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Intolerance of Uncertainty as a Contributor to Fear and Avoidance Symptoms of Panic Attacks
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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 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
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“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
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“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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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069
Curran, P. J., West, S. G., & Finch, J. F. (1996) · Psychological Methods · doi:10.1037/1082-989x.1.1.16 · Cited by 5,512
GPOWER: A general power analysis program
Erdfelder, E., Faul, F., & Buchner, A. (1996) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03203630 · Cited by 4,864
Rhemtulla, M., Brosseau-Liard, P. É., & Savalei, V. (2012) · Psychological Methods · doi:10.1037/a0029315 · Cited by 2,816
Hays, W. (1983) · Contemporary Psychology · doi:10.1037/022267 · Cited by 2,399
Fearing the unknown: A short version of the Intolerance of Uncertainty Scale
Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.03.014 · Cited by 2,288
Self-citationTaylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., Abramowitz, J. S., Holaway, R. M., Sandin, B., Stewart, S. H., et al. (2007) · Psychological Assessment · doi:10.1037/1040-3590.19.2.176 · Cited by 1,866
Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994) · Personality and Individual Differences · doi:10.1016/0191-8869(94)90048-5 · Cited by 1,731
Multicenter Collaborative Panic Disorder Severity Scale
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., Gorman, J. M., & Papp, L. A. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.11.1571 · Cited by 1,001 · cited 1×
“Cognitive Behavior Therapy, 32, 82–94, doi: 10.1080/16506070302321 Shear, M.K., Brown, T.A., Barlow, D.H., Money, R., Sholomskas, D.E., Woods, S.W., . . . , Papp, L.A. (1997).”
InfluentialReiss, S. (1985) · Medical Entomology and Zoology · Cited by 912
Kessler, R. C., Chiu, W. T., Jin, R., Ruscio, A. M., Shear, K., & Walters, E. E. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.4.415 · Cited by 795
Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression
Carleton, R. N., Mulvogue, M. K., Thibodeau, M. A., McCabe, R. E., Antony, M. M., & Asmundson, G. J. G. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2012.01.011 · Cited by 775
Self-citationAnxiety sensitivity and panic disorder
McNally, R. J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01475-0 · Cited by 717
Carleton, R. N. (2012) · Expert Review of Neurotherapeutics · doi:10.1586/ern.12.82 · Cited by 665 · cited 11×
“Given increasing evidence supporting IU as a critical component of all anxiety disorders (Carleton, 2012), prospective IU and inhibi tory IU were expected to independently account for a statistically significant pro portion of fear and avoidance symptoms for panic disorder, above and beyond the…”
BackgroundResultInfluentialSelf-citationSchmidt, N. B., Lerew, D. R., & Jackson, R. J. (1997) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.106.3.355 · Cited by 661
How does anxiety sensitivity vary across the anxiety disorders?
Taylor, S. J., Koch, W. J., & McNally, R. J. (1992) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(92)90037-8 · Cited by 640
Taylor, S. J. (2014) · Routledge eBooks · doi:10.4324/9781410603326 · Cited by 630
Gentes, E. L., & Ruscio, A. M. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.05.001 · Cited by 601
Intolerance of uncertainty and worry: investigating specificity in a nonclinical sample
Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001) · Cognitive Therapy and Research · doi:10.1023/a:1005553414688 · Cited by 538 · cited 1×
“Summary Conclusions Despite the aforementioned limitations, the current results extend prior theory and research (Carleton 2012; Carleton, Mulvogue, et al., 2012; Carleton, Sharpe et al., 2007; Dugas et al., 2001; McEvoy & Mahoney, 2011) with evidence that inhibitory IU is associated with symptoms of panic disorder; m…”
ResultSchmidt, N. B., Lerew, D. R., & Jackson, R. J. (1997) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.106.3.355 · Cited by 533
Intolerance of uncertainty in obsessive-compulsive disorder
Tolin, D. F., Abramowitz, J. S., Brigidi, B. D., & Foa, E. B. (2003) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00182-2 · Cited by 494
McEvoy, P. M., & Mahoney, A. E. J. (2012) · Behavior Therapy · doi:10.1016/j.beth.2011.02.007 · Cited by 468
Self-citationBirrell, J., Meares, K., Wilkinson, A., & Freeston, M. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.07.009 · Cited by 459
Intolerance of uncertainty and social anxiety
Boelen, P. A., & Reijntjes, A. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.04.007 · Cited by 436
Anxiety sensitivity in 1984 and panic attacks in 1987
Maller, R. G., & Reiss, S. (1992) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(92)90036-7 · Cited by 429
Buhr, K., & Dugas, M. J. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.12.004 · Cited by 421 · cited 1×
“Introduction evidence has related IU to generalized anxiety disorder (Buhr & Dugas, 2006; Koerner & Intolerance of uncertainty (IU) is a disposi- Dugas, 2008; Dugas, Marchand, & Ladou tional characteristic resulting from negative ceur, 2005), with early research evidence beliefs about uncertainty…”
BackgroundMcEvoy, P. M., & Mahoney, A. E. J. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.08.010 · Cited by 412
Self-citationOxford Handbook of Anxiety and Related Disorders
(2008) · doi:10.1093/oxfordhb/9780195307030.001.0001 · Cited by 402
Holaway, R. M., Heimberg, R. G., & Coles, M. E. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2005.01.002 · Cited by 399
Reliability and validity of the Panic Disorder Severity Scale: replication and extension
Shear, M. K., Rucci, P., Williams, J., Frank, E., Grochocinski, V., Vander Bilt, J., Houck, P., & Wang, T. (2001) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(01)00028-0 · Cited by 360
Brief Report: Intolerance of Uncertainty, Worry, and Depression
Dugas, M. J., Schwartz, A., & Francis, K. (2004) · Cognitive Therapy and Research · doi:10.1007/s10608-004-0669-0 · Cited by 337
Treatment of Gad: Targeting Intolerance of Uncertainty in Two Types of Worry
Dugas, M. J., & Ladouceur, R. (2000) · Behavior Modification · doi:10.1177/0145445500245002 · Cited by 334
Koerner, N., & Dugas, M. J. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-007-9125-2 · Cited by 301
Anxiety sensitivity and intolerance of uncertainty: requisites of the fundamental fears?
Nicholas Carleton, R., Sharpe, D., & Asmundson, G. J. G. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.04.006 · Cited by 293
Self-citationCarleton, R. N., Collimore, K. C., & Asmundson, G. J. G. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.10.007 · Cited by 268 · cited 2×
“In addition, the shared and unique relationships between inhibitory IU and each of the panic disorder symptoms are compar able to or larger than those identified between inhibitory IU and symptoms of social anxiety (Carleton et al., 2010).”
BackgroundMethodSelf-citationDugas, M. J., Marchand, A., & Ladouceur, R. (2005) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.02.002 · Cited by 258
A Transdiagnostic Examination of Intolerance of Uncertainty Across Anxiety and Depressive Disorders
Mahoney, A. E. J., & McEvoy, P. M. (2012) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2011.622130 · Cited by 237 · cited 6×
“One limitation of both studies by Mahoney and McEvoy (2012a, 2012c) is that they did not include measures of AS so that the relationship between IU, AS, and panic symptoms could be explored.”
BackgroundResultInfluentialSelf-citationAnxiety sensitivity and its dimensions across the anxiety disorders
Deacon, B., & Abramowitz, J. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.01.003 · Cited by 216
Smits, J. A. J., Powers, M. B., Cho, Y., & Telch, M. J. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.4.646 · Cited by 203
Intolerance of Uncertainty and Decisions About Delayed, Probabilistic Rewards
Luhmann, C. C., Ishida, K., & Hajcak, G. (2011) · Behavior Therapy · doi:10.1016/j.beth.2010.09.002 · Cited by 190
Hierarchical model of generalized and specific vulnerabilities in anxiety
Sexton, K. A., Norton, P. J., Walker, J. R., & Norton, G. R. (2003) · Cognitive Behaviour Therapy · doi:10.1080/16506070302321 · Cited by 183
A comparison of the 27-item and 12-item intolerance of uncertainty scales
Khawaja, N. G., & Yu, L. N. H. (2010) · Clinical Psychologist · doi:10.1080/13284207.2010.502542 · Cited by 181
Rosen, N. O., & Knäuper, B. (2009) · Health Communication · doi:10.1080/10410230902804125 · Cited by 177
Cognitive specificity of anxiety disorders: a review of selected key constructs
Starcevic, V., & Berle, D. (2006) · Depression and Anxiety · doi:10.1002/da.20145 · Cited by 121
Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder
Meuret, A. E., White, K. S., Ritz, T., Roth, W. T., Hofmann, S. G., & Brown, T. A. (2006) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2005.09.006 · Cited by 103
Mahoney, A. E. J., & McEvoy, P. M. (2012) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2011.622131 · Cited by 103 · cited 6×
“One limitation of both studies by Mahoney and McEvoy (2012a, 2012c) is that they did not include measures of AS so that the relationship between IU, AS, and panic symptoms could be explored.”
BackgroundResultInfluentialSelf-citationCarleton, R. N., Weeks, J. W., Howell, A. N., Asmundson, G. J. G., Antony, M. M., & McCabe, R. E. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.10.006 · Cited by 98
Self-citationCognitive Behavioral Treatment for Generalized Anxiety Disorder: From Science to Practice
Robichaud, M., Koerner, N., & Dugas, M. J. (2019) · doi:10.4324/9781315709741 · Cited by 97
Intolerance of Uncertainty, Hypochondriacal Concerns, Obsessive-Compulsive Symptoms, and Worry
Boelen, P. A., & Carleton, R. N. (2012) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e318247cb17 · Cited by 90
Self-citationChanges in intolerance of uncertainty during cognitive behavior group therapy for social phobia.
Mahoney, A. E. J., & McEvoy, P. M. (2012) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2011.12.004 · Cited by 88 · cited 6×
“One limitation of both studies by Mahoney and McEvoy (2012a, 2012c) is that they did not include measures of AS so that the relationship between IU, AS, and panic symptoms could be explored.”
BackgroundResultInfluentialSelf-citationDoes anxiety sensitivity predict symptoms of panic, depression, and social anxiety?
Grant, D. M., Beck, J. G., & Davila, J. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.02.008 · Cited by 77
A brief screen for panic disorder
Apfeldorf, W. J., Shear, M. K., Leon, A. C., & S, L. P. M. (1994) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)90024-8 · Cited by 52
McLeish, A. C., Zvolensky, M. J., & Bucossi, M. M. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.11.003 · Cited by 51
Understanding Anxiety Disorders from a “Triple Vulnerability” Framework
Suárez, L., Bennett, S. M., Goldstein, C. R., & Barlow, D. H. (2008) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195307030.013.0013 · Cited by 43
The Latent Structure of Anxiety Sensitivity—Revisited
Broman-Fulks, J. J., Green, B. A., Berman, M., Olatunji, B., Arnau, R. C., Deacon, B., & Sawchuk, C. N. (2008) · Assessment (Odessa, Fla.) · doi:10.1177/1073191107311284 · Cited by 37
Manfro, G. G., Heldt, E., Cordioli, A. V., & Otto, M. W. (2008) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.1590/s1516-44462008000600005 · Cited by 1
Research works printed but not linked: 3
- Barlow, D.H. (2002). Anxiety and its disorders (2nd ed.). New York, NY: Guilford Press.
- Barlow, D.H. (Ed.). (1993). Clinical handbook of psychological disorders (3rd ed.). New York, NY: Guilford Press.
- Peterson, R.A. & Reiss, S. (1992). Anxiety sensitivity index manual (2nd ed.). Worthington, OH: International Diagnostic Systems.
Cited by
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Self-citationFear of the unknown: One fear to rule them all?
Carleton, R. N. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.03.011 · Cited by 647
Self-citationIntolerance of uncertainty in emotional disorders: what uncertainties remain?
Shihata, S., McEvoy, P. M., Mullan, B. A., & Carleton, R. N. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.05.001 · Cited by 301
Self-citationMcEvoy, 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
Self-citationLonsdorf, T. B., & Merz, C. J. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.07.007 · Cited by 253
Metadata
- 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
- 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
- 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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