Intolerance of uncertainty as a contributor to fear and avoidance symptoms of panic attacks

Carleton, R. Nicholas; Fetzner, Mathew G.; Hackl, Jennifer L.; McEvoy, Peter

doi:10.1080/16506073.2013.792100

Cited by 126Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their TreatmentsCOVID-19 and Mental Health

Intolerance of uncertainty as a contributor to fear and avoidance symptoms of panic attacks

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Carleton, R. Nicholas, Fetzner, Mathew G., Hackl, Jennifer L., McEvoy, Peter·2013·Cognitive Behaviour Therapy

DOI 10.1080/16506073.2013.792100

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Abstract

Panic disorder symptoms are persistent for 50-80% of cases even after treatment, resulting in experiences of disability and dissatisfaction in life. Previous research has focused on anxiety sensitivity (AS) and its dimensions as contributing to symptoms of panic disorder; however, recent research has suggested that intolerance of uncertainty (IU)-the tendency for a person to consider the possibility of a negative event occurring as threatening, irrespective of the actual probability of its occurrence-may also play a critical role. The current study was designed to assess the specific relationships between dimensions of IU (i.e. prospective IU and inhibitory IU) and the fear and avoidance symptoms associated with panic disorder. Participants included 122 community members (81% women) with a history of at least one panic attack who participated in a larger study on fear. Participants completed measures of AS, IU, and panic disorder symptoms. Correlation and regression analyses supported a significant and substantial relationship between AS, inhibitory IU, and panic disorder symptoms. Inhibitory IU accounted for relatively more variance in avoidance symptoms related to panic disorder than did the fears of physical sensations dimension of AS. As such, further investigation of the role of IU in panic disorder symptoms appears warranted. Comprehensive results, implications, and directions for future research are discussed.

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The IUS-12 has excellent internal consistency for the full scale (α = 0.93) and good internal consistency for prospective IU (α = 0.89) and inhibitory IU (α = 0.89).
“The IUS-12 has been found to have excellent internal consistency of α = 0.93 for the full scale and good internal consistency for subscale scores α = 0.89 (prospective IU) and α = 0.89 (inhibitory IU) (Carleton et al., 2013).”
From Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic (2021) · cites this paper as Carleton et al., 2013
The IUS-12 section reports internal consistency in the current sample of α = .93 for the total score and α = .89 for prospective IU. It reports α = .88, not .89, for inhibitory IU; the figures also describe this study’s sample rather than the scale universally. (LLM, conf=0.94)
Experimental — accuracy not yet measured
Intolerance of uncertainty is common across several emotional disorders, including OCD, social anxiety, panic disorder and agoraphobia, and depression.
“However, evidence has since accumulated that IU is common across multiple emotional disorders, including obsessive compulsive disorder (OCD, Holaway, Heimberg, & Coles, 2006;Tolin, Abramowitz, Brigidi, & Foa, 2003), social anxiety (Boelen & Reijntjes, 2009;Carleton, Collimore, & Asmundson, 2010;Riskind, Tzur, Williams, Mann, & Shahar, 2007), panic disorder and agoraphobia (Carleton, Hackl, Fetzner”
From The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty (2016) · cites this paper as Carleton, Hackl, Fetzner, & McEvoy, 2013
A significant and substantial relationship between the IU inhibitory dimension and panic symptom severity was reported in a community sample.
“A significant and substantial relationship between the IU inhibitory dimension and panic symptom severity was reported in a community sample.12”
From Impact of mindfulness-based cognitive therapy on intolerance of uncertainty in patients with panic disorder (2016) · cites this paper as [12]

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“Only one study, by Carleton et al.13 was conducted in patients with panic disorder exclusively.13 Sexton et al.4 measured general anxiety symptom severity instead of panic symptom severity.4 The reduction in IU was significantly correlated with the reduction in panic symptoms after MBCT.”
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Aversive responding to safety signals in panic disorder: The moderating role of intolerance of uncertainty
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Impact of mindfulness-based cognitive therapy on intolerance of uncertainty in patients with panic disorder
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Authors: Carleton, R. N., Fetzner, M. G., Hackl, J. L., & McEvoy, P.
Affiliations: University of Regina (CA)
The University of Western Australia (AU)
Corresponding author: Carleton, R. Nicholas
ORCID: Carleton, R. Nicholas
McEvoy, Peter
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2013-12
Volume: 42
Issue: 4
Pages: 328-341
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506073.2013.792100
OpenAlex: W2085975433
Semantic Scholar: c368aa76115f7d88557f2b68817ff7481dd57df4
Cited by: 126
References: 58
Citations by year: 2026: 4 · 2025: 6 · 2024: 5 · 2023: 10 · 2022: 12 · 2021: 7 · 2020: 8 · 2019: 26 · 2018: 5 · 2017: 12 · 2016: 21 · 2015: 4 · 2014: 6
FWCI: 13.97
Type: journal article
Language: en
Open access: green
hdl.handle.net
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
eSpace (Curtin University) (submittedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords: intolerance of uncertainty, panic disorder, anxiety sensitivity, inhibitory intolerance of uncertainty, avoidance symptoms, panic attacks
MeSH terms: Adolescent, Adult, Aged, Anxiety, Fear, Female, Humans, Male, Middle Aged, Panic Disorder, Uncertainty

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Intolerance of uncertainty as a contributor to fear and avoidance symptoms of panic attacks

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Integrity signals

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