Intolerance of uncertainty: Neural and psychophysiological correlates of the perception of uncertainty as threatening

The Perils of the Unknown: Intolerance of Uncertainty and Intimate Partner Violence Across the First Four Pandemic Waves

Theory suggests that intolerance of uncertainty (IU), a tendency to perceive uncertain events as threatening, may serve as a potential risk factor for increased intimate partner violence (IPV) perpetration; however, few studies have investigated this association, and none have taken a longitudinal approach. We investigated the issue in two longitudinal online investigations (initial N = 282 and 1,118), with time periods ranging from just before the COVID-19 pandemic to the fourth pandemic wave, approximately 1.5 years later. IU was a significant predictor of IPV cross-sectionally, and in the short term longitudinally (i.e., over periods of weeks); however, it did not predict IPV over the longer term (i.e., over periods of months or years). In addition, our longitudinal design allowed assessment of IPV trends across pandemic waves. Physical IPV rates remained low and steady across time. Psychological IPV rates showed an increase in the early days of the pandemic, but then dropped and stabilized, albeit at a somewhat higher rate than pre-pandemic. Study 2 had ample representation of LGBTQ+ respondents and showed that the patterns and processes worked similarly for LGBTQ+ and non-LGBTQ+ individuals.

Differentiating neural sensitivity and bias during face-emotion processing in youth: a computational approach

The ability to interpret face-emotion displays is critical for the development of adaptive social interactions. Using a novel variant of a computational model and fMRI data, we examined behavioral and neural associations between two metrics of face-emotion labeling (sensitivity and bias) and age in youth. Youth and adults (n = 44, M age = 20.02, s.d. = 7.44, range = 8-36) completed an explicit face-emotion labeling fMRI task including happy to angry morphed face emotions. A drift-diffusion model was applied to choice and reaction time distributions to examine sensitivity and bias in interpreting face emotions. Model fit and reliability of parameters were assessed on adult data (n = 42). Linear and quadratic slopes modeled brain activity associated with dimensions of face-emotion valence and ambiguity during interpretation. Behaviorally, age was associated with sensitivity. The bilateral anterior insula exhibited a more pronounced neural response to ambiguity with older age. Associations between sensitivity and bias metrics and activation patterns indicated that systems encoding face-emotion valence and ambiguity both contribute to the ability to discriminate face emotions. The current study provides evidence for age-related improvement in perceptual sensitivity to facial affect across adolescence and young adulthood.

Uncertain world: How children's curiosity and intolerance of uncertainty relate to their behaviour and emotion under uncertainty

Curiosity and intolerance of uncertainty (IU) are both thought to drive information seeking but may have different affective profiles; curiosity is often associated with positive affective responses to uncertainty and improved learning outcomes, whereas IU is associated with negative affective responses and anxiety. Curiosity and IU have not previously been examined together in children but may both play an important role in understanding how children respond to uncertainty. Our research aimed to examine how individual differences in parent-reported curiosity and IU were associated with behavioural and emotional responses to uncertainty. Children aged 8 to 12 (n = 133) completed a game in which they were presented with an array of buttons on the screen that, when clicked, played neutral or aversive sounds. Children pressed buttons (information seeking) and rated their emotions and worry under conditions of high and low uncertainty. Facial expressions were also monitored for affective responses. Analyses revealed that children sought more information under high uncertainty than low uncertainty trials and that more curious children reported feeling happier. Contrary to expectations, IU and curiosity were not related to the number of buttons children pressed, nor to their self-reported emotion or worry. However, exploratory analyses suggest that children who are high in IU may engage in more information seeking that reflects checking or safety-seeking than those who are low in IU. In addition, our findings suggest that there may be age-related change in the effects of IU on worry, with IU more strongly related to worry in uncertain situations for older children than younger children.

Early life adversity is associated with greater similarity in neural representations of ambiguous and threatening stimuli

Exposure to early life adversity (ELA) is hypothesized to sensitize threat-responsive neural circuitry. This may lead individuals to overestimate threat in the face of ambiguity, a cognitive-behavioral phenotype linked to poor mental health. The tendency to process ambiguity as threatening may stem from difficulty distinguishing between ambiguous and threatening stimuli. However, it is unknown how exposure to ELA relates to neural representations of ambiguous and threatening stimuli, or how processing of ambiguity following ELA relates to psychosocial functioning. The current fMRI study examined multivariate representations of threatening and ambiguous social cues in 41 emerging adults (aged 18 to 19 years). Using representational similarity analysis, we assessed neural representations of ambiguous and threatening images within affective neural circuitry and tested whether similarity in these representations varied by ELA exposure. Greater exposure to ELA was associated with greater similarity in neural representations of ambiguous and threatening images. Moreover, individual differences in processing ambiguity related to global functioning, an association that varied as a function of ELA. By evidencing reduced neural differentiation between ambiguous and threatening cues in ELA-exposed emerging adults and linking behavioral responses to ambiguity to psychosocial wellbeing, these findings have important implications for future intervention work in at-risk, ELA-exposed populations.

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.

Understanding anxiety through uncertainty quantification

Uncertainty has been a central concept in psychological theories of anxiety. However, this concept has been plagued by divergent connotations and operationalizations. The lack of consensus hinders the current search for cognitive and biological mechanisms of anxiety, jeopardizes theory creation and comparison, and restrains translation of basic research into improved diagnoses and interventions. Drawing upon uncertainty decomposition in Bayesian Decision Theory, we propose a well-defined conceptual structure of uncertainty in cognitive and clinical sciences, with a focus on anxiety. We discuss how this conceptual structure provides clarity and can be naturally applied to existing frameworks of psychopathology research. Furthermore, it allows formal quantification of various types of uncertainty that can benefit both research and clinical practice in the era of computational psychiatry.

Beyond the RewP: The reward feedback-elicited LPP and its potential associations with perceived stress and internalizing symptoms in late childhood

Internalizing problems increase substantially during late childhood and early adolescence, which are known to be associated with elevated perceived stress as children transition into adolescence. One risk factor that may moderate the stress-symptom association is reward processing. While neurophysiological research in this field has focused on the reward positivity component (RewP) elicited during reward processing, little work has examined the reward feedback-elicited late positive potential (LPP) and its association with internalizing psychopathology. The present study examined the moderating roles of the RewP and feedback-elicited LPP in the relationship between perceived stress and internalizing symptoms in late childhood. A community sample of 115 nine-to-12-year-old children (66 girls, Mean age = 11.00 years, SD = 1.16) completed an EEG version of the reward feedback paradigm, the Doors task, and completed questionnaires on perceived stress and internalizing symptoms. A principal component analysis revealed three temporo-spatial factors that were temporally and spatially analogous to the RewP, anterior LPP, and posterior LPP, respectively. As expected, an enlarged RewP was found towards the win condition compared to the loss condition. We also observed a potentiated LPP towards loss relative to win feedback, which may reflect the evaluation and reappraisal processes following unsuccessful performance (i.e., loss). We did not, however, find significant moderating effects of any ERP components on the stress-symptom association. Our study was first to isolate the feedback-elicited LPP in a reward processing paradigm in children and provide initial evidence on the modulation of the ERP component by task conditions. Future research is warranted to further explore the functional significance of the reward feedback-elicited LPP in association with perceived stress and internalizing psychopathology in youths.

Heart Rate Variability Assessment of Land Navigation and Load Carriage Activities in Specialist Police Selection

Police tactical group (PTG) personnel are exposed to physical, mental, and emotional stressors. Consequently, PTG selection courses (SCs) impart similar challenges, often resulting in candidate attrition. Holistic assessment may provide additional support to stakeholders given these risks. Heart Rate Variability (HRV) is an objective holistic stress measure that may be applicable in PTG SCs but has not been thoroughly researched. Therefore, this study aimed to report HRV data in an end-user accessible format and determine the relationship between HRV and attrition. A total of 18 qualified Australian State law enforcement officers completed a 1-day physical readiness assessment. Of those, six males progressed to an additional two-day course, on which this study is focused. This two-day selection consisted of additional physical challenges and occupational assessments. HRV was obtained from 2-lead ECGs and defined as the percentage of R-R intervals that varied by ≥50 ms (pRR50). Data were summarized in a heat map of consecutive short-term analyses. Three candidates withdrew. A logistic regression based on heat map data found high HRV was significant for predicting attrition, χ2 (6) = 8.318, p = 0.004. HRV may provide insight for PTG stakeholders monitoring attrition. While the sample size was limited and replication is needed, this study tentatively establishes value for HRV monitoring in PTG SCs.

Understanding anxiety symptoms as aberrant defensive responding along the threat imminence continuum

Threat-anticipatory defensive responses have evolved to promote survival in a dynamic world. While inherently adaptive, aberrant expression of defensive responses to potential threat could manifest as pathological anxiety, which is prevalent, impairing, and associated with adverse outcomes. Extensive translational neuroscience research indicates that normative defensive responses are organized by threat imminence, such that distinct response patterns are observed in each phase of threat encounter and orchestrated by partially conserved neural circuitry. Anxiety symptoms, such as excessive and pervasive worry, physiological arousal, and avoidance behavior, may reflect aberrant expression of otherwise normative defensive responses, and therefore follow the same imminence-based organization. Here, empirical evidence linking aberrant expression of specific, imminence-dependent defensive responding to distinct anxiety symptoms is reviewed, and plausible contributing neural circuitry is highlighted. Drawing from translational and clinical research, the proposed framework informs our understanding of pathological anxiety by grounding anxiety symptoms in conserved psychobiological mechanisms. Potential implications for research and treatment are discussed.

Anxiety in autistic preschool children: Phenomenology and a network analysis of correlates

Anxiety disorders in autistic children are associated with significant functional impairment. Few studies have examined impairing anxiety presentations in autistic preschool children (i.e., 3-5 years old). This cross-sectional study examined the phenomenology of impairing anxiety and the strongest correlates of anxiety in 75 autistic preschool children. Parents completed a diagnostic interview that assesses two anxiety types, DSM-5 anxiety disorders and impairing distinct anxiety presentations, and measures of anxiety correlates. An exploratory network analysis examined connections between anxiety and its correlates. Forty percent of children had impairing anxiety. Specific phobia followed by 'other social fear,' a type of distinct anxiety, were the most common anxiety types. Child intolerance of uncertainty (IU) was the only correlate that was associated with anxiety in a network analysis framework. Child IU linked anxiety to two other correlates, sensory over-responsivity and somatic symptoms. Findings emphasize the need for early intervention for anxiety and further research on its correlates.

Intolerance of uncertainty enhances generalisation of cued conditioned threat: An event-related potential study

Overgeneralisation is one of the aetiologies of anxiety disorders and is closely associated with elevated intolerance of uncertainty (IU) levels. However, the underlying mechanisms are unclear. Considering the inconsistency of previous results and the high sensitivity of IU to uncertainty, the present study investigated the effect of IU on threat generalisation in predictable and unpredictable conditions. We compared self-reported unconditioned stimuli (US) expectancy and event-related potentials (ERPs) during generalisation in high IU (n = 34) and low IU (n = 35) participants. The results indicated that high IU was associated with higher US expectancy for generalisation stimuli (GS) than with low IU. At the electrophysiological level, compared to low IU, high IU showed increased P1 to ambiguous GS as well as decreased early late positive potential (LPP) to GS in unpredictable conditions, and no differential response to GS in late LPP in predictable conditions. These findings suggest that IU enhances threat generalisation and may be related to increased early automatic attention to ambiguous stimulus and inadequate late elaborate processing in a high uncertainty context. These findings might contribute to the treatment of mood disorders characterized by high IU.

Revisiting uncertainty as a felt sense of unsafety: The somatic error theory of intolerance of uncertainty

Intolerance of uncertainty (IU) has gained widespread interest as a construct of broad interest from both transdiagnostic and trans-situational perspectives. We have approached this article inspired by the curiosity, clinical observation, consideration of different theoretical perspectives, speculation, optimism and indeed fun that can be seen in S. J. Rachman's work. We address some of what we know about IU before considering one way of conceptualizing IU from the standpoint of a felt sense or embodied experience. In the first part, we start with Woody and Rachman's (1994) observations of people with GAD. Second, we consider some key findings from the literature. Third, we consider two important perspectives on uncertainty, namely, Brosschot et al.'s (2016, 2018) influential Generalized Unsafety Theory of Stress and uncertainty as an emotion. In the second part, backing our clinical hunch about the importance of the felt sense of uncertainty, we consider IU from the perspective of interoception and the somatic error theory of anxiety (Khalsa & Feinstein, 2018). We propose the somatic error theory of intolerance of uncertainty, which places the experience of uncertainty at the heart of our understanding of intolerance of uncertainty. This is followed by predictions, unresolved questions, and potential clinical implications. Finally, we revisit Woody and Rachman's (1994) suggestions for treatment as internalizing "a sense of safety in a range of circumstances (p. 750)" and update this from the perspective of the felt sense of uncertainty. We finish by suggesting that uncertainty can be tolerated, perhaps accepted, and even embraced.

Uncertainty aversion predicts the neural expansion of semantic representations

Correctly identifying the meaning of a stimulus requires activating the appropriate semantic representation among many alternatives. One way to reduce this uncertainty is to differentiate semantic representations from each other, thereby expanding the semantic space. Here, in four experiments, we test this semantic-expansion hypothesis, finding that uncertainty-averse individuals exhibit increasingly differentiated and separated semantic representations. This effect is mirrored at the neural level, where uncertainty aversion predicts greater distances between activity patterns in the left inferior frontal gyrus when reading words, and enhanced sensitivity to the semantic ambiguity of these words in the ventromedial prefrontal cortex. Two direct tests of the behavioural consequences of semantic expansion further reveal that uncertainty-averse individuals exhibit reduced semantic interference and poorer generalization. Together, these findings show that the internal structure of our semantic representations acts as an organizing principle to make the world more identifiable.

The relationship between social anxiety and self-injury of junior high school students: Mediation by intolerance of uncertainty and moderation by self-esteem

Objective

The problem of adolescents' self-injury has gradually attracted social attention, however, a lack of research exists on the internal mechanism between social anxiety and self-injury. This study explored the relationship between social anxiety and self-injury in Chinese junior high school students.

Method

An adolescent self-injury questionnaire, social anxiety scale, intolerance of uncertainty questionnaire and self-injury questionnaire were used to survey 614 junior high school students.

Results

The results showed that: (1) social anxiety had a significant positive predictive effect on self-injury; (2) intolerance of uncertainty had a significant mediating effect between social anxiety and self-injury; and (3) self-esteem had a significant moderating effect on the mediating effect of intolerance of uncertainty.

Conclusion

The study suggested that social anxiety in junior high school students has an impact on self-injury through mediation of intolerance of uncertainty and modulation of self-esteem.

Intolerance of uncertainty and neural measures of anticipation and reactivity for affective stimuli

Intolerance of uncertainty (IU) is a transdiagnostic construct referring to the aversive interpretation of contexts characterized by uncertainty. Indeed, there is a growing body of research examining individual differences in IU and how these are associated with emotional anticipation and reactivity during periods of certainty and uncertainty, however, how these associations are reflected via neurophysiological indices remain understudied and poorly understood. The present study examined the relationship between self-reported IU and neurophysiological measures of emotional anticipation and reactivity, namely stimulus preceding negativity (SPN) and late positive potential (LPP), and self-report measures of emotional experiences. These measures were captured during an S1-S2 picture viewing tasks in which participants were presented with cues (S1) that either indicated the affective valence of upcoming picture (S2) or provided no information about the valence. Findings here provide evidence for significant associations between SPN amplitude and IU scores during uncertain and certain-positive cueing conditions, and significant associations between LPP amplitude and IU scores during both certain- and uncertain-negative picture viewing conditions that appear driven by prospective IU sub-scores. These positive associations between IU and SPN amplitude are suggestive of heightened emotional anticipation following S1 cues, while positive associations between IU and LPP are suggestive of heightened emotional reactivity following S2 images. These findings are discussed in detail relative to existing IU literature, and potential implications of these findings.

Intolerance of uncertainty and functional connectivity of the anterior insula during anticipation of unpredictable reward

Individuals with high intolerance of uncertainty (IU) tend to display maladaptive cognitive, behavioral, physiological, and/or neural responses during anticipation of uncertain or ambiguous outcomes, both positive and negative in valence. Importantly, high IU has been proposed as a key transdiagnostic phenotypic risk factor for the onset and maintenance of several psychiatric disorders. Within the context of reward processing, high IU has been related to dysfunctional reward anticipation, which may be mediated by hyperactive anterior insula (AIC) response to uncertainty. The present study further investigated the relationship between the AIC and IU by examining the association between individual differences in IU and task-based functional connectivity of the right AIC using functional magnetic resonance imaging (fMRI). Participants (N = 171) completed a self-report measure of IU and a reward anticipation task during fMRI. Generalized psychophysiological interaction (gPPI) analyses were performed with a seed in the right AIC. In the U-threat model, we found that greater self-reported levels of IU were correlated with increased functional connectivity between the right AIC and the dorsal anterior cingulate cortex (dACC) and the right dorsolateral prefrontal cortex (dlPFC). In the P-threat model, we did not find these associations, perhaps indicating that they may be more robust during uncertainty. These preliminary findings suggest that parts of salience and central executive control networks may be impacted by and underlie the expression of IU. Future studies should examine the generalizability of these findings to clinical populations and investigate how disruption of these functional networks may contribute to psychopathology.

Intolerance of uncertainty heightens negative emotional states and dampens positive emotional states

Individuals high in self-reported Intolerance of Uncertainty (IU) tend to view uncertainty as unbearable and stressful. Notably, IU is transdiagnostic, and high levels of IU are observed across many different emotional disorders (e.g., anxiety, depression). Research has primarily focused on how IU evokes and modulates emotional states such as fear and anxiety. However, recent research suggests that IU may have relevance for a broader range of emotional states. Here, an online survey was conducted to examine whether IU evokes and modulates a range of negative (e.g., fear/anxiety, sadness/upset, anger/frustration, disgust) and positive (e.g., happiness/joy, excitement/enthusiasm, surprise/interest) emotional states. Findings within a community sample (n = 231) revealed that individuals with higher levels of IU report: (1) that uncertainty in general and uncertainty under ambiguity are more likely to evoke negative emotional states and less likely to evoke positive emotional states, (2) that uncertainty under risk is less likely to evoke positive emotional states, and (3) that uncertainty heightens existing negative emotional states and dampens existing positive emotional states. Importantly, these IU-related findings remained when controlling for current experiences of general distress, anxious arousal, and anhedonic depression. Taken together, these findings suggest that IU is involved in evoking and modulating a wide array of emotional phenomena, which likely has relevance for transdiagnostic models and treatment plans for emotional disorders.

Intolerance of uncertainty, anxiety sensitivity, and health anxiety during the COVID-19 pandemic: Exploring temporal relationships using cross-lag analysis

Intolerance of uncertainty (IU) and anxiety sensitivity (AS) have been widely discussed and explored as factors that may contribute to health anxiety. We propose that IU and AS are salient issues for many during the COVID-19 pandemic, and may play a role in the development or exacerbation of health anxiety during the pandemic. Studies have examined links between IU and AS with health anxiety during the pandemic, but these relationships have not been tested together using a longitudinal study design. In the present study, measures of IU, AS, and health anxiety were collected from 301 adults at two time points 6 months apart during (early stages of) the COVID-19 pandemic using an online survey platform. Cross-lagged analysis was utilized to simultaneously estimate cross-sectional and longitudinal associations between these three variables. Robust cross-sectional associations were observed, and IU prospectively predicted changes in both health anxiety and AS. No other statistically significant prospective associations emerged. Present findings support the putative role of IU in health anxiety, suggesting that some observed links between AS and health anxiety could be driven by shared variance with IU. IU may be an important factor to monitor and target in health anxiety interventions during the pandemic.

COVID-19 pandemic and tourism: The impact of health risk perception and intolerance of uncertainty on travel intentions

Understanding tourist behavior during and after major tourism crises is essential to help destinations recover. The COVID-19 pandemic - a period of uncertainty and risk - makes it relevant to assess factors that influence travel intentions. There has been little research on tourist behavior during health crises and, in particular, on perceived health risk and uncertainty effects on travel intentions. This study was carried out at the beginning of the pandemic in Brazil and aims to investigate the role of health risk perception and intolerance of uncertainty on travel intentions for 2020 and 2021. We applied an online survey to 1150 Brazilian participants from April to May 2020. Our findings indicate that perceived COVID-19 severity, perceived probability of infection, and expected duration of the pandemic are significant predictors of travel intentions for both years. This paper contributes to a deeper understanding of crisis-resistant tourists' characteristics and provides insights for destinations' recovery.

Brain networks under uncertainty: A coordinate-based meta-analysis of brain imaging studies

In recent years, uncertainty has been extensively studied as a core factor in anxiety models. However, it remains unclear whether there is a stable brain circuitry to cope with uncertainty. Addressing this yet open question, we first distinguish uncertainty into three different states: risky, ambiguity, and threat anticipation. Then, we performed three meta-analyses of fMRI studies to identify those regions that are commonly activated by the three domains using activation likelihood estimation (ALE). The overlapping analyses of the three ALE maps revealed major conjunctions of the risk decision making, ambiguity decision making, and the threat anticipation in specifically the right insula. Contrast analysis further confirmed this finding. In addition, different uncertainty states also have different brain networks involved. Specifically, a large number of brain regions in the frontal-parietal cortex were recruited under ambiguity state, while subcortical gray matter regions were recruited under risk decision making, and the bilateral insula were closely associated with threat anticipation. Additionally, we assessed the co-activation pattern of identified regions using meta-analytic connectivity modeling (MACM) to investigate the potential network underlying the relationship of three domains. The MACM analysis further confirmed that different uncertain states have specific brain network basis. We concluded that the right insula serves as a convergent brain region for brain regions recruited for different uncertain states, and its co-activation pattern also corresponds to the brain network of the three uncertain states. This study is a preliminary attempt to further uncover the brain circuitry of anxiety models with uncertainty at their core.

Model-based prioritization for acquiring protection

Protection often involves the capacity to prospectively plan the actions needed to mitigate harm. The computational architecture of decisions involving protection remains unclear, as well as whether these decisions differ from other beneficial prospective actions such as reward acquisition. Here we compare protection acquisition to reward acquisition and punishment avoidance to examine overlapping and distinct features across the three action types. Protection acquisition is positively valenced similar to reward. For both protection and reward, the more the actor gains, the more benefit. However, reward and protection occur in different contexts, with protection existing in aversive contexts. Punishment avoidance also occurs in aversive contexts, but differs from protection because punishment is negatively valenced and motivates avoidance. Across three independent studies (Total N = 600) we applied computational modeling to examine model-based reinforcement learning for protection, reward, and punishment in humans. Decisions motivated by acquiring protection evoked a higher degree of model-based control than acquiring reward or avoiding punishment, with no significant differences in learning rate. The context-valence asymmetry characteristic of protection increased deployment of flexible decision strategies, suggesting model-based control depends on the context in which outcomes are encountered as well as the valence of the outcome.

The role of emotion dysregulation and intolerance of uncertainty in autism: Transdiagnostic factors influencing co-occurring conditions

BACKGROUND

Individuals with autism spectrum disorders (ASD) are more likely to have co-occurring psychiatric conditions such as depression and anxiety. Transdiagnostic constructs such as intolerance of uncertainty (IU) and emotion dysregulation (ED) have both been shown to be individually associated with depression and anxiety in those with ASD.

AIMS

The current study examined the relationship between IU and ED, depression, and anxiety in an ED treatment-seeking sample and examined whether ED acts as a mediator between IU-depression and IU-anxiety.

METHODS AND PROCEDURES

We examined baseline scores for 78 adolescents and young adults (12-21 years old) who were participating in an ED treatment. We assessed for correlations between IU, Reactivity and Dysphoria, anxiety, and depression symptoms, and then conducted mediation analyses to determine whether Reactivity and Dysphoria functioned as a mediator in IU- anxiety and IU- depression relationships.

OUTCOMES AND RESULTS

Concordant with prior research, ED, IU, anxiety, and depression scores were correlated. Both Reactivity and Dysphoria were found to mediate both IU-depression and IU-anxiety.

CONCLUSIONS AND IMPLICATIONS

Findings suggest that ED contributes to how IU affects psychopathology. Furthermore, both IU and ED may be pertinent treatment targets for individuals with depression or anxiety and ASD.

Resting-state heart rate variability (HRV) mediates the association between perceived chronic stress and ambiguity avoidance

Chronic stress is associated with profound behavioral and physiological alterations, including intolerance to uncertainty and reduced resting-state heart-rate-variability (HRV). Critically, uncertainty may arise in situations with known probabilities (risk) or unknown probabilities (ambiguity). Whether associations between chronic stress and decision-making under uncertainty are dependent on the specific type of uncertain decisions, and whether physiological alterations play a role in these putative associations is not yet clear. Here, ninety-two healthy adults that exhibit various levels of perceived chronic stress underwent resting-state HRV recording before completing a behavioral task that involves decision-making under either risk or ambiguity. Computational modelling quantified participants' behavioral attitudes of approach and avoidance separately for risk and ambiguity. Results indicate, as expected, that perceived chronic stress is positively associated with intolerance to uncertainty and negatively associated with resting-state HRV. Contrary to expectations, behavioral attitudes towards risk and ambiguity were not directly associated with perceived chronic stress, yet HRV fully mediated the association between chronic stress and ambiguity avoidance. Taken together and given the direction of the associations, elevated HRV despite chronic stress may foster adaptive behavior in the form of avoiding ambiguous situations, and hence contribute to reduced exposure to uncertainty and to lower levels of allostatic load.

Effects of early childhood behavioral inhibition and parental anxiety disorder on adolescents' startle response to predictable and unpredictable threat

Numerous studies in children, adolescents and adults have reported that anxiety disorders and symptoms are associated with greater threat-potentiated startle responses. This suggests that it may also be related to risk factors that have been implicated in the genesis of anxiety disorders. Therefore, we examined the roles of early childhood temperamental behavioral inhibition (BI) and parental history of anxiety disorders in predicting threat-potentiated startle response in a community sample of 346 adolescents. Parental history of anxiety disorders moderated the effects of BI on subsequent startle responses. For both total startle response and unpredictable threat startle potentiation, higher levels of BI at age 3 predicted larger startle responses at age 15, but only among offspring of parents with a history of anxiety disorders. Among offspring of parents with no lifetime history of anxiety disorder, BI was unrelated to startle magnitude. These findings were evident even after adjusting for youth's biological sex, concurrent anxiety symptoms, and lifetime history of anxiety disorders. In contrast, neither BI nor parental anxiety significantly predicted startle potentiation to predictable threat. These findings have implications for tracing pathways to the development of anxiety disorders.

International air travel attitude and travel planning lead times across 45 countries in response to the COVID-19 pandemic

This paper explores global differences in travel risk perception based on i) attitudes towards travel abroad, and ii) the time required to plan travel. Baseline data from 2019 is compared with data from 2020, the first year of the COVID-19 pandemic. A methodology based on Big Data is developed through the Skyscanner metasearch engine, working with 20,756 million flight searches and 1979 million flight picks worldwide. We conduct an exploratory analysis by region, followed by a cluster analysis of 45 countries. We argue that the findings respond to uncertainty avoidance, with clear differences between Europe, America and Asia-Pacific. This knowledge has marketing implications for tourist destinations in terms of what marketing messages to convey and the best time to introduce marketing campaigns for each country or group of countries, so that the opportunity for reactivation of tourism is maximised.

Correlates of Dampening and Savoring in Generalized Anxiety Disorder

Chronic worry and generalized anxiety disorder (GAD) symptoms are associated with infrequent savoring, and high dampening, of positive emotions. The goal of the present study was to investigate the indirect role of GAD-relevant processes, including intolerance of uncertainty (IU), fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation, in the relationship between GAD symptom severity and the tendency to engage in dampening and not savor positive emotions. Community participants (N = 233) completed questionnaires online.

In separate models, IU, fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation fully mediated the relationships between GAD symptom severity and greater dampening and lower savoring. However, controlling for depression, only IU remained a significant mediator. A post hoc latent analysis of the mediators provided support for an underlying construct that may reflect intolerance of uncomfortable states. Intolerance of uncomfortable states was found to significantly mediate the relationship between GAD symptoms and greater dampening and lower savoring. Difficulty withstanding uncertainty may be particularly relevant in understanding why people with elevated GAD symptoms engage in efforts to avoid experiencing positive emotions. Further, the findings suggest that there may be a common factor underlying a variety of GAD-associated constructs reflecting a broad intolerance of uncomfortable inner states. Theoretical and clinical implications are discussed.

Trait Intolerance of Uncertainty Is Associated with Decreased Reappraisal Capacity and Increased Suppression Tendency

The COVID-19 pandemic has been a time of great uncertainty for the general population and highlights the need to understand how attitudes towards uncertainty may affect well-being. Intolerance of uncertainty is a trait associated with worry, anxiety, and mood disorders. As adaptive emotion regulation supports well-being and mental health, it is possible that intolerance of uncertainty is also associated with the ability and tendency to regulate emotions. However, the relationships between intolerance of uncertainty and widely studied cognitive emotion regulation strategies - such as reappraisal and suppression - have received little attention. In two studies that recruited participants online from the United States, we tested the hypotheses that higher trait intolerance of uncertainty would be associated with greater worry, decreased capacity and tendency to use reappraisal, and increased tendency to use suppression in daily life. Study 1 provided an initial test of our hypotheses. Study 2 was a confirmatory, preregistered study that replicated findings in a young adult sample, demonstrating that scores on the Intolerance of Uncertainty Scale (IUS) were associated with greater COVID-related worry, decreased capacity to regulate negative emotions on a task that manipulated the use of reappraisal, and greater self-reported use of suppression in daily life. Together, these results indicate that intolerance of uncertainty is associated with the capacity and tendency to use emotion regulation strategies important for well-being.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-022-00115-8.

The relationships of family income and caste-status with religiousness: Mediation role of intolerance of uncertainty

The relationship between lower socioeconomic status (SES) and religiousness is well known; however, its (psychological mediation) mechanism is not clear. In the present study, we studied the mediation role of intolerance of uncertainty (IU; a personality measure of self-uncertainty) in the effect of SES on religiousness and its dimensions (i.e., believing, bonding, behaving, and belonging), in two different samples (students sample, N = 868, and community sample, N = 250), after controlling the effects of factors like age, sex, handedness, and self-reported risk-taking. The results showed that IU mediated the effects of lower family income and lower caste status (in students’ sample only) on religiousness and its dimensions; higher caste status had a direct effect on religiousness (and its dimensions), and; among the sub-factors of IU, only prospective IU affected religiousness. Thus, along with showing that IU is a mediator of the effects of lower family income and lower caste status on religiousness, the present study supports the contention that religiousness is a latent variable that varied factors can independently initiate. Moreover, the present study suggests a nuanced model of the relationship between the hierarchical caste system and religiousness.

The role of intolerance of uncertainty when solving the exploration-exploitation dilemma

When making behavioral decisions, individuals need to balance between exploiting known options or exploring new ones. How individuals solve this exploration-exploitation dilemma (EED) is a key research question across psychology, leading to attempting to disentangle the cognitive mechanisms behind it. A potential predictive factor of performance in an EED is intolerance of uncertainty (IU), an individual difference factor referring to the extent to which uncertain situations are reported to be aversive. Here, we present the results of a series of exploratory analyses in which we tested the relationship between IU and performance in an EED task. For this, we compiled data from 3 experiments, in which participants received the opportunity to exploit different movements in order to avoid a painful stimulus and approach rewards. For decomposing performance in this task, we used different computational models previously employed in studies on the EED. Then, the parameters of the winning model were correlated with the scores of participants in the IU scale. Correlational and cluster analyses, within both frequentists and Bayesian frameworks, did not provide strong evidence for a relation between EED and IU, apart from the decay rate and the subscale "tendency to become paralyzed in the face of uncertainty". Given the theoretical relation between EED and IU, we propose research with different experimental paradigms.

Work Expectations, Depressive Symptoms, and Passive Suicidal Ideation Among Older Adults: Evidence From the Health and Retirement Study

BACKGROUND AND OBJECTIVES

Employment and work transitions (e.g., retirement) influence mental health. However, how psychosocial contexts such as anticipation and uncertainty about work transitions, irrespective of the transitions themselves, relate to mental health is unclear. This study examined the relationships of work expectations with depressive symptoms, major depression episodes (MDE), and passive suicidal ideation over a 10-year period among the "Baby Boom" cohort of the Health and Retirement Study.

RESEARCH DESIGN AND METHODS

Analysis was limited to 13,247 respondents aged 53-70 observed from 2008 to 2018. Past-year depressive symptoms, MDE, and passive suicidal ideation were indexed using the Composite International Diagnostic Interview-Short Form. Expectations regarding working full-time after age 62 were assessed using a probability scale (0%-100%). Mixed-effect logistic regressions with time-varying covariates were used to assess the relationship of work expectations with mental health, accounting for demographics, health status, and functioning, and stratified by baseline employment status.

RESULTS

At baseline, higher work expectations were inversely associated with depressive symptoms. Longitudinally, higher expectations were associated with lower odds of depressive symptoms (odds ratio [OR] = 0.93, 95% CI: 0.91, 0.94). This association was more pronounced among respondents not working at baseline (ORNot working = 0.93 vs ORWorking = 0.96). Greater uncertainty (i.e., expectations near 50%) was also inversely associated with depressive symptoms. Results were similar for past-year MDE and passive suicidal ideation.

DISCUSSION AND IMPLICATIONS

Expectations (overall likelihood and uncertainty), as indicators of psychosocial context, provide insight into the processes that link work transitions with depression risk.

The role of relief, perceived control, and prospective intolerance of uncertainty in excessive avoidance in uncertain-threat environments

Excessive avoidance is a key feature of pathological anxiety. However, the precise mechanisms underlying the development of excessive avoidance are still unknown. In the present study, we tested the hypothesis that excessive avoidance, especially in individuals with high Intolerance of Uncertainty (IU) is aimed at distress reduction via the enhancement of subjective perceived control in uncertain-threat environments. In our experiment, participants learned to avoid an uncertain aversive sound through a discriminated free operant procedure. In a later test phase in extinction, we manipulated the amount of avoidance responses available per trial by creating a limited and an unrestricted response condition. Nonetheless, the aversive sound could be effectively avoided in both conditions. We measured response frequency, avoidance confidence ratings and anxiety-predisposing traits such as intolerance of uncertainty, trait anxiety and distress tolerance. The degree of distress suffered during trials was inferred from post-trial relief ratings that were requested after trials in which the aversive sound had been omitted. In the avoidance acquisition phase, we found a positive association between prospective intolerance of uncertainty (P-IU) and the decline rate of distress. This relationship was not significant, however, when inhibitory intolerance of uncertainty (I-IU) was controlled for. At test, we found that the increase in avoidance responses led to distress reduction through the enhancement of avoidance confidence. Finally, we found a significant modulating role of P-IU in the effect of response limit on distress reduction that lends further support to our hypothesis. Specifically, P-IU was positively associated with the effect of response limit on distress. However, such modulating role was not significant when controlling for trait anxiety or I-IU.

Impact of the COVID-19 pandemic on psychological distress and biological rhythm in China’s general population: A path analysis model

Objective

When facing major emergency public accidents, men and women may react differently. Our research aimed to assess the influence of gender difference on social support, information preference, biological rhythm, psychological distress, and the possible interaction among these factors during the COVID-19 pandemic.

Methods

In this cross-sectional study, 3,237 respondents aged 12 years and older finished the online survey. Levels of social support, information preference, biological rhythm, and psychological distress were assessed using validated scales. A path analysis was conducted to explore possible associations among these variables.

Results

The path analysis indicated that women with high levels of social support had a lower possibility of biological rhythm disorders and lower levels of somatization symptoms of psychological distress during the COVID-19 pandemic. The influence of social support on somatization symptoms was exerted via biological rhythm. Women tended to believe both negative and positive information, while men preferred more extreme information.

Conclusion

Our results highlighted gender difference in study variables during the COVID-19 pandemic and the importance of social support in alleviating psychological distress and biological rhythm disorders. Moreover, we confirmed that information preference differed significantly by somatization symptoms of psychological distress, suggesting extra efforts to provide more individualized epidemic information. Longitudinal research is required to further explore casual inferences.

A rare scare: The role of intolerance of uncertainty in startle responses and event-related potentials in anticipation of unpredictable threat

Intolerance of uncertainty (IU) represents a transdiagnostic risk factor for internalizing psychopathology. However, little is known regarding its psychophysiological correlates. IU is thought to render individuals hypersensitive to threatening events, even if the occurrence probability is low. To test this, we recruited 90 students who completed two NPU-threat tests separating temporal unpredictability from probabilistic unpredictability (i.e., probability of occurrence): First, a NPU version in which the timing of threat (i.e., shock) was either predictable or unpredictable but the shock probability was 100 % in each trial. Second, a probabilistic NPU version in which the timing of the shock was also either predictable or unpredictable, but the shock probability was 33 % in each trial. Startle reflex, event-related potentials N1 and P3 locked to auditory startle probes, and anxiety ratings were analyzed. As expected, temporally unpredictable threat modulated startle, N1, and anxiety ratings. IU predicted increased startle to lower shock probability, regardless of the temporal predictability. No evidence emerged for IU affecting N1 or P3. However, IU predicted anxiety ratings to threat conditions regardless of temporal or probabilistic predictability. Individual differences in IU shape startle responses to eventual threat: IU increases automatic defensive responding to unpredictable and potentially threatening situations if the threat probability is low. Individuals with higher IU may tend to "err on the side of caution" with a mismatch between physiological preparation and threat probability, such that the effects of IU are particularly observable in low threat probability conditions.

Intolerance of uncertainty and psychophysiological reactivity in anticipation of unpredictable threat in youth

OBJECTIVE

Intolerance of uncertainty (IU) is a key transdiagnostic feature of internalizing psychopathology. An increasing body of research suggests that IU is associated with increased psychophysiological reactivity in anticipation of unpredictable threat. However, most studies examining the psychophysiological correlates of IU have been conducted in adults. There is a critical need to understand the relationship between IU and psychophysiological reactivity in anticipation of unpredictable threat during adolescence, a key developmental period associated with increased exploration of situations with uncertain outcomes. Thus, the present study examined the association between (1) youth IU and (2) parental IU (as an indicator of risk) in relation to youth defensive motivation (startle reflex) and attention (startle probe N100 and P300) in anticipation of unpredictable threat.

METHODS

The sample included 193 13 to 22-year-old (M = 17.33, SD = 1.97) females and a biological parent. Participants and their parent completed a self-report measure of prospective and inhibitory IU. Youth startle potentiation, probe N100 enhancement, and probe P300 suppression (indicating increased attention to threat) were measured in anticipation of predictable and unpredictable threat.

RESULTS

Youth prospective IU and inhibitory IU were not related to youth psychophysiological reactivity to predictable or unpredictable threat. Greater parental prospective IU was associated with greater youth startle potentiation and probe N100 enhancement in anticipation of unpredictable threat.

CONCLUSION

The present study suggests that parental IU, but not concurrent IU, is associated with heightened defensive motivation and attentional engagement in anticipation of unpredictable threat in youth.

The Prevalence of Fear of Childbirth and Its Association With Intolerance of Uncertainty and Coping Styles Among Pregnant Chinese Women During the COVID-19 Pandemic

Background

Fear of childbirth (FOC) is one of the most common psychological symptoms among pregnant women and significantly relates to cesarean section, anxiety, and depression. However, it is not clear the prevalence and risk factors of FOC among Chinese pregnant women since the outbreak of the COVID-19 pandemic.

Aims

The objective of this study was to examine the associations between coping styles, intolerance of uncertainty, and FOC.

Method

From December 2021 to April 2022, a cross-sectional survey was conducted in two hospitals in China through convenient sampling. The cross-sectional survey was conducted among 969 pregnant women, which included the Childbirth Attitude Questionnaire (CAQ), Intolerance of Uncertainty Scale-12 (IUS-12), and Simplified Coping Style Questionnaire (SCSQ).

Results

The total prevalence of FOC was 67.8%. The percentages of women with mild (a score of 28-39), moderate (40-51), and severe FOC (52-64) were 43.6, 20.2, and 4.0%, respectively. The regression results indicated that primiparas, unplanned pregnancy, few spousal support, intolerance of uncertainty, and negative coping styles were significant risk factors of FOC. Women who adopt positive coping strategies experienced a lower level of childbirth fear.

Conclusion

These findings suggest that cultivating positive coping styles and obtaining sufficient childbirth information may be helpful for mothers' mental health. Regular screening assessment of perinatal psychological symptoms, such as the high level of intolerance of uncertainty and negative coping styles, should be adopted to reduce the risk of fear of childbirth.

Does educational stress mediate the relationship between intolerance of uncertainty and academic life satisfaction in teenagers during the COVID-19 pandemic?

The present study aims to investigate the mediator role of educational stress in the relationship between intolerance to uncertainty and academic life satisfaction among teenagers. The sample consisted of 257 female and 202 male high school students with an average age of 16.03 (SD = 1.21) continuing their education in the spring semester of the 2020-2021 academic year in Turkey. The data were collected via an online survey. Analyses revealed that intolerance of uncertainty directly and indirectly via educational stress affects the academic life satisfaction of teenagers. Educational stress partially mediates the relationship. It was also found that the full mediation model has a good fit with the data. The academic life satisfaction of teenagers was harmed by their tendencies in tolerating the uncertainties they have been facing during the COVID-19 pandemic and elevated levels of educational stress.

Aversive response to uncertainty as a mediator for the effect of a mindfulness intervention on symptoms of anxiety

THEORETICAL BACKGROUND

Intolerance of uncertainty plays a central role in anxiety and research suggests that it's an important treatment target. Investigating response to uncertainty using other dimensions than self-report, such as physiological responses, can further the effort to understand the role of uncertainty in anxiety more fully. Mindfulness interventions have become increasingly interesting in their application to anxiety, as they foster acceptance of unpleasant aspects of experience. The aims of the study were to examine whether a mindfulness intervention reduced response to uncertainty and anxiety symptoms, and to examine the associations between intolerance of uncertainty, physiological response to uncertainty, mindfulness and anxiety.

METHODS

Participants were 117 students who completed a two-week mindfulness or audiobook control intervention. At pre- and post-intervention assessments, measures of anxiety, mindfulness, and intolerance of uncertainty were completed and a threat-of-shock task assessing startle responding to unpredictable shock was administered.

RESULTS

Findings showed a significant effect of the intervention for social anxiety symptoms. Furthermore, intolerance of uncertainty mediated the effect of the intervention on symptoms for social anxiety and worry. No such effects were found for physiological response to uncertainty.

CONCLUSION

The study adds to the understanding of the role of response to uncertainty in anxiety as well as to its mechanistic role in the context of mindfulness practice. Implications and possible explanations for the non-significant main effects of the intervention on anxiety symptoms and physiological response to uncertainty are discussed.

Uncertain in the face of change: Lack of contingency shift awareness during extinction is associated with higher fear-potentiated startle and PTSD symptoms in children

Intolerance of uncertainty is a transdiagnostic risk factor for fear-related disorders and is associated with higher levels of anxiety in children and adolescents. It is unclear how uncertainty relates to development of psychopathology in children who have experienced trauma in early life. The present study used a fear-potentiated startle paradigm in children to examine associations between uncertainty (assessed as unawareness of a change in reinforcement during fear extinction) and symptoms of anxiety and posttraumatic stress disorder (PTSD), as well as startle potentiation to threat and safety cues. Results showed that unaware children had strong positive associations between trauma exposure and PTSD symptoms, whereas aware children did not. Uncertainty interacted with anxiety in that children who were both unaware and had higher anxiety displayed higher fear-potentiated startle to safety cues and did not show discrimination between threat and safety during fear conditioning. These results suggest that anxious children who persist in associating a threat cue with an aversive event during extinction, after repeated presentations of the no longer reinforced conditioned stimulus, may express psychophysiological phenotypes related to PTSD.

Unbalanced functional connectivity at rest affects the ERP correlates of affective prediction in high intolerance of uncertainty individuals: A high density EEG investigation

In a recent study we outlined the link between Intolerance of Uncertainty (IU) and the neural correlates of affective predictions, as constructed by the brain (generation stage) to prepare to relevant stimuli (implementation stage), and update predictive models according to incoming stimuli (updating stage). In this study we further explored whether the brain's functional organization at rest can modulate neural activity elicited within an emotional S1-S2 paradigm as a function of IU and uncertainty of S1-S2 contingencies. We computed resting state functional connectivity (RS-FC) from a 3-min resting period recorded with high density EEG, and we tested whether RS graph theory nodal measures (i.e., strength, clustering coefficient, betweenness centrality) predicted in-task ERP modulation as a function of IU. We found that RS-FC differently predicted in-task ERPs within the generation and updating stages. Higher IU levels were associated to altered RS-FC patterns within both domain-specific (i.e., right superior temporal sulcus) and domain-general regions (i.e., right orbitofrontal cortex), predictive of a reduced modulation of in-task ERPs in the generation and updating stages. This is presumably ascribable to an unbalancing between synchronization and integration within these regions, which may disrupt the exchange of information between top-down and bottom-up pathways. This altered RS-FC pattern may in turn result in the construction of less efficient affective predictions and a reduced ability to deal with contextual uncertainty in individuals high in IU.

Using what we know about threat reactivity models to understand mental health during the COVID-19 pandemic

The COVID-19 pandemic has been accompanied by unprecedented levels of stress and threats in a variety of domains (e.g., health, livelihood). Individual differences in threat reactivity may explain why some individuals are at elevated risk for the development or maintenance of psychopathology during the COVID-19 pandemic. This article describes several prominent models, mechanisms, and components of threat reactivity (e.g., appraisals, intolerance of uncertainty, avoidance) and discusses how they might help improve understanding of changes in psychopathology during and following the COVID-19 pandemic.

Life goals and proactive career behaviors: The mediating role of visions about the future and the moderating role of intolerance of uncertainty

Dominated by uncertainties, today's work world pushed university students to exhibit proactive career behaviors. Thus, this created a need for more research conducted to determine the variables associated with proactive career behaviors, on the grounds that additional research may contribute to an increase in proactive career behaviors. In this context the study explored the mediating role of visions about the future and the moderating role of intolerance of uncertainty in the relationship between university students' life goals and their proactive career behaviors. The study was carried out with 519 students (299 females and 220 males) studying at a university in the Eastern Mediterranean Region of Turkey. The Scale of Setting Life Goals with Respect to Positive Psychotherapy, the Visions about the Future Scale, the Career Engagement Scale, and the Intolerance of Uncertainty Scale were employed as data collection tools. Data were analyzed using correlation analysis, structural equation modeling methods, and regression analysis based on the bootstrap method. The correlation analysis revealed a positive relationship between proactive career behaviors, life goals and visions about the future, and a negative relationship between proactive career behaviors and intolerance of uncertainty. Furthermore, the analyses put forth that visions about the future have a mediating role in the relationship between life goals and proactive career behaviors and that intolerance of uncertainty has a moderating role in the same relationship. Increasing university students' life goals and their visions about the future and reducing their intolerance of uncertainty will help them exhibit proactive career behaviors.

Error Processing and Pain: A New Perspective

Errors put organisms in danger. Upon error commission, error processing allows for the updating of behavior that proved ineffective in light of the current context and goals, and for the activation of behavioral defensive systems. Pain, on the other hand, signals actual or potential danger to one's physical integrity and, likewise, motivates protective behavior. These parallels suggest the existence of cross-links between pain and error processing but so far their relationship remains elusive. In this review, we tie together findings from the field of pain research with those from electroencephalography studies on error processing [specifically the Error Related Negativity (ERN) and Positivity (Pe)]. More precisely, we discuss three plausible associations: Firstly, pain may enhance error processing as it increases error salience. Secondly, persons fearful of pain may be particularly vigilant towards painful errors and thus show a stronger neural response to them. Thirdly, the ERN as a component of the neural response to error commission is considered an endophenotype of threat sensitivity. As high sensitivity to pain threats is known to incite avoidance behavior, this raises the intriguing possibility that neural signatures of error processing predict pain-related protective behaviors, such as avoidance. We propose an integration of these findings into a common framework to inspire future research. Perspectives Inspired by research in anxiety disorders, we discuss the potential bi-directional relationships between error processing and pain, and identify future directions to examine the neural and psychological processes involved in acute and chronic pain and respective avoidance behavior.

Hyperreactivity to uncertainty is a key feature of subjective cognitive impairment

With an increasingly ageing global population, more people are presenting with concerns about their cognitive function, but not all have an underlying neurodegenerative diagnosis. Subjective cognitive impairment (SCI) is a common condition describing self-reported deficits in cognition without objective evidence of cognitive impairment. Many individuals with SCI suffer from depression and anxiety, which have been hypothesised to account for their cognitive complaints. Despite this association between SCI and affective features, the cognitive and brain mechanisms underlying SCI are poorly understood. Here, we show that people with SCI are hyperreactive to uncertainty and that this might be a key mechanism accounting for their affective burden. Twenty-seven individuals with SCI performed an information sampling task, where they could actively gather information prior to decisions. Across different conditions, SCI participants sampled faster and obtained more information than matched controls to resolve uncertainty. Remarkably, despite their ‘urgent’ sampling behaviour, SCI participants were able to maintain their efficiency. Hyperreactivity to uncertainty indexed by this sampling behaviour correlated with the severity of affective burden including depression and anxiety. Analysis of MRI resting functional connectivity revealed that SCI participants had stronger insular-hippocampal connectivity compared to controls, which also correlated with faster sampling. These results suggest that altered uncertainty processing is a key mechanism underlying the psycho-cognitive manifestations in SCI and implicate a specific brain network target for future treatment.

Uncertainty Makes Me Emotional: Uncertainty as an Elicitor and Modulator of Emotional States

Uncertainty and emotion are an inevitable part of everyday life and play a vital role in mental health. Yet, our understanding of how uncertainty and emotion interact is limited. Here, an online survey was conducted (n = 231) to examine whether uncertainty evokes and modulates a range of negative and positive emotions. The data show that uncertainty is predominantly associated with negative emotional states such as fear/anxiety. However, uncertainty was also found to modulate a variety of other negative (i.e., sadness/upset, anger/frustration, and confusion) and positive (i.e., surprise/interest and excited/enthusiastic) emotional states, depending on the valence of an anticipated outcome (i.e., negative and positive) and the sub parameter of uncertainty (i.e., risk and ambiguity). Uncertainty increased the intensity of negative emotional states and decreased the intensity of positive emotional states. These findings support prior research suggesting that uncertainty is aversive and associated with negative emotional states such as fear and anxiety. However, the findings also revealed that uncertainty is involved in eliciting and modulating a wide array of emotional phenomena beyond fear and anxiety. This study highlights an opportunity for further study of how uncertainty and emotion interactions are conceptualised generally and in relation to mental health.

Event-related potentials to acoustic startle probes during unpredictable threat are associated with individual differences in intolerance of uncertainty

Individual differences in sensitivity to unpredictable threat may be a critical mechanism for internalizing psychopathology phenotypes. The present study examined whether the startle probe-elicited N100 and P300 during unpredictable threat - two event-related potentials indexing early and elaborative attentional processing of unpredictable threat - may be endophenotypes for internalizing psychopathology, including fear and distress/misery disorders and intolerance of uncertainty (IU), a clinical trait that is transdiagnostically associated with internalizing disorders. A large sample of adult siblings (N = 375) completed the no, predictable, and unpredictable threat task, during which the N100 and P300 were recorded. Relative to the no threat condition, N100 was more strongly enhanced in anticipation of unpredictable than predictable threat while P300 was suppressed to both predictable and unpredictable threat. While neither N100 enhancement nor P300 suppression to unpredictable threat was associated with fear or distress/misery disorders, they were negatively linked to inhibitory IU (a facet of IU). Thus, individuals high in inhibitory IU showed reduced attentional engagement with the threatening context when it was unpredictable. Further, N100 enhancement and, to a lesser degree, P300 suppression to unpredictable threat showed familial aggregation - a key criterion for determining whether a biomarker is an endophenotype. In sum, N100 enhancement and P300 suppression to unpredictable threat may be endophenotypes for dimensional measures of internalizing psychopathology.