Does intolerance of uncertainty predict anticipatory startle responses to uncertain threat?
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Intolerance of uncertainty (IU) has been proposed to be an important maintaining factor in several anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, and social phobia. While IU has been shown to predict subjective ratings and decision-making during uncertain/ambiguous situations, few studies have examined whether IU also predicts emotional responding to uncertain threat. The present study examined whether IU predicted aversive responding (startle and subjective ratings) during the anticipation of temporally uncertain shocks. Sixty-nine participants completed three experimental conditions during which they received: no shocks, temporally certain/predictable shocks, and temporally uncertain shocks. Results indicated that IU was negatively associated with startle during the uncertain threat condition in that those with higher IU had a smaller startle response. IU was also only related to startle during the uncertain (and not the certain/predictable) threat condition, suggesting that it was not predictive of general aversive responding, but specific to responses to uncertain aversiveness. Perceived control over anxiety-related events mediated the relation between IU and startle to uncertain threat, such that high IU led to lowered perceived control, which in turn led to a smaller startle response. We discuss several potential explanations for these findings, including the inhibitory qualities of IU. Overall, our results suggest that IU is associated with attenuated aversive responding to uncertain threat.
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Nelson and colleagues found a negative association between startle in response to unpredictable threat and inhibitory IU, and a positive association with prospective IU.
“Further, Nelson and colleagues have conducted research with the individual IU subscales to detect possible suppressor effects and have found a negative association between startle in response to unpredictable threat and inhibitory IU, and a positive association with prospective IU”
From Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety (2021) · cites this paper as Nelson & Shankman, 2011
Section 3.4 (Subscales of IUS; page unavailable) reports a negative association between inhibitory IU and startle during uncertain threat, including after controlling for prospective IU. It does not report the claimed positive association with prospective IU; the prospective-subscale-by-condition interaction was not significant. The section describes examining which subscale drove the result, not testing for suppressor effects. (LLM, conf=0.90)
Experimental — accuracy not yet measuredOthers have shown a negative relation between startle during unpredictable threat and IU.
“and others have shown a negative relation (Nelson and Shankman, 2011)”
From Aversive response to uncertainty as a mediator for the effect of a mindfulness intervention on symptoms of anxiety (2022) · cites this paper as Nelson and Shankman, 2011
The IU subscales may reflect hyper-reactive (prospective IU) and inhibitory (inhibitory IU) manifestations of IU.
“suggesting that the IU subscales may reflect hyper-reactive (prospective IU) and inhibitory (inhibitory IU) manifestations of IU (Nelson & Shankman, 2011;Nelson et al., 2016).”
From Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety (2021) · cites this paper as Nelson & Shankman, 2011
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Self-citationIf or when? Uncertainty's role in anxious anticipation
Bennett, K. P., Sinclair, J. V., & Larson, C. L. (2018) · Psychophysiology · doi:10.1111/psyp.13066 · Cited by 58 · see citing works
Chin, B., Nelson, B. D., Jackson, F., & Hajcak, G. (2016) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.11.006 · Cited by 60 · see citing works
An Event-Related Potential Investigation of Fear Generalization and Intolerance of Uncertainty
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Self-citationIntolerance of Uncertainty and Adult Separation Anxiety
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Intolerance of uncertainty and threat generalization: A replication and extension
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Intolerance of uncertainty mediates reduced reward anticipation in major depressive disorder
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Self-citationNelson, B. D., Hodges, A., Hajcak, G., & Shankman, S. A. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.05.003 · Cited by 53 · see citing works
Self-citationJacoby, R. J., Abramowitz, J. S., Reuman, L., & Blakey, S. M. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.02.003 · Cited by 47 · see citing works
Nelson, B. D., & Hajcak, G. (2017) · Psychophysiology · doi:10.1111/psyp.12869 · Cited by 44 · see citing works
Self-citationWorry 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 45 · see citing works
Morriss, J. (2019) · Psychophysiology · doi:10.1111/psyp.13396 · Cited by 42 · see citing works
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Unpredictability and Uncertainty in Anxiety: A New Direction for Emotional Timing Research
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Relationships among attention networks and physiological responding to threat
Sarapas, C., Weinberg, A., Langenecker, S. A., & Shankman, S. A. (2016) · Brain and Cognition · doi:10.1016/j.bandc.2016.09.012 · Cited by 40 · see citing works
Self-citationResponding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety
Papenfuss, I., Lommen, M. J. J., Grillon, C., Balderston, N. L., & Ostafin, B. D. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102332 · Cited by 38 · see citing works
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Positivity impairment as a broad-based feature of social anxiety.
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Intolerance of Uncertainty: A Temporary Experimental Induction Procedure
Mosca, O., Lauriola, M., & Carleton, R. N. (2016) · PLoS ONE · doi:10.1371/journal.pone.0155130 · Cited by 37 · see citing works
Gorka, S. M., Nelson, B. D., Sarapas, C., Campbell, M. L., Lewis, G. F., Bishop, J. R., Porges, S. W., & Shankman, S. A. (2013) · Journal of Psychophysiology · doi:10.1027/0269-8803/a000091 · Cited by 36 · see citing works
Self-citationLin, H., Gao, H., You, J., Liang, J., Ma, J., Yang, N., Xu, H. Y., & Jin, H. (2014) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2014.10.004 · Cited by 34 · see citing works
Nelson, B. D., Liu, H., Sarapas, C., & Shankman, S. A. (2016) · Journal of Experimental Psychopathology · doi:10.5127/jep.048115 · Cited by 32 · see citing works
Anxiety and the Neurobiology of Temporally Uncertain Threat AnticipationPreprint
Hur, J., Smith, J. F., DeYoung, K., Anderson, A. S., Kuang, J., Kim, H. C., Tillman, R., Kuhn, M., Fox, A., & Shackman, A. (2020) · Journal of Neuroscience · doi:10.1101/2020.02.25.964734 · Cited by 101 · see citing works
Lee, A., & Jung, E. (2021) · Sustainability · doi:10.3390/su13137099 · Cited by 30 · see citing works
Papenfuss, I., Lommen, M. J. J., Huisman, M., & Ostafin, B. D. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.06.014 · Cited by 27 · see citing works
Sandre, A., & Weinberg, A. (2019) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2019.09.015 · Cited by 27 · see citing works
Morriss, J., Biagi, N., & Dodd, H. (2020) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2020.07.009 · Cited by 18 · see citing works
Paoletti, P., Perasso, G., Lillo, C., Serantoni, G., Maculan, A., Vianello, F., & di Giuseppe, T. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1122264 · Cited by 17 · see citing works
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Defensive activation to (un)predictable interoceptive threat: The NPU respiratory threat test (NPUr)
Schroijen, M., Fantoni, S., Rivera, C. L., Vervliet, B., Schruers, K. R. J., den Bergh, O. V., & Diest, I. V. (2016) · Psychophysiology · doi:10.1111/psyp.12621 · Cited by 24 · see citing works
The impact of unpredictability on dyspnea perception, anxiety and interoceptive error processing
Tan, Y., Van den Bergh, O., Qiu, J., & von Leupoldt, A. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.00535 · Cited by 22 · see citing works
Differential impact of threat type on defensive motivation and attention during the NPU-threat task
Ferry, R. A., & Nelson, B. D. (2020) · Motivation and Emotion · doi:10.1007/s11031-020-09835-5 · Cited by 23 · see citing works
Self-citationMorriss, J., Bradford, D. E., Wake, S. J., Biagi, N., Tanovic, E., Kaye, J. T., & Joormann, J. (2021) · Biological Psychology · doi:10.1016/j.biopsycho.2021.108223 · Cited by 23 · see citing works
Campbell, M. L., Gorka, S., McGowan, S. K., Nelson, B. D., Sarapas, C., Katz, A. C., Robison-Andrew, E. J., & Shankman, S. (2013) · Cognition & Emotion · doi:10.1080/02699931.2013.799062 · Cited by 24 · see citing works
Self-citationCristaldi, F. D. P., Mento, G., Sarlo, M., & Buodo, G. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254045 · Cited by 22 · see citing works
Cognitive processes across anxiety disorders related to intolerance of uncertainty: Clinical review
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Anticipating the unknown: The stimulus-preceding negativity is enhanced by uncertain threat
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Morriss, J., Bennett, K. P., & Larson, C. L. (2020) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2020.101620 · Cited by 21 · see citing works
Carsten, H. P., Härpfer, K., & Riesel, A. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.06.018 · Cited by 20 · see citing works
Unpredictability increases the error-related negativity in children and adolescents
Speed, B. C., Jackson, F. L., Nelson, B. D., Infantolino, Z. P., & Hajcak, G. (2017) · Brain and Cognition · doi:10.1016/j.bandc.2017.09.006 · Cited by 22 · see citing works
Self-citationGvozden, T. V., Baucal, A., Krstic, K., & Filipović, S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.737188 · Cited by 18 · see citing works
“It is known that individuals who are intolerant of uncertainty will perceive many more sources of danger in their daily life and have more reactions of hypervigilance when they are faced with uncertain or ambiguous situations (Dugas et al., 2004; Nelson and Shankman, 2011).”
BackgroundUnpredictable pain timings lead to greater pain when people are highly intolerant of uncertainty
Bélanger, C., Morin, B. B., Brousseau, A., Gagné, N., Tremblay, A., Daigle, K., Goffaux, P., & Léonard, G. (2017) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2017.09.013 · Cited by 19 · see citing works
Penney, A. M., Rachor, G. S., & Deleurme, K. A. (2020) · Journal of Experimental Psychopathology · doi:10.1177/2043808720970072 · Cited by 18 · see citing works
Shankman, S. A., Katz, A. C., Passarotti, A. M., & Pavuluri, M. N. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.06.021 · Cited by 18 · see citing works
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Olivera-Pasilio, V., & Dabrowska, J. (2023) · Neuroscience · doi:10.1016/j.neuroscience.2023.08.030 · Cited by 16 · see citing works
Nelson, B. D., Bishop, J. R., Sarapas, C., Kittles, R. A., & Shankman, S. A. (2014) · Emotion · doi:10.1037/a0035776 · Cited by 16 · see citing works
Self-citationIntolerance of uncertainty in parents of childhood cancer survivors: A clinical profile analysis
Haegen, M. V., & Étienne, A.-M. (2018) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2018.1499692 · Cited by 16 · see citing works
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Carsten, H. P., Härpfer, K., Nelson, B. D., Kathmann, N., & Riesel, A. (2023) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-023-01094-4 · Cited by 15 · see citing works
Self-citationFerry, R. A., & Nelson, B. D. (2021) · Biological Psychology · doi:10.1016/j.biopsycho.2021.108094 · Cited by 7 · see citing works
Self-citationCorrea, K. A., Li, L. Y., Nelson, B. D., & Shankman, S. A. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.01.016 · Cited by 12 · see citing works
Self-citationGorka, S. M., McGowan, S. K., Campbell, M. L., Nelson, B. D., Sarapas, C., Bishop, J. R., & Shankman, S. A. (2013) · Biological Psychology · doi:10.1016/j.biopsycho.2013.03.003 · Cited by 13 · see citing works
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Interrelationships between negative mood and clinical constructs: a motivational systems approach
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Using a cultural and RDoC framework to conceptualize anxiety in Asian Americans
Liu, H., Lieberman, L., Stevens, E. S., Auerbach, R. P., & Shankman, S. A. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.09.006 · Cited by 10 · see citing works
Self-citationIntolerance of uncertainty and neural measures of anticipation and reactivity for affective stimuli
Wiese, A. D., Lim, S.-L., Filion, D. L., & Kang, S. S. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.11.010 · Cited by 9 · see citing works
McEvoy, P., Carleton, R., Correa, K. A., Shankman, S., & Shihata, S. (2018) · The Cambridge Handbook of Anxiety and Related Disorders · doi:10.1017/9781108140416.008 · Cited by 156 · see citing works
Self-citationGrützmann, R., Kathmann, N., & Heinzel, S. (2022) · PLoS ONE · doi:10.1371/journal.pone.0276994 · Cited by 7 · see citing works
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Effect of Comorbid Post-Traumatic Stress Disorder and Panic Disorder on Defensive Responding
Katz, A. C., Weinberg, A., Gorka, S. M., Auerbach, R. P., & Shankman, S. A. (2017) · Journal of Psychophysiology · doi:10.1027/0269-8803/a000193 · Cited by 7 · see citing works
Self-citationSarapas, C., Katz, A. C., Nelson, B. D., Campbell, M. L., Bishop, J. R., Robison-Andrew, E. J., Altman, S. E., Gorka, S. M., & Shankman, S. A. (2013) · Cognition & Emotion · doi:10.1080/02699931.2013.848787 · Cited by 7 · see citing works
Self-citationUnpredictability impairs goal-directed target processing and performance
Dieterich, R., Endraß, T., Kathmann, N., & Weinberg, A. (2019) · Biological Psychology · doi:10.1016/j.biopsycho.2019.01.007 · Cited by 8 · see citing works
Beatty, C. C., Ferry, R. A., & Nelson, B. D. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.06.017 · Cited by 7 · see citing works
Self-citationEffects of anticipated emotional category and temporal predictability on the startle reflex
Parisi, E. A., Hajcak, G., Aneziris, E., & Nelson, B. D. (2017) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2017.03.003 · Cited by 6 · see citing works
Self-citationA Machine Learning Study of Anxiety-related Symptoms and Error-related Brain Activity
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Intolerance of Uncertainty and Its Association With Cancer-Related Symptoms
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INTOLERANCE OF UNCERTAINTY AND WORRY DURING THE COVID-19 PANDEMIC
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- Authors
- Nelson, B. D., & Shankman, S. A.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Shankman, Stewart A.
- Venue
- International Journal of Psychophysiology
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 81
- Issue
- 2
- Pages
- 107-115
- ISSN
- 0167-8760 (ISSN-L)
- PMC
- PMC3139737
- OpenAlex
- W2129726574
- Cited by
- 115
- References
- 80
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 4 · 2023: 10 · 2022: 12 · 2021: 8 · 2020: 10 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 10 · 2015: 6 · 2014: 13 · 2013: 6 · 2012: 4
- FWCI
- 9.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Psychophysiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R21MH080689)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- intolerance of uncertainty, perceived control, anxiety disorders, generalized anxiety disorder, startle response, defensive responding, temporal uncertainty
- MeSH terms
- Acoustic Stimulation, Analysis of Variance, Anxiety, Cues, Electromyography, Electroshock, Female, Humans, Male, Predictive Value of Tests, Surveys and Questionnaires, Reaction Time, Reflex, Startle, Statistics as Topic, Students, Universities, Uncertainty
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