Into the unknown: A review and synthesis of contemporary models involving uncertainty

Abstract

The current review and synthesis serves to define and contextualize fear of the unknown relative to related constructs, such as intolerance of uncertainty, and contemporary models of emotion, attachment, and neuroticism. The contemporary models appear to share a common core in underscoring the importance of responses to unknowns. A recent surge in published research has explored the transdiagnostic impact of not knowing on anxiety and related pathologies; as such, there appears to be mounting evidence for fear of the unknown as an important core transdiagnostic construct. The result is a robust foundation for transdiagnostic theoretical and empirical explorations into fearing the unknown and intolerance of uncertainty.

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

“…Further, the socially anxious and control groups reported similar IU levels with regard to contamination concerns, while the obsessive-compulsive and control groups reported similar IU levels with regard to social interactions (Jensen & Heimberg, 2015). Thus, in line with recent theory (Carleton, 2016), context remains a critical component for considering uncertainty threatening, even for persons reporting high trait IU and anxiety symptoms.…”

“…Models of psychopathology posit that uncertainty is a central feature in anxiety-related experience (Carleton, 2016) and the incapacity to endure unknowns appears to be a robust vulnerability factor associated with a range of psychological disorders (Grupe & Nitschke, 2013;Hong & Cheung, 2015). IU was originally defined as a broad construct that reflects "cognitive, emotional, and behavioral reactions to uncertainty in everyday life situations" (Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994, p. 792).…”

“…For example, uncertainty about catastrophic consequences of physical symptoms in panic disorder may differ from uncertainty about social evaluative cues in social anxiety disorder. Thus, the nature of uncertainty may differ between emotional disorders and IU may manifest differently based on contextual factors (Boswell, Thompson-Hollands, Farchione, & Barlow, 2013;Carleton, 2016;Mahoney & McEvoy, 2012c). State IU can be considered as any instance of heightened negative affect in response to an uncertain stimulus, which may or may not co-occur with high trait IU or occur within the context of emotional disorders.…”

“…For example, elucidating pathways by which transdiagnostic processes lead to multiple diagnoses (i.e., multifinality) and different disorders (i.e., divergent trajectories) in different people may be critical for advancing theory, treatment, and prevention (Nolen-Hoeksema & Watkins, 2011). Indirect research and theory implicates the developmental importance of IU (Carleton, 2016); however, direct research into the development of IU is nascent and is reviewed here with a focus on potential processes and developmental origins. We consider IU as a proximal transdiagnostic risk factor akin to Nolen-Hoeksema and Watkin's (2011) proposed heuristic for developing transdiagnostic models, which incorporates distal factors, proximal factors, and linking mechanisms for psychopathology.…”

“…Cross-sectional research can provide information about the associations between theoretically related variables, but precludes the ability to draw causal conclusions. Accordingly, broad theoretical and applied progress for understanding IU will require valid and reliable multimodal assessments (Carleton, 2012(Carleton, , 2016Einstein, 2014).…”