The DOI matches its Crossref record; 118 of the 121 references it cites were found in a registry or an index.
Intolerance of uncertainty: Neural and psychophysiological correlates of the perception of uncertainty as threatening
Abstract
Intolerance of uncertainty (IU) reflects the perception of uncertainty as threatening, regardless of the true probability of threat. IU is elevated in various forms of psychopathology, uniquely associated with anxiety and depression symptoms after controlling for related constructs, and prospectively predicts symptoms. Given the ubiquity of uncertainty in daily life and the clinical implications of IU, recent work has begun to investigate the neural and psychophysiological correlates of IU. This review summarizes the existing literature and integrates findings within a mechanistic neural model of responding to uncertainty. IU is associated with heightened reactivity to uncertainty reflected in greater activity of the anterior insula and amygdala, alterations in neural responses to rewards and errors evident in event-related potentials, a mixed pattern of startle responses to uncertain threat, and deficiencies in safety learning indexed by startle and skin conductance responding. These findings provide evidence of disruptions in several domains of responding to uncertainty, threat, and reward associated with IU that may confer risk for the development of psychopathology. Significant attention is devoted to recommendations for future research, including consideration of the complex interplay of IU with emotion regulation, cognitive control, and reward processing.
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In the citing paper
“whereas other research has not found an association between IU and startle potentiation or subjective responses in an unpredictable threat-context (Bennett, Dickmann, & Larson, 2018; see Tanovic, Gee, & Joormann, 2018 for a recent review of the relationship between IU and startle).”
From Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety (2021) · cites this paper as Tanovic, Gee, & Joormann, 2018
In the citing paper
“Theoretical models have considered uncertainty a central feature in the understanding of psychopathology, especially in anxiety-related disorders. 5”
From Psychometric properties of the brazilian intolerance of uncertainty scale – short version (Ius-12) (2020) · cites this paper as [5]
In the citing paper
“With regard to anxiety-related disorders per se, IU has been related to social anxiety, generalized anxiety disorder, panic disorder, agoraphobia and hypochondria, PTSD, and major depressive disorder. 5,18,19-21”
From Psychometric properties of the brazilian intolerance of uncertainty scale – short version (Ius-12) (2020) · cites this paper as [5]
In the citing paper
“Accordingly, the IUS-12 has shown suitable psychometric properties and has been considered a useful tool in the transdiagnostic evaluation of trait IU. 5”
From Psychometric properties of the brazilian intolerance of uncertainty scale – short version (Ius-12) (2020) · cites this paper as [5]
In the citing paper
“and increased physiological arousal (Morriss, Abend, et al., 2023; Tanovic et al., 2018)”
From Intolerance of uncertainty, paranoia, and prodromal symptoms: Comparisons between a schizophrenia spectrum disorder, anxiety disorder and non‐clinical sample. (2025) · cites this paper as Tanovic et al., 2018
In the citing paper
“IU has been identified as a critical transdiagnostic risk factor and component of internalizing psychopathology across a range of mental disorders, such as generalized panic and social anxiety disorders, obsessive-compulsive disorder, depression, eating disorders, and others [87-89].”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [88]
In the citing paper
“The studies that have examined both reward and threat cue processing do suggest highly overlapping neurobiological and psychological processing abnormalities in anxiety disorders that may generally encompass the attribution of value and recruitment of attention to valenced cues, rather than just threat cues (Gorka, Nelson, Phan, & Shankman, 2016; Tanovic et al., 2018).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Tanovic et al., 2018
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Gorka, S. M., Nelson, B. D., Phan, K. L., & Shankman, S. A. (2016) · Cognitive, Affective, & Behavioral Neuroscience · doi:10.3758/s13415-016-0443-2 · Cited by 55
Intolerance of uncertainty mediates reduced reward anticipation in major depressive disorder
Nelson, B. D., Shankman, S. A., & Proudfit, G. H. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.02.014 · Cited by 53
Thibodeau, M. A., Carleton, R. N., Gómez-Pérez, L., & Asmundson, G. J. G. (2013) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e3182a21298 · Cited by 48
Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers.
Ottaviani, C., Borlimi, R., Brighetti, G., Caselli, G., Favaretto, E., Giardini, I., Marzocchi, C., Nucifora, V., Rebecchi, D., Ruggiero, G. M., et al. (2014) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2014.05.010 · Cited by 41
Intolerance of uncertainty predicts increased striatal volume.
Kim, M. J., Shin, J., Taylor, J. M., Mattek, A. M., Chavez, S., & Whalen, P. J. (2017) · Emotion · doi:10.1037/emo0000331 · Cited by 36
McCarroll, J. E. (2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181e4f750 · Cited by 34
Lieberman, L., Gorka, S. M., Sarapas, C., & Shankman, S. A. (2016) · Cognition and Emotion · doi:10.1080/02699931.2015.1067189 · Cited by 33
Psychophsyiological reactivity during uncertainty and ambiguity processing in high and low worriers
Kirschner, H., Hilbert, K., Hoyer, J., Lueken, U., & Beesdo‐Baum, K. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.06.001 · Cited by 31
Sensitivity towards Fear of Electric Shock in Passive Threat Situations
Ring, P., & Kaernbach, C. (2015) · PLoS ONE · doi:10.1371/journal.pone.0120989 · Cited by 31
Gorka, S. M., Lieberman, L., Nelson, B. D., Sarapas, C., & Shankman, S. A. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.06.004 · Cited by 28
Are we certain about which measure of intolerance of uncertainty to use yet?
Roma, V. G., & Hope, D. A. (2016) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2016.1252792 · Cited by 28
Oathes, D. J., Hilt, L. M., & Nitschke, J. B. (2015) · PLoS ONE · doi:10.1371/journal.pone.0115820 · Cited by 19
Deschênes, S. S., Dugas, M. J., & Gouin, J. (2015) · Personality and Individual Differences · doi:10.1016/j.paid.2015.11.015 · Cited by 17
Examining the specific dimensions of distress tolerance that prospectively predict perceived stress
Bardeen, J. R., Fergus, T. A., & Orcutt, H. K. (2016) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2016.1233454 · Cited by 15
Scanning for Danger: Readjustment to the Noncombat Environment
CONOSCENTI, L. M., VINE, V., PAPA, A., & Litz, B. T. (2009) · Routledge eBooks · doi:10.4324/9780203893906-16 · Cited by 3
Shikatani, B., Antony, M., Cassin, S., & Kuo, J. R. (2015) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-015-9516-8
Flagged first, then by citations
3 of the 121 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Tanovic, E., Hajcak, G., & Joormann, J.. Hating waiting: Individual differences in willingness to wait in uncertainty. Journal of Experimental Psychopathology. (in press)
Cited by
Sorted by citations
McEvoy, P. M., Hyett, M. P., Shihata, S., Price, J. E., & Strachan, L. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101778 · Cited by 271
Towards a model of uncertainty distress in the context of Coronavirus (COVID-19)
Freeston, M., Tiplady, A., Mawn, L., Bottesi, G., & Thwaites, S. (2020) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x2000029x · Cited by 221
Balakrishnan, J., Dwivedi, Y. K., Hughes, L., & Boy, F. (2021) · Information Systems Frontiers · doi:10.1007/s10796-021-10203-y · Cited by 215
Morriss, J., Zuj, D. V., & Mertens, G. (2021) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2021.05.011 · Cited by 116
Golets, A., Farias, J. E. M., Pilati, R., & Costa, H. A. (2021) · Current Psychology · doi:10.1007/s12144-021-02282-6 · Cited by 114
Metadata
- Authors
- Tanovic, E., Gee, D. G., & Joormann, J.
- Affiliations
- Yale University (US)
- Corresponding author
- Tanovic, Ema
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 60
- Pages
- 87-99
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2782498233
- Semantic Scholar
- 6e173ea412d0920b7cd6c7020e57f52d6037d150
- Cited by
- 214
- References
- 121
- Citations by year
- 2026: 25 · 2025: 34 · 2024: 22 · 2023: 21 · 2022: 42 · 2021: 32 · 2020: 22 · 2019: 11 · 2018: 4
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- intolerance of uncertainty, neural correlates, psychophysiological correlates, anterior insula, amygdala, event-related potentials, startle response, skin conductance, safety learning, reward processing, threat processing, anxiety, depression, emotion regulation, cognitive control
- MeSH terms
- Anxiety, Brain, Emotions, Fear, Humans, Uncertainty
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