Therefore, higher generalization scores and the related abnormal brain activation may be key markers of IU as a vulnerability factor for anxiety disorders.

The moderated-mediation role of risk perception and intolerance of uncertainty in the association between residual symptoms and psychological distress: a cross-sectional study after COVID-19 policy lifted in China.

BACKGROUND: A considerable number of individuals infected with COVID-19 experience residual symptoms after the acute phase. However, the correlation between residual symptoms and psychological distress and underlying mechanisms are scarcely studied. We aim to explore the association between residual symptoms of COVID-19 and psychological distress, specifically depression, anxiety, and fear of COVID-19, and examine the role of risk perception and intolerance of uncertainty in the association. METHODS: A cross-sectional survey was conducted by online questionnaire-based approach in mid-January 2023. Self-reported demographic characteristics, COVID-19-related information, and residual symptoms were collected. Depression, anxiety, fear, risk perception and intolerance of uncertainty were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Fear of COVID-19 Scale (FCV-19S), COVID-19 Risk Perception Scale and Intolerance of Uncertainty Scale-12 (IUS-12), respectively. Linear regression analyses were conducted to explore the associations. A moderated mediation model was then constructed to examine the role of risk perception of COVID-19 and intolerance of uncertainty in the association between residual symptoms and psychological distress. RESULTS: 1735 participants effectively completed the survey. 34.9% of the patients experienced residual symptoms after acute phase of COVID-19. Psychological distress was markedly increased by COVID-19 infection, while residual symptoms had a significant impact on psychological distress (Ps < 0.001), including depression (ß = 0.23), anxiety (ß = 0.21), and fear of COVID-19 (ß = 0.14). Risk perception served as a mediator between residual symptoms and all forms of psychological distress, while intolerance of uncertainty moderated the effect of risk perception on depression and anxiety. CONCLUSION: A considerable proportion of patients experience residual symptoms after acute phase of COVID-19, which have a significant impact on psychological distress. Risk perception and intolerance of uncertainty play a moderated-mediation role in the association between residual symptoms and depression/anxiety. It highly suggests that effective treatment for residual symptoms, maintaining appropriate risk perception and improving intolerance of uncertainty are critical strategies to alleviate COVID-19 infection-associated psychological distress.

The relationship between COVID-19 stress and test anxiety in art students: the chain mediating roles of intolerance of uncertainty and sleep quality.

BACKGROUND: The global spread of COVID-19 has brought immense physiological and psychological distress to students, such as test anxiety and poor sleep quality. This study aims to explore the relationship between COVID-19 stress and test anxiety and the mediating roles of intolerance of uncertainty and sleep quality between them. METHODS: A study was conducted in China during the late stage of the pandemic. A total of 936 Chinese art students (age M = 18.51, SD = 2.11, 46.6% female) completed the Coronavirus Stress Measure (CSM), the 12-item Intolerance of Uncertainty (IUS-12), the Brief Version of the Pittsburgh Sleep Quality Index (B-PSQI), and the Test Anxiety Inventory (TAI). A chain mediation model analysis was conducted to examine the mediating effects of intolerance of uncertainty and sleep quality on the association with COVID-19 stress and test anxiety. RESULTS: COVID-19 stress was positively associated with test anxiety (ß = 0.50, p < 0.001). The intolerance of uncertainty and sleep quality partially and serially mediated the relationship between COVID-19 stress and test anxiety (ß = 0.01, 95% CI = 0.01 to 0.02). CONCLUSION: These findings suggest that art students' intolerance of uncertainty and sleep quality partially and serially mediate the relation between COVID-19 stress and test anxiety. The results have significant implications for the intervention and prevention of test anxiety, providing additional evidence for the relationship between COVID-19 stress and test anxiety.

Intolerance of uncertainty, experiential avoidance, and trust in physician: a moderated mediation analysis of emotional distress in advanced cancer.

We tested whether patients' trust in physician moderated the hypothesized indirect association between intolerance of uncertainty (IU; inability to tolerate the unknown) and emotional distress through the mediator, experiential avoidance (EA; efforts to avoid negative emotions, thoughts, or memories), in patients with advanced cancer. The sample included 108 adults with Stage III or IV cancer (53% female; Mage = 63 years) recruited from a metropolitan cancer center. All constructs were measured by standardized self-report instruments. The PROCESS macro for SPSS tested the moderated mediation model. IU evidenced significant direct and indirect relationships with anxiety and depressive symptoms. Trust in physician moderated the indirect relationship between IU and anxiety (not depressive symptoms), albeit in an unexpected direction. Specifically, the indirect relationship between IU and anxiety symptoms through EA was significant for those with moderate to high physician trust but not low trust. Controlling for gender or income did not change the pattern of findings. IU and EA may be key intervention targets, particularly in acceptance-or meaning-based interventions for patients with advanced cancer.

Intolerance of uncertainty and psychological flexibility as predictors of mental health from adolescence to old age.

PURPOSE: The COVID-19 pandemic brought with it significant social, economic and health uncertainties. These were proposed to impact young people more compared to adults, leading adolescents to report more mental health problems during the pandemic. The current study examined whether differences in cognitive risk (tolerance of uncertainty) and protective (psychological flexibility) factors accounted for age-related differences in depression and anxiety. METHODS: These associations were investigated in the COVID-19 Risks Across the Lifespan (CORAL) cohort (N = 2280, 11-89 years). RESULTS: The results showed that adolescents experienced greater intolerance of uncertainty and lower psychological flexibility compared to adults and older adults. Tolerance of uncertainty did not account for age-related differences in depression or anxiety. However, psychological flexibility conferred more protective advantage for anxiety in adults compared to adolescents. CONCLUSION: The observed age-related differences in risk and protective factors advance our understanding of developmental vulnerabilities to depression and anxiety. Implications for mental health interventions in the context of future pandemics are discussed.

The impact of psychological strengths on Veteran populations' mental health trajectories during the COVID-19 pandemic.

PURPOSE: Mental health trajectories during the COVID-19 pandemic have been examined in Veterans with tenuous social connections, i.e., those with recent homelessness (RHV) or a psychotic disorder (PSY), and in control Veterans (CTL). We test potential moderating effects on these trajectories by psychological factors that may help individuals weather the socio-emotional challenges associated with the pandemic (i.e., 'psychological strengths'). METHODS: We assessed 81 PSY, 76 RHV, and 74 CTL over 5 periods between 05/2020 and 07/2021. Mental health outcomes (i.e., symptoms of depression, anxiety, contamination concerns, loneliness) were assessed at each period, and psychological strengths (i.e., a composite score based on tolerance of uncertainty, performance beliefs, coping style, resilience, perceived stress) were assessed at the initial assessment. Generalized models tested fixed and time-varying effects of a composite psychological strengths score on clinical trajectories across samples and within each group. RESULTS: Psychological strengths had a significant effect on trajectories for each outcome (ps < 0.05), serving to ameliorate changes in mental health symptoms. The timing of this effect varied across outcomes, with early effects for depression and anxiety, later effects for loneliness, and sustained effects for contamination concerns. A significant time-varying effect of psychological strengths on depressive symptoms was evident in RHV and CTL, anxious symptoms in RHV, contamination concerns in PSY and CTL, and loneliness in CTL (ps < 0.05). CONCLUSION: Across vulnerable and non-vulnerable Veterans, presence of psychological strengths buffered against exacerbations in clinical symptoms. The timing of the effect varied across outcomes and by group.

The impact of anxiety and intolerance of uncertainty on climate change distress, policy support, and pro-environmental behaviour.

OBJECTIVES: As the threat of climate change continues to grow, bolstering individual-level support for climate change initiatives is crucial. More research is needed to better understand how individual difference factors, such as climate change anxiety and intolerance of uncertainty (IU), may shape how people perceive climate change and respond to climate change messaging. To date, the majority of published studies have not taken these individual difference factors into consideration, and IU has been particularly neglected in the climate change literature. This study examined the independent effects of climate change anxiety and IU on three climate change-related outcomes: climate-related distress, support for climate change policies, and behavioural engagement. METHODS: Participants were Florida residents (N = 441) who completed an online survey, including measures of climate change anxiety and IU. Participants then watched a video describing climate change consequences and completed three outcome measures: post-video distress, climate change policy support, and behavioural engagement. RESULTS: Controlling for demographic covariates, both climate change anxiety (ß = .43, p < .001) and IU (ß = .27, p < .001) were associated with greater post-video distress, but only IU independently predicted greater policy support (ß = .10, p = .034) and behavioural engagement (ß = .12, p = .017). CONCLUSIONS: Our findings suggest that IU may be an important factor in promoting pro-environmental behaviour and policy support, but climate change anxiety may increase emotional distress without boosting meaningful behaviours or support. Our findings highlight the potential influence of cognitive factors on climate change engagement and suggest that invoking uncertainty rather than anxiety may be more effective in catalysing effective environmental engagement.

Urged to feel certain again: The role of emotion-related impulsivity on the relationships between intolerance of uncertainty and OCD symptom severity.

OBJECTIVES: Obsessive-compulsive disorder (OCD) is a debilitating mental disorder characterized by persistent and intrusive thoughts accompanied by repetitive mental or physical acts. While both intolerance of uncertainty and emotion-related impulsivity have been consistently evidenced as cognitive risk factors of OCD, no studies have considered their joint effects. The current study examined the interaction between intolerance of uncertainty and two forms of emotion-related impulsivity-including both a behavioural and cognitive form-in predicting OCD symptoms. DESIGN: Cross-sectional data were collected online from community-based adult participants. METHODS: Participants (N = 673) completed a battery of self-report measures of OCD symptom severity, intolerance of uncertainty, and emotion-related impulsivity. RESULTS: The behavioural form of emotion-related impulsivity positively moderated the relationship between intolerance of uncertainty and OCD symptoms. Elevated levels of both factors predicted the most severe symptoms, particularly checking, washing, and obsessing. This interaction effect was not found for the cognitive form of emotion-related impulsivity, which still emerged as a unique predictor of OCD symptom severity, specifically obsessing symptoms. CONCLUSIONS: Current findings furthered the understanding of the link between intolerance of uncertainty and OCD symptoms by highlighting the role of emotion-related impulsivity. When uncertainty triggers distress in individuals with high intolerance of uncertainty, the urge to behaviourally alleviate this distress could promote the use of maladaptive obsessions and compulsions, leading to greater OCD symptoms. Results also indicated the potentially differential effects from the behavioural versus cognitive forms of emotion-related impulsivity on different symptom domains, and the mechanistic link here is worthy of further investigation.

Intolerance of uncertainty modulates brain-to-brain synchrony during politically polarized perception.

Political partisans see the world through an ideologically biased lens. What drives political polarization? Although it has been posited that polarization arises because of an inability to tolerate uncertainty and a need to hold predictable beliefs about the world, evidence for this hypothesis remains elusive. We examined the relationship between uncertainty tolerance and political polarization using a combination of brain-to-brain synchrony and intersubject representational similarity analysis, which measured committed liberals' and conservatives' (n = 44) subjective interpretation of naturalistic political video material. Shared ideology between participants increased neural synchrony throughout the brain during a polarizing political debate filled with provocative language but not during a neutrally worded news clip on polarized topics or a nonpolitical documentary. During the political debate, neural synchrony in mentalizing and valuation networks was modulated by one's aversion to uncertainty: Uncertainty-intolerant individuals experienced greater brain-to-brain synchrony with politically like-minded peers and lower synchrony with political opponents-an effect observed for liberals and conservatives alike. Moreover, the greater the neural synchrony between committed partisans, the more likely that two individuals formed similar, polarized attitudes about the debate. These results suggest that uncertainty attitudes gate the shared neural processing of political narratives, thereby fueling polarized attitude formation about hot-button issues.

Friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors in times of COVID-19.

INTRODUCTION: This cross-sectional study used a convergent parallel mixed-method design to investigate friendship attachment style, intolerance of uncertainty, and psychological distress among unaccompanied immigrant minors (UIMs) during the second wave of the COVID-19 pandemic in Italy. METHOD: Participants were 80 male UIMs (Mage = 17 years, standard deviation = 0.84) hosted in residential care communities. Individual interviews comprising questionnaires and open-ended questions assessed the constructs of interest. Qualitative data were analyzed through thematic content analysis, whereas descriptive statistics and regression analysis were computed on quantitative data. RESULTS: Several UIMs mentioned positive relationships with peers, but more than half also felt reluctant to trust others and build new friendships due to events experienced before and during migration. However, in quantitative data, 69% identified themselves with the secure friendship attachment style. Regarding intolerance of uncertainty, participants expressed feelings of worry about the pandemic, but also emphasized their resources in terms of confidence, optimism, and planning skills, as well as being accustomed to uncertainty; indeed, levels of this variable were low-to-medium. In regression analysis, insecure attachment and higher intolerance of uncertainty were each associated with greater psychological distress. Moreover, psychological distress was lower among securely attached UIMs with low (vs. high) levels of intolerance of uncertainty. CONCLUSION: The findings suggest that, even in conditions of societal insecurity, UIMs display resilience and employ effective coping strategies; however, a lack of trust in peer relationships and the inability to tolerate uncertainty may undermine their psychological adjustment. Implications for developmental theory and practice are discussed.

Sociability Alcohol Expectancies Shape Predictions of Drinking Behavior and Anxiety in a Novel Affective Forecasting Task.

Background: Existing work proposes that people with higher social anxiety symptoms and sociability alcohol expectancies believe alcohol can lower their anxiety. However, studies have primarily analyzed retrospective reports, not anticipatory motives. Since predictions of future emotion (i.e., affective forecasts) strongly influence behavior, it is critical to understand how people predict alcohol will influence their anxiety. Additionally, intolerance of uncertainty (IU) is related to the use of alcohol as a coping tool, but there is a dearth of work testing whether IU influences alcohol-related forecasts. Objectives: Utilizing a novel affective forecasting task, we tested the prediction that social anxiety symptoms, sociability alcohol expectancies, and IU would relate to predictions about alcohol use. In an initial study and preregistered replication, participants imagined themselves in stressful social scenarios and forecasted how anxious they would feel when drinking and when sober. In the replication, participants also forecasted whether they would drink in the imagined scenarios. Results: Contrary to hypotheses, social anxiety symptoms and IU did not significantly predict higher forecasted anxiety across studies, nor did they predict forecasted drinking. Exploratory analyses showed that participants with higher sociability alcohol expectancies forecasted being more likely to drink, and forecasted feeling less anxious when drinking (versus being sober). Even after statistically controlling for social anxiety, the effect of sociability expectancies remained significant in predicting forecasted anxiety and forecasted drinking. Conclusions: Clinicians could consider specifically targeting sociability expectancies for alcohol use difficulties, and future research should continue utilizing affective forecasting paradigms to test links between social anxiety, alcohol expectancies, and alcohol-use problems.

Insecure attachment and eating disorder symptoms: Intolerance of uncertainty and emotion regulation as mediators.

OBJECTIVE: Literature on eating disorder (ED) symptoms of Black, Indigenous, and People of Color (BIPOC) group is extremely scarce. This study aimed to understand the mechanisms underlying the associations between insecure attachment and ED symptoms and examine whether these mechanisms differed between White and BIPOC groups. METHOD: The study investigated direct and indirect relationship between attachment anxiety/avoidance and ED symptoms via intolerance of uncertainty (IU) and emotion regulation strategies of suppression and reappraisal. Further, we examined whether the proposed mechanisms equally represented White versus BIPOC using Multigroup Structural Equation Model (MG-SEM). A total of 1227 college students (48.50% BIPOC and 51.50% White) completed research questionnaires. RESULTS: Results showed that IU and suppression mediated the relations between insecure attachment and ED symptoms for both White and BIPOC groups. Uniquely, reappraisal mediated the relations between insecure attachment and ED symptoms for the White group, but not for the BIPOC group. DISCUSSION: The implications of the findings for culturally informed practice are discussed, including targeting increasing tolerability of uncertainties and improving emotion regulation to mitigate ED symptoms for those with insecure attachment.

Nature-friendly hands: The relationship between nursing students' climate change anxiety, intolerance of uncertainty, and anxiety about the future.

AIM/OBJECTIVE: This study examined the relationship between climate change anxiety, intolerance of uncertainty, and future anxiety levels of nursing students. BACKGROUND: The effects of climate change, an important global problem, on people's emotional and intellectual states are becoming increasingly important. It is important to understand to what extent prospective health professionals, such as nursing students, are affected by such environmental concerns and the possible impact of this level on their professional behaviors to develop an environmentally focused approach to health services. DESIGN: This study was conducted using a descriptive and correlational design. METHODS: Students enrolled in the Nursing Undergraduate Program of a university in Turkey in the 2023-2024 academic year participated in the study. The participants were administered a personal information form, climate change anxiety scale, intolerance of uncertainty scale, and future anxiety scale in university students. The data were evaluated using advanced statistical analyses, and relationships were examined. RESULTS: As a result of these analyses, it was determined that there was a significant relationship between future anxiety and climate change anxiety in university students (R = 0.234, p = .000). In addition, there was a substantial relationship between climate change anxiety and intolerance of uncertainty (R = 0.562, p = .000). CONCLUSIONS: These findings indicate significant and linear relationships between nursing students' emotional and cognitive states associated with environmental factors such as climate change, uncertainty, and future anxiety. Developing support and interventions in nursing education is crucial to help students cope with these issues and function more effectively in their future professional lives.

Effect of Psychotherapy on Intolerance of Uncertainty: A Systematic Review and Meta-Analysis.

Intolerance of uncertainty (IU) is the tendency to react negatively on affective, cognitive and behavioural levels to uncertain situations and to harbour negative beliefs about the implications of uncertainty. IU has been linked to psychopathology and shown to impact treatment outcomes. This study systematically reviewed the literature and performed a meta-analysis of the effects of psychotherapy on IU. A total of 22 studies (1491 participants) were identified in online searches and included in the meta-analyses. Analyses were performed on studies with passive and active control conditions. The pooled effect on IU from studies with passive control was large (g = -0.94 [95% CI -1.25 to -0.62]) but with significant heterogeneity. Pooled effects on IU from studies with active controls were not significant. Moderator analysis showed that among studies with a passive control condition, studies that recruited participants from clinical care facilities produced smaller effect sizes. Among studies with an active control condition, study quality significantly moderated the results, with higher quality leading to a larger effect size. These results indicate that changes in IU may be difficult to reliably achieve in psychotherapy and leave many questions about the effect of psychotherapy on IU unanswered, such as what active components produced the observed changes in studies with passive control.

Acute Stress Symptoms, Intolerance of Uncertainty and Coping Strategies in Reaction to the October 7 War.

BACKGROUND: On 7 October 2023, hundreds of armed Hamas fighters breached the security border fence and entered Israel from the Gaza Strip. More than 1400 Israeli citizens were murdered, and 239 individuals were kidnapped. Many Israeli citizens experienced these occurrences as psychologically traumatic events that caused stress and uncertainty. OBJECTIVES: The present study aimed to examine the relationship between exposure to war (in more distant circles), intolerance of uncertainty (IU) and disengaged coping on acute stress symptoms (ASS). First, we examined whether exposure to war and IU were directly associated with ASS. Second, we tested the mediating role of disengaged coping in the relationship among war exposure, IU and ASS. METHODS: This cross-sectional study involved 393 Israeli citizens. Participants answered questionnaires on exposure to war, IU, coping strategies and ASS. RESULTS: The study results indicate that higher exposure and higher levels of IU were directly associated with more intensive ASS, and this association was partially mediated by higher use of disengaged coping strategies. CONCLUSIONS: Individuals during wartime are at risk of experiencing high levels of ASS and developing ASD. However, degree of exposure to war alone was not associated with ASS, but it was related to personal resources and coping strategies.

[Psychometric properties of the Hungarian version of the Intolerance of Uncertainty Scale - Short Version (IUS-12)]. / Az alkoholhasználat és az öndetermináció kapcsolata: a Kezelési Önszabályozási Kérdoív pszichometriai jellemzoi magyar mintán.

INTRODUCTION: Intolerance of uncertainty is the tendency to react negatively to an uncertain situation, regardless of the probability of the occurrence of the event and its consequences. Intolerance of uncertainty (IU) can also be conceptualized as a personality trait that is prominent in many anxiety and rumination-related pathologies. A growing body of research highlights its key role in understanding anxiety disorders. METHOD: The aim of present study was to investigate the dimensionality, validity and reliability of the Intolerance of Uncertainty Scale in a large non-clinical sample (N = 1747). Former was analysed by confirmatory factor analysis, the validity by correlation with the Perceived Stress Scale. Reliability was assessed using Cronbach's alpha coefficient and test-retest analysis. RESULTS: Confirmatory factor analysis failed to confirm the hypothesized two-factor structure (CFI = 0.907; TLI = 0.885; RMSEA = 0.103 [90% CI = 0.096-0.110]; SRMR = 0.071). However, the exploratory factor analysis identified the same two factors as in the original study: "Prospective" and "Inhibitory". The scale showed excellent internal reliability (α = 0.897) and test-retest reliability. There was moderate correlation with the Perceived Stress Scale (r = 0.438). CONCLUSION: Based on the results, the Hungarian version of the BTS-12 is a valid and reliable measurement tool. However, before its use in a Hungarian sample, its psychometric properties need to be confirmed by further studies on a large sample. In the future, the questionnaire will be useful in measuring intolerance of uncertainty and may be useful in identifying susceptibility to anxiety disorders.

Spirituality, Intolerance and Fear of COVID-19: Psychological Distress Among Older Adults in Pakistan.

The present study aimed to investigate the role of spirituality, intolerance of uncertainty (IU), and fear of COVID-19 as correlates and predictors of psychological distress among older adults in Pakistan and also assess the gender differences among research variables. Using a quantitative correlational survey research design, a sample of 150 (75 = Men, 75 = Women) older adults aged 55 years and above from different cities of Pakistan were approached through a non-probability purposive sampling strategy. Participants completed the Daily Spiritual Experience Scale, Intolerance of Uncertainty Scale IUS-12, Fear of COVID-19, and Kessler Psychological Distress Scale-K10. Spirituality has a significant negative relationship with psychological distress. Whereas, IU (Inhibitory anxiety and prospective anxiety) and fear of COVID-19 have a significant positive relationship with psychological distress. Results also showed that spirituality, IU dimensions, and fear of COVID-19 emerged as significant predictors of psychological distress among older adults after controlling for the effect of covariates. In addition, elderly females significantly showed more spirituality, less IU, and fear of COVID-19 as compared to elderly males. It is proposed that mental health care plays an important role in treating the psychological needs of older adults in pandemic situations and that further study is needed to develop effective solutions for older persons in stressful situations such as pandemics.

The bodily threat monitoring scale: Development and preliminary validation in adult and childhood cancer survivors.

OBJECTIVE: Bodily threat monitoring is a core clinical feature of Fear of cancer recurrence (FCR) and is targeted in psycho-oncology treatments, yet no comprehensive self-report measure exists. The aim of this study was the theory-informed development and initial validation of the Bodily Threat Monitoring Scale (BTMS). METHODS: Adult survivors of breast and gynaecological cancers (Study 1: N = 306, age = 37-81 years) and childhood cancer survivors (Study 2: N = 126, age = 10-25 years) completed the BTMS, designed to assess how individuals monitor for and interpret uncertain symptoms as indicating that something is wrong with their body. Participants completed measures to assess construct and criterion validity of the BTMS, and childhood cancer survivors (Study 2) completed the BTMS again 2 weeks later to assess test-retest reliability. RESULTS: The 19-item BTMS demonstrated excellent internal consistency across adult and childhood cancer samples (α = 0.90-0.96). Factor analyses indicated two subscales capturing 1. Monitoring of bodily sensations and 2. Threatening interpretations of bodily sensations. Two-week stability estimates were acceptable. For construct validity, the BTMS correlated with body vigilance and anxiety sensitivity. The BTMS also demonstrated criterion validity, yielding significant associations with FCR, intolerance of uncertainty, help-seeking behaviours, and quality of life. The BTMS was associated with FCR while controlling for body vigilance and anxiety sensitivity, indicating a unique contribution of this theory-informed measure. CONCLUSIONS: The BTMS shows evidence of sound psychometric properties and could be used to elucidate the role of bodily threat monitoring in the maintenance and management of FCR.

Perfectionism, intolerance of uncertainty and coping in relation to fear of cancer recurrence in breast cancer patients.

OBJECTIVE: Improved medical treatment has led to an increased cohort of cancer survivors. The prevalence of emotional problems in this group is high, with fear of cancer recurrence (FCR) being among the most prevalent and distressing conditions. In order to gain more insight in the psychological mechanisms playing a role in levels of FCR, this study examined the relationship between perfectionism and FCR in breast cancer patients, as well as the mediating role of intolerance of uncertainty (IU) and coping in this relationship. In order to contribute to a more comprehensive understanding of the mechanisms related to the experience of FCR in breast cancer patients, the purpose of the present study is to investigate the relationship between perfectionism and FCR, with IU and coping strategies as possible mediating factors. METHODS: Validated Dutch versions of the FCR Inventory, the Multidimensional Perfectionism Scale, the Intolerance of Uncertainty Scale and the Utrechtse Coping List were filled out by 146 breast cancer patients, at least one year after (finishing) medical treatment. Correlation analyses were conducted to administer the associations between FCR, perfectionism, IU, coping and demographic/medical variables. PROCESS was used to examine mediation mechanisms. RESULTS: A significant correlation was found between perfectionism and FCR (r = 0.19, p = 0.024). IU was found to mediate the relationship between perfectionism and FCR. In contrast, coping style did not emerge as a significant mediating factor. CONCLUSIONS: This study shows that intolerance of uncertainty mediates the relationship between perfectionism and FCR. Psychological interventions targeting FCR may benefit from incorporating specific modules on dealing with uncertainty. Future research is necessary to further increase understanding of the mechanisms that play a role in FCR, in order to optimize and personalize psychological treatment for cancer patients with this type of emotional distress.

Anxiety Sensitivity and Intolerance of Uncertainty: Transdiagnostic Risk Factors for Anxiety as Targets to Reduce Risk of Suicide.

PURPOSE OF REVIEW: Suicide has a profound impact on individuals, families, and society. One prominent, if understudied, risk factor for suicide is anxiety. More than 70% of people with at least one suicide attempt meet diagnostic criteria for an anxiety disorder. There are several limitations to exploring the associations between anxiety and suicide using diagnosis-based classification systems. A better approach would be to consider transdiagnostic risk factors for anxiety. RECENT FINDINGS: Through a negative reinforcement model of suicide, anxiety sensitivity (AS) and intolerance of uncertainty (IU) appear to exacerbate the experience of unpleasant anxiety sensations and likely contribute to chronic suicide risk as well as acute suicidal acts. Although more research is needed to clarify the mechanisms through which AS and IU confer risk, brief interventions may offer an ideal suicide prevention strategy for anxious people.