Intolerance of uncertainty in opioid dependency–Relationship with trait anxiety and impulsivity
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Intolerance of uncertainty (IU) is the tendency to interpret ambiguous situations as threatening and having negative consequences, resulting in feelings of distress and anxiety. IU has been linked to a number of anxiety disorders, and anxiety felt in the face of uncertainty may result in maladaptive behaviors such as impulsive decision making. Although there is strong evidence that anxiety and impulsivity are risk factors for addiction, there is a paucity of research examining the role of IU in this disorder. The rate of opioid addiction, in particular, has been rising steadily in recent years, which necessitates deeper understanding of risk factors in order to develop effective prevention and treatment methods. The current study tested for the first time whether opioid-dependent adults are less tolerant of uncertainty compared to a healthy comparison group. Opioid dependent patients undergoing methadone maintenance therapy (n = 114) and healthy comparisons (n = 69) completed the following scales: Intolerance of Uncertainty Scale, the Barrett Impulsivity Scale, and the State Trait Anxiety Inventory. Analysis revealed that these measures were positively correlated with each other and that opioid-dependent patients had significantly higher IU scores. Regression analysis revealed that anxiety mediated the relationship between IU and impulsivity. Hierarchical moderation regression found an interaction between addiction status and impulsivity on IU scores in that the relationship between these variables was only observed in the patient group. Findings suggest that IU is a feature of addiction but does not necessarily play a unique role. Further research is needed to explore the complex relationship between traits and how they may contribute to the development and maintenance of addiction.
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Opioid users with intolerance of uncertainty might use opioids to alleviate uncertainty-induced anxiety, seek temporary relief, and perpetuate a cycle of use and addiction.
“Opioid users with this trait might use opioids to alleviate uncertainty-induced anxiety, seek temporary relief, and perpetuate a cycle of use and addiction.[9]”
From Decision-making styles, magical thinking, and intolerance of uncertainty in opioid use disorder (2024) · cites this paper as [9]
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ОСОБИСТІСНІ ДИСПОЗИЦІІ У СТРУКТУРІ ПРИИНЯТТЯ РІШЕННЯ ОСІБ, ЗАЛЕЖНИХ ВІД ПСИХОАКТИВНИХ РЕЧОВИН
Darvishov, N. (2020) · International Journal of Innovative Technologies in Social Science · doi:10.31435/rsglobal_ijitss/31032020/7014
Cognitive heuristics are generalisation processes that reduce uncertaintyPreprint
Houser, T. M. (2023) · doi:10.31219/osf.io/wjqpb
Yuan, C., Fan, Y.-Q., Wu, C., Hong, A., Ou, Y., & Wang, Z. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.03.099
Drubina, B., Kökönyei, G., & Reinhardt, M. (2021) · Figshare · doi:10.6084/m9.figshare.15178389
Intolerance of uncertainty, psychopathology, and emerging adult sibling relationships
Morgan, D. D., Martin, M. J., Ingram, P. B., Oh, W., & Rogers, C. R. (2026) · Current Psychology · doi:10.1007/s12144-026-09413-x
Belcher, A. M., Hamilton-Moseley, K. R., Massey, E. C., Yoon, M., Cole, T. O., Wagner, M. D., Billing, A. S., Greenblatt, A. D., WEINTRAUB, E., & Wish, E. D. (2026) · Addiction Science & Clinical Practice · doi:10.1186/s13722-026-00699-7
- Authors
- Garami, J., Haber, P., Myers, C. E., Allen, M. T., Misiak, B., Frydecka, D., & Moustafa, A. A.
- Affiliations
- Western Sydney University (AU)
- The University of Sydney (AU)
- Rutgers, The State University of New Jersey (US)
- University of Northern Colorado (US)
- Wroclaw Medical University (PL)
- Corresponding author
- Moustafa, Ahmed A.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-07-31
- Volume
- 12
- Issue
- 7
- Pages
- e0181955
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5536349
- OpenAlex
- W2742141001
- Cited by
- 45
- References
- 66
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 11 · 2019: 5 · 2018: 7
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- intolerance of uncertainty, opioid use disorder, trait anxiety, impulsivity, methadone maintenance treatment, mediation, addiction risk factors, addiction maintenance
- MeSH terms
- Adult, Analgesics, Opioid, Anxiety, Decision Making, Heroin, Female, Humans, Impulsive Behavior, Male, Methadone, Middle Aged, Opioid-Related Disorders, Personality Inventory, Psychiatric Status Rating Scales, Regression Analysis, Risk Factors, Case-Control Studies, Uncertainty
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