Intolerance of uncertainty and psychological distress in individuals experiencing health changes

Abstract

Review: This review investigated the relationship between Intolerance of uncertainty (IU) and psychological distress, including anxiety, depression, PTSD, and fear of cancer recurrence (FCR), in individuals who have experienced a change in health due to illness or injury. PsycINFO, Medline, and CINAHL Complete were searched for articles published up to March 2024 which used quantitative methodologies. The review included 20 studies (2850 participants). Meta-analysis indicated significant positive correlations between IU and anxiety (r = 0.53, 95% CI: 0.42–0.62), depression (r = 0.45, 95% CI: 0.35–0.55), and FCR (r = 0.30, 95% CI: 0.20–0.40). The review findings suggest that IU is a significant transdiagnostic factor associated with increased psychological distress in individuals undergoing health changes. Future research should focus on longitudinal studies to determine causal relationships, explore diverse populations, and evaluate intervention strategies targeting IU.

Empirical study: Psychological distress, such as anxiety, depression, and PTSD, is common following hand injury. Intolerance of Uncertainty (IU) has been identified as a potential contributor to distress. However, the specific role of IU relative to other known risk factors remains unclear. This study aimed to explore the relationship between IU and distress in hand injury patients, compared to other known risk factors. Using a cross-sectional survey design, 84 hand injury patients completed self-report measures assessing potential predictors of distress (gender, psychiatric history, subjective severity rating, IU, social support, functional impairment, and coping mechanisms). Hierarchical regressions showed that IU was a significant predictor of anxiety (β = 0.335, p = 0.001), PTSD (β = 0.380, p <.001) and depression (β = 0.271, p = 0.008), contributing uniquely beyond other predictors. IU plays a crucial role in predicting anxiety, depression and PTSD following injury, highlighting its potential as a therapeutic target. Future research should explore longitudinal relationships and intervention effectiveness to reduce IU.

Thesis embargoed until 31st December 2026

Date of Award	Dec 2025
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Northern Health and Social Care Trust
Supervisor	Martin Dempster (Supervisor) & Jenny Cross (Supervisor)