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Intolerance Of Uncertainty

Information Handout

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives where they seek excitement. Other people find uncertainty aversive, stressful, or distressing, and don’t function as well in uncertain situations. They might hold negative beliefs about uncertainty and may try to avoid it, or use strategies to try to control or eliminate it. Psychologists label these reactions as ‘intolerance of uncertainty’ (IU). The Intolerance Of Uncertainty information handout describes IU in the context of worry, and outlines some of the unhelpful strategies that people high in IU tend to use to control how they feel.

Intolerance Of Uncertainty CBT Handout Intolerance Of Uncertainty CBT Handout Intolerance Of Uncertainty CBT Handout Intolerance Of Uncertainty CBT Handout

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Description

Intolerance of uncertainty can be viewed as a dispositional characteristic that results from a set of negative beliefs about uncertainty and its implications. (Dugas & Robichaud, 2007)

Intolerance of uncertainty involves the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events. (Dugas, Buhr, & Ladouceur, 2004)

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives where they seek excitement: they often score highly on personality measures of ‘openness to experience’. Other people find uncertainty aversive, stressful, or distressing, and don’t function as well in uncertain situations. They might hold negative beliefs about uncertainty and may try to avoid it, or use strategies to try to control or eliminate it. Psychologists label these reactions as ‘intolerance of uncertainty’. Commonly-used metaphors are that people who are intolerant of uncertainty are behave as though they have a phobia of uncertainty, or as though they are ‘allergic to uncertainty’.

Intolerance of uncertainty (IU) was first described in individuals suffering from Generalized Anxiety Disorder (GAD). Many behaviors associated with GAD, such as worry and avoidance, can be framed as attempts to increase ones sense of certainty: worry is the attempt to look ahead and foresee potentially negative consequences, avoidance and ‘sticking to what is known and safe’ reduces exposure to the unknown. More recent research has recognised intolerance of uncertainty as a transdiagnostic risk factor for many clinical conditions including anxiety, depression, obsessive-compulsive disorder, and eating disorders (Carleton et al, 2012; Toffolo et al, 2014; Renjan et al, 2016).

The Intolerance Of Uncertainty information handout describes IU in the context of worry, and outlines some of the unhelpful strategies that people high in IU tend to use to control how they feel. One important aspect of treatment for GAD is the effort to increase client’s willingness to tolerate uncertainty, sometimes framed as the challenge of ‘embracing uncertainty’.

Instructions

This is a Psychology Tools information handout. Suggested uses include:

  • Client handout – a psychoeducation resource.
  • Discussion point – to provoke a discussion and explore your client’s beliefs.
  • Therapist learning tool – to improve your familiarity with a psychological construct.
  • Supervision tool – to develop formulations and knowledge.
  • Teaching resource – a learning tool during training.

References

  • Carleton, R. N., Mulvogue, M. K., Thibodeau, M. A., McCabe, R. E., Antony, M. M., Asmundson, G. J. (2012). Increasingly certain about uncertainty: intolerance of uncertainty across anxiety and depression. Journal of Anxiety Disorders, 26(3), 468–79. 
  • Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: advances in research and practice (pp. 143–163). New York: Guilford Press.
  • Dugas, M. J., & Robichaud, M. (2007). Cognitive-behavioural treatment for generalized anxiety disorder: from science to practice. New York: Routledge.
  • Renjan, V., McEvoy, P. M., Handley, A. K., Fursland, A. (2016). Stomaching uncertainty: relationships among intolerance of uncertainty, eating disorder pathology, and comorbid emotional symptoms. Anxiety Disorders, 41, 88–95.
  • Toffolo, M. B., van den Hout, M. A., Engelhard, I. M., Hooge, I. T., Cath, D. C. (2014). Uncertainty, checking, and intolerance of uncertainty in subclinical obsessive compulsive disorder: an extended replication. Journal of Obsessive Compulsive and Related Disorders, 3(4), 338–44.
  • Wilkinson, A., Meares, K., Freeston, M. 2011. CBT for worry & generalised anxiety disorder. London: Sage.