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State of the Science: Intolerance of Uncertainty.

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Title: State of the Science: Intolerance of Uncertainty.
Authors: Dugas MJ; Université du Québec en Outaouais. Electronic address: michel.dugas@uqo.ca., Koerner N; Toronto Metropolitan University., Freeston MH; Newcastle University.
Source: Behavior therapy [Behav Ther] 2026 Jan; Vol. 57 (1), pp. 17-36. Date of Electronic Publication: 2025 Sep 02.
Publication Type: Journal Article; Review
Language: English
Journal Info: Publisher: Elsevier Country of Publication: England NLM ID: 1251640 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-1888 (Electronic) Linking ISSN: 00057894 NLM ISO Abbreviation: Behav Ther Subsets: MEDLINE
Imprint Name(s): Publication: 2006- : London : Elsevier
Original Publication: New York, Academic Press.
MeSH Terms: Generalized Anxiety Disorder*/diagnosis , Psychometrics*/methods , Psychometrics*/trends , Uncertainty* , Psychiatric Status Rating Scales*, Humans ; Sensitivity and Specificity ; Self Report
Abstract: Over 30 years ago, a group of researchers at Laval University, Canada, conceptualized the construct of intolerance of uncertainty (IU) and proposed a self-report measure of IU, the Intolerance of Uncertainty Scale (IUS; Freeston et al., 1994). At the time, we were interested in identifying a cognitive vulnerability factor for the development and maintenance of worry and GAD. Initial nonclinical and clinical research by the Laval group suggested that IU, as measured by the IUS, was a sensitive and relatively specific marker of worry and GAD. Subsequent studies by countless other research groups indicate that although IU does show some evidence of specificity to worry and GAD, it is also a transdiagnostic and trans-situational construct. In the current State of the Science paper, we review the research on IU, with a focus on (1) initial studies on the specificity of IU to worry and GAD, (2) the construct and measurement of IU, (3) the transdiagnostic and trans-situational nature of IU, (4) cultural and related considerations, (5) IU and cognitive processing, (6) the neural and psychophysiological correlates of IU, (7) treatment and IU, and (8) future directions. Overall, it can be concluded that the construct of intolerance of uncertainty, despite the fact that its definition and measurement remain actively debated, has established itself as a central construct in the field of mental health and psychopathology. Indeed, research on IU over the past three decades has led to significant improvements in both theory and clinical practice, and to a better understanding of what people think, feel, and do when experiencing uncertainty.
(Copyright © 2025 Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd. All rights reserved.)
Contributed Indexing: Keywords: cognitive processing and psychophysiology; construct and measurement; culture and development; intolerance of uncertainty; treatment
Entry Date(s): Date Created: 20260131 Date Completed: 20260311 Latest Revision: 20260311
Update Code: 20260311
DOI: 10.1016/j.beth.2025.08.009
PMID: 41620241
Database: MEDLINE
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  Data: <searchLink fieldCode="AU" term="%22Dugas+MJ%22">Dugas MJ</searchLink>; Université du Québec en Outaouais. Electronic address: michel.dugas@uqo.ca.<br /><searchLink fieldCode="AU" term="%22Koerner+N%22">Koerner N</searchLink>; Toronto Metropolitan University.<br /><searchLink fieldCode="AU" term="%22Freeston+MH%22">Freeston MH</searchLink>; Newcastle University.
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  Data: Over 30 years ago, a group of researchers at Laval University, Canada, conceptualized the construct of intolerance of uncertainty (IU) and proposed a self-report measure of IU, the Intolerance of Uncertainty Scale (IUS; Freeston et al., 1994). At the time, we were interested in identifying a cognitive vulnerability factor for the development and maintenance of worry and GAD. Initial nonclinical and clinical research by the Laval group suggested that IU, as measured by the IUS, was a sensitive and relatively specific marker of worry and GAD. Subsequent studies by countless other research groups indicate that although IU does show some evidence of specificity to worry and GAD, it is also a transdiagnostic and trans-situational construct. In the current State of the Science paper, we review the research on IU, with a focus on (1) initial studies on the specificity of IU to worry and GAD, (2) the construct and measurement of IU, (3) the transdiagnostic and trans-situational nature of IU, (4) cultural and related considerations, (5) IU and cognitive processing, (6) the neural and psychophysiological correlates of IU, (7) treatment and IU, and (8) future directions. Overall, it can be concluded that the construct of intolerance of uncertainty, despite the fact that its definition and measurement remain actively debated, has established itself as a central construct in the field of mental health and psychopathology. Indeed, research on IU over the past three decades has led to significant improvements in both theory and clinical practice, and to a better understanding of what people think, feel, and do when experiencing uncertainty.<br /> (Copyright © 2025 Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd. All rights reserved.)
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