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A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety

Published online by Cambridge University Press:  09 August 2019

S. Milne ,
C. Lomax  and
M. H. Freeston
S. Milne*
Affiliation:
Great Ormond Street Children’s Hospital NHS Foundation Trust, London, UK
C. Lomax
Affiliation:
Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
M. H. Freeston
Affiliation:
Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK Newcastle University, Newcastle upon Tyne, UK
*
*Corresponding author. Email: Sara_milne@hotmail.co.uk
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Abstract

The development and conceptual relationship of the constructs of threat appraisal (TA) and intolerance of uncertainty (IU) are explored in the context of anxiety disorders. A narrative review tracking the development of these constructs and their relationship is undertaken. There is some evidence to suggest that the interaction between the components of threat appraisal (probability × cost) may partially account for or provide a theoretical framework which explains presenting levels of anxiety. Furthermore, research suggested that IU is a construct which contributes to a broad range of anxiety disorders. It was concluded that distinctive cognitive biases linked with IU – such as interpreting ambiguous and uncertain (both positive and negative) information as highly concerning – suggests that IU is interpreted negatively independent of threat appraisal. These findings mean a number of issues remain unclear, including whether IU in anxiety-provoking situations is sufficient in itself – independent of threat appraisal – in eliciting high levels of anxiety. Additionally, it is unclear whether threat appraisal and IU act as independent constructs, or more in an interactive manner in anxiety. To achieve further clarity on these issues, methodological recommendations for future research are made.

Key learning aims

  1. (1) To understand the conceptual foundations of TA and IU in the cognitive model of anxiety.

  2. (2) To understand the empirical evidence supporting the role of both TA and IU in anxiety.

  3. (3) To appreciate the potential relationship between these concepts in anxiety.

Keywords

anxietyintolerance of uncertaintythreat appraisaluncertainty
Type
Review Paper
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e38
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Further reading

A chapter on ‘Intolerance of Uncertainty’ in the book Overcoming Worry by Kevin Meares and Mark Freeston, Basic Books Publisher.Google Scholar

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