Intolerance of uncertainty in pediatric patients: A transdiagnostic pathway to multiple disorders
Main Article Content
Abstract
The search for transdiagnostic pathways and processes to emotional disorders in youth is an emerging and compelling field. In this mini-review, intolerance of uncertainty is posed as a transdiagnostic pathway. The theoretical foundation of intolerance of uncertainty is discussed. Subtypes of intolerance of uncertainty are explained, a behavioral typology is reviewed, neuropsychological correlates are briefly discussed, and age differences are addressed. The role of the Coronavirus-19 pandemic as a critical incident is examined. Subsequently, the research supporting the association between intolerance of uncertainty and anxiety, obsessive-compulsive,, depression, autism, as well as eating disorders is reviewed. The findings are then integrated into a parsimonious theoretical synthesis. Limitations of the research are delineated and clinical implications are presented
Key Words: Intolerance of uncertainty, transdiagnostic, anxiety, depression, autism, eating disorders
Keywords:
Intolerance of uncertainty, transdiagnostic, anxiety, depression, autism, eating disorders
Article Details
How to Cite
FRIEDBERG, Robert D et al.
Intolerance of uncertainty in pediatric patients: A transdiagnostic pathway to multiple disorders.
Medical Research Archives, [S.l.], v. 10, n. 11, nov. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3314>. Date accessed: 22 july 2024.
doi: https://doi.org/10.18103/mra.v10i11.3314.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, Sanislow C, Wang P.
Research domain criteria (RDoC): Toward a new classification framework for research on
mental disorders. Am J Psychiatr. 2010; 167: 748-751. [PMID: 20595427
DOI: 10.1176/appi.ajp.2010.09091379}
2. McEvoy PM, Erceg-Hurn DM. The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty. J Anxiety Disord. 2016; 41: 96-107. [PMID: 26898177 DOI: 10.1016/j.janxdis.2016.02.002]
3. Correa KA, Liu H, Shankman SA. The role of intolerance of uncertainty in current and remitted internalizing and externalizing psychopathology. J Anxiety Disord. 2019; 62: 68-76. [PMID: 30639836
DOI: 10.1016/j.janxdis.2019.01.001]
4. DeSerisy M, Hirsch E, Stratterman J, Silverman M, Roy A. Intolerance of uncertainty and risk for anxiety: Neural mechanisms and cross-cultural implications. Behavr Therapist. 2021; 44, 346-356.
5. Carleton RN. Into the unknown: A review and synthesis of contemporary models involving uncertainty. J Anxiety Disord. 2016; 39: 30-43.
[PMID: 26945765 DOI: 10.1016/j.janxdis.2016.02.007]
6. Comer JS, Roy AK, Furr JM, Gotimer K, Beidas RS, Dugas MJ, Kendall PC. The Intolerance of Uncertainty Scale for Children: A psychometric evaluation. Psychol Assess. 2009; 21: 402-411. [PMID: 19719351 PMCID: PMC2952545
DOI: 10.1037/a0016719]
7. Dugas MJ, Hedayati M, Karavidas A, Buhr K, Francis K, Phillips NA. Intolerance of uncertainty and information processing: Evidence of biased recall and Interpretations. Cogn Behav The.r 2005; 29: 57-70. [DOI: 10.1007/s10608-005-1648-9]
8. Freeston M, Tiplady A, Mawn L, Bottesi G, Thwaites S. Towards a model of uncertainty distress in the context of coronavirus (COVID-19). Cogn Behav Ther..2020; 13:e 31 .[PMID: 34191941 PMCID: PMC7426588 DOI: 10.1017/S1754470X2000029X]
9. Geronimi EMC, Richards A, Gramszlo C, Woodruff-Borden J. A preliminary investigation of cognitive features associated with worry among Africa American youth. J Black Psychol. 2019; 45: 518-539. [DOI: 10.1177/0095798419870076]
10. Gillette CB, Bilek EL, Hanna GL, Fitzgerald KD. Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment. Clin Psychol Rev. 2018; 60: 100-108[PMID:29426573 DOI: 10.1016/j.cpr.2018.01.007]
11. Hearn CS, Donovan CL, Spence SH, March S, Holmes MC. What’s the worry with social anxiety? Comparing cognitive processes in children with generalized anxiety disorder and social anxiety disorder. Child Psychiatry Hum Dev. 2017; 48: 786-795. [PMID:
27917455 DOI: 10.1007/s10578-016-0703-y]
12. Kendall, PC, Norris, LA., Rabner, JC, Crane, ME, Rifkin, LS. (2020). Intolerance of uncertainty and parental accommodation: Promising targets for personalized intervention for youth anxiety. Curr Psychiatr Rep. 2020; 22: 1-8.[DOI: 10.1007/s11920-020-01170-3
13. Pinciotti CM, Riemann BC, Abramowitz JS. Intolerance of uncertainty and obsessive-compulsive disorder dimensions. J Anxiety Disord. 2021; 81: 102417. [PMID: 33991818 DOI: 10.1016/j.janxdis.2021.102417]
14. Read KL, Comer JS, Kendall PC. The Intolerance of Uncertainty Scale for Children
(IUSC): Discriminating principal anxiety diagnoses and severity. Psychol Assess. 2013; 25: 722-729.
[PMID: 23647032 DOI: 10.1037/a0032392]
15. Rettie H, Daniels J. Coping and tolerance of uncertainty: Predictors and mediators of mental health during the COVID-19 pandemic. Am Psychol. 2020; 76: 427-437. [PMID: 32744841 DOI: 10.1037/amp0000710]
16, Rifkin LS, Kendall PC. Intolerance of uncertainty in youth: Psychometrics of the Intolerance of Uncertainty Index-A for Children. J Anxiety Disord. 2020; 71: 102197. [PMID: 32126335 DOI: 10.1016/j.janxdis.2020.102197
17. Shihata S, McEvoy PM, Mullan BA, Carleton RN. Intolerance of uncertainty in emotional disorders: What uncertainties remain? J Anxiety Disord. 2016; 41: 115-124. [PMID: 27212227
DOI: 10.1016/j.janxdis.2016.05.001]
18. Watts R, Cossar J, Ferreira N. Applicability of the intolerance of uncertainty model to generalized anxiety disorder symptoms in young people. Mediterr J Clin Psychol. 2021; 9: 1-20. [DOI: 10.13129/2282-1619/mjcp-2978]
19. Wheaton MG, Messner GR, Marks JB. Intolerance of uncertainty as a factor
linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of
the novel coronavirus (COVID-19) in the United States. J Obsessive Compuls Relat Disord. 2021; 28: 100605. [PMID: 33251098 PMCID: PMC7681070
DOI: 10.1016/j.jocrd.2020.100605]
20. Wright KD, Adams Lebell MAN, Carleton RN. Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth. J Anxiety Disord. 2016; 41: 35-42. [PMID: 27302203 DOI: 10.1016/j.janxdis.2016.04.011]
21. Milne S, Lomax C, Freeston MH. A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety. Cogn Behav Ther. 2019; 12: 1-18. [DOI: 10.1017/S1754470X19000230]
22. Bottesi G, Marchetti I, Sica C, Ghisi M. What is the internal structure of intolerance of uncertainty? A network analysis approach. J Anxiety Disord. 2020; 75: 102293. [PMID: 32827868
DOI: 10.1016/j.janxdis.2020.102293]
23. Vasa, RA, Kreiserm NL, Keefer,A, Singh, V, Mostofsky, SH. Relationships between Autism Spectrum Disorder and intolerance of uncertainty. Autism Re.s 2018; 11: 636-644. [PMCID PMC: 5903967
DOI: 10.1002/aur1916]
24. Sankar R, Robinson L, Freeston M. ‘We know intolerance of uncertainty is a transdiagnostic factor but we don’t know what it looks like in everyday life’: A systematic review of intolerance of uncertainty behaviours. Clin Psychol Forum. 2017; 296: 10-15.
25. Hawes MT, Farrell MR, Cannone JL, Finsaas MC, Olino TM, Klein DN. Early childhood temperament predicts intolerance of uncertainty in adolescence. J Anxiety Disord. 2021; 80: 102390. [PMID: 33857835 DOI: 10.1016/j.janxdis.2021.102390]
26. Jenkinson, R, Milne, E, Thompson, A. The relationship between the intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis. Autism. 2020; 24: 1933-1944. [PMCID 7539603 doi:10.1177/136236 320932437}
27 Osmanağaoğlu N, Creswell C, Dodd HF. Intolerance of uncertainty, anxiety, and worry in children and adolescents: A meta-analysis. J Affect Disord. 2018; 225: 80-90. [PMID: 28802117 DOI: 10.1016/j.jad.2017.07.035]
28. Stevens K, Rogers T, Campbell M, Björgvinsson T, Kertz S. A transdiagnostic examination of decreased intolerance of uncertainty and treatment outcome. Cog Behav Ther. 2018; 47: 19-33. [PMID: 28650777
DOI: 10.1080/16506073.2017.1338311]
29. Korte C, Friedberg RD, Wilgenbusch T, Paternostro JK, Brown K, Kakolu A, et al. Intolerance of uncertainty and health-related anxiety in youth amid the COVID-19 pandemic: Understanding and weathering the continuing storm. J Clin Psychol Med Settings. 2022; 29:645 653. [PMID: 34478037 PMCID: PMC8414950 DOI: 10.1007/s10880-021-09816-x]
30, Geok ET, Lee KYC, Sündermann O. An experimental investigation of intolerance of uncertainty and its impact on sub-clinical psychopathology. J Behav Ther Exp Psychiatry. 2022;75: 101718.
[PMID: 35081482 DOI: 10.1016/j.jbtep.2021.101718]
31. McEvoy PM, Hyett MP, Shihata S, Price JE, Strachan L. The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clin Psychol Rev. 2019; 73: 101778.
[PMID: 31678816 DOI: 10.1016/j.cpr.2019.101778]
32. Beauchaine TP, Gatze-Kopp LM. Genetic and environmental influences on behavior. In: Beauchaine, TP, Hinshaw, SP eds. Child and adolescent psychopathology. 2nd ed.. New York: John Wiley; 2013: 111-142.
33. DeSerisy M, Musial A, Comer JS, Roy AK. Functional connectivity of the anterior insula associated with intolerance of uncertainty in youth. Cogn Affect Behav Neurosci. 2020; 20: 493-502.
[PMID: 32124254 PMCID: PMC7272284 DOI: 10.3758/s13415-020-00780-x]
34. Beesdo-Baum K, Jenjahn E, Höfler M, Lueken U, Becker ES, Hoyer J. Avoidance, safety behavior, and reassurance seeking in generalized anxiety disorder. Depress Anxiety. 2012; 29:948-957. [PMID: 22581482 DOI: 10.1002/da.21955]
35. Satici B, Saricali M, Satici SA, Griffiths MD. Intolerance of uncertainty and mental wellbeing: Serial mediation by rumination and fear of COVID-19. Int J Ment Health Addict. 2020; 1-12. [PMID: 32427165 PMCID: PMC7228430 DOI: 10.1007/s11469-020-00305-0]
36. Petrongolo JL, Zelikovsky N, Keegan RM, Furth SL, Knight A. Examining uncertainty in illness in parents and children with chronic kidney disease and systemic lupus erythematosus: A mediational model of internalizing symptoms and health-related quality of life. J Clin Psychol Med Settings. 2020; 27: 31-40. [PMID: 30989366 DOI: 10.1007/s10880-019-09617-3]
37. Baker AE, Galván A. Threat or thrill? The neural mechanisms underlying the development of anxiety and risk taking in adolescence. Dev Cogn Neurosci. 2020; 45: 100841.
[PMID: 32829216 PMCID: PMC7451699
DOI: 10.1016/j.dcn.2020.100841]
38. Fialko L, Bolton D, Perrin S. Applicability of a cognitive model of worry to children and adolescents. Behav Res Ther. 2012; 50: 341-349. [PMID: 22459733
DOI: 10.1016/j.brat.2012.02.003].
39. Goupil L, Romand-Monnier M, Kouider S. Infants ask for help when they know they don’t know. Proc Natl Acad Sci. USA 2016; 113: 3492-3496.
[PMID: 26951655 PMCID: PMC4822620
DOI: 10.1073/pnas.1515129113].
40. Lyons KE, Ghetti S. I don’t want to pick! Introspection on uncertainty supports early strategic behavior. Child Dev. 2013; 84: 726-736. [PMID: 23278486
DOI: 10.1111/cdev.12004]
41. Dekkers LMS, Jansen BRJ, Salemink E, Huizenga HM. Intolerance of Uncertainty Scale: Measurement invariance among adolescent boys and girls and relationships with anxiety and risk taking. J Behav Ther Exp Psychiatry. 2017; 55: 57-65. [PMID: 27914319 DOI: 10.1016/j.jbtep.2016.11.009]
42. Thielsch C, Andor T, Ehring T. Metacognitions, intolerance of uncertainty, and worry: An investigation in adolescents. Pers Individ Dif. 2015; 74: 94-99. [DOI: 10.1016/j.paid.2014.10.004]
43. Weissman DG, Rodman AM, Rosen ML, Kasparek S, Mayes M, Sheridan MA, Lengua MA, et al.Contributions of emotional regulation and brain structure to adolescent internalizing problems and stress vulnerability during the COVID-19 pandemic: A longitudinal study. Bio Psychiatr. 2021; 1: 272-282 [DOI: 10.1016/j.bpsgps.2021.06.001]
44. Reizer A, Geffen L, Koslowski M. Life under the COVID-19 lockdown: On the relationship between intolerance of uncertainty and psychological distress. Psychol Trauma. 2021; 13: 432-437, [PMID: 33539162 DOI: 10.1037/tra0001012]
45, Racine N, McArthur BA, Cooke JE, Eirich R., Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A meta-analysis. JAMA Pediatr. 2021; 175: 1142–1150.
[doi: 10.1001/jamapediatrics.2021.2482]
46. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child Adolesc Health. 2020; 4: 347-349. [PMID: 32224303 PMCID: PMC7118598 DOI: 10.1016/S2352-4642(20)30096-1]
47. Paluszek MM, Asmundson AJN., Landry CA, McKay D, Taylor S, Asmundson GJG. Effects of anxiety sensitivity, disgust, intolerance of uncertainty on the COVID stress symdrome: a longitudinal assessment of the transdiagnostic constructs and the behavioral immune system. Cogn Behav Ther., 2021; 3, [10.1080/16506073.2021.1877339]
48. American Psychological Association. Stress in America™ 2020: A national mental crisis. Washington, DC: American Psychological Association 2020.
49. Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depress Anxiety. 2020; 37: 706-714. [PMID: 32627255 PMCID: PMC7362150
DOI: 10.1002/da.23071]
50, Office of the Surgeon General (OSG). Protecting youth mental health: The U.S. Surgeon General's advisory. Washington, DC: US Department of Health and Human Services 2021. [PMID: 34982518]
51. Haig-Ferguson A, Cooper K, Cartwright E, Loades ME, Daniels J. Practitioner review: Health anxiety in children and young people in the context of the COVID-19 pandemic. Behav Cogn Psychother. 2021; 49: 129-143. [PMID: 32829718 PMCID: PMC7503041
DOI: 10.1017/S1352465820000636]
52. Gee DG, Odriozoloa P. When uncertainty is a certainty: Optimizing exposure-based therapies. Biol Psychiatry. 2021 1:166-167. [DOI: 10.1016/j.bpsgos.2021.08.001]
53. Donovan CL, Holmes MC, Farrell LJ. Investigation of the cognitive variables associated with worry in children with generalised anxiety disorder and their parents. J Affect Disord. 2016; 192: 1-7. [PMID: 26702733
DOI: 10.1016/j.jad.2015.12.003]
54. Donovan CL, Holmes MC, Farrell LJ, Hearn CS. Thinking about worry: Investigation of the cognitive components of worry in children. J Affect Disord 2017; 208: 230-237. [PMID: 27792968
DOI: 10.1016/j.jad.2016.09.061]
55. Panarello B, Bukowski WM. Young adolescent experiences with the intolerance of uncertainty, worry, and anxious arousal across contexts. Can J Behav Sci. 2021; 53: 514-521. [DOI: 10.1037/cbs0000262]
56. Songco A, Hudson JL, Fox E. A cognitive model of pathological worry in children and adolescents: A systematic review. Clin Child Fam Psychol Rev. 2020; 23: 229-249. [PMID: 31989444 PMCID: PMC7192867 DOI: 10.1007/s10567-020-00311-7]
57 Cowie J, Clementi MA, Alfano CA. Examination of the intolerance of uncertainty construct in youth with generalized anxiety disorder. J Clin Child Adolesc Psychol. 2018; 47: 1014-1022.
[PMID: 27654145 PMCID: PMC7364664 DOI: 10.1080/15374416.2016.1212358]
58. Lee AH, Woodruff-Borden J. Roles of emotional reactivity, intolerance of uncertainty, and negative problem orientation on developing childhood worry. Pers Individ Dif. 2018; 135: 25-30.
[DOI: 10.1016/j.paid.2018.06.048]
59. Khan AN, Bilek E, Tomlinson RC, Becker-Haimes EM. Treating social anxiety in an era of social distancing: Adapting exposure therapy for youth during COVID-19. Cogn Behav Pract. 2021; 28: 669-678. [PMID: 33564222 PMCID: PMC7862041
DOI: 10.1016/j.cbpra.2020.12.002]
60. Oliver AM, Wright KD, Kakadekar A, Pharis S, Pockett C, Bradley TJ, Tomczak CR, Erlandson MC. Health anxiety and associated constructs in children and adolescents with congenital heart disease: A CHAMPS cohort study. J Health Psychol. 2020; 25: 1355-1365. [PMID: 29402140
DOI: 10.1177/1359105318755263]
61. Sauer KS, Jungmann, SM, Witthoft, M. Emotional and behavioral consequences of the COVID-19 pandemic: The role of health anxiety, intolerance of uncertainty, and distress (in) tolerance. Intl J Environ Res Public Health. 2020; 17:7241. [doi:10.3390/ijerph 17197241]
62. Cervin, M, Perrin, S, Olsson E, Aspvall K, Geller, DA, Wilhem S, et al. The centrality of doubting and checking in the network structure of obsessive-compulsive symptoms in youth. J Am Acad Child Adolesc Psychiatr. 2020; 95: 880-887.
[doi; 10.1016/j.aac.2019.06.018 PMCID: 7219532]
63. Pozza A, Albert U, Dèttore U. Perfectionism and intolerance of uncertainty are predictors of OCD symptoms in children and early adolescents: A prospective, cohort, one-year, follow-up study. Clin Neuropsychiatry. 2019; 16: 53-61. [PMID: 34908939
PMCID: PMC8650182]
64. Sperling J. The role of intolerance of uncertainty in treatment for pediatric anxiety disorders and obsessive-compulsive disorder. Evid Based Pract Child Adol Ment Hlth. 2022. [DOI: 10.1080/23794925.2022.2051215]
65. Cummings CM, Caporino NE, Kendall PC. Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull. 2014; 140: 816-845. [PMID: 24219155 PMCID: PMC4006306
DOI: 10.1037/a0034733]
66. Yao N, Qian M, Jiang Y, Elhai JD. The influence of intolerance of uncertainty on anxiety and depression symptoms in Chinese-speaking samples: Structure and validity of the Chinese translation of the Intolerance of Uncertainty Scale. J Per Assess. 2021: 103:406-415. [doi:10.1080/0022.3891.2020.1739058 PMCID: 32216599]
67. Zhuo L, Wu, Q, Le H, Li, H, Zheng L, Ma G, Tao H. COVID-19 related intolerance of uncertainty and mental health among back-to-school students in Wuhan: The moderation effect of social support. Intl J Environ Res Public Health. 2021; 18: 981.
[doi: 10/3390/ijerpn18030981]
68. Evans SC, Blossom JB, Fite PJ. Exploring longitudinal mechanisms of irritability in children: Implications for cognitive-behavioral intervention. Behav Ther. 2020; 51: 238-252. [PMID: 32138935
DOI: 10.1016/j.beth.2019.05.006]
69. Li Q, Luo R, Zhang X, Meng G, Dai B, Liu X. Intolerance of uncertainty and negative emotions among Chinese adolescents: A moderated mediation model of risk perception, social exclusion, and perceived efficacy. Intl J Environ Public Health. 2021; 18:2864. [doi:10.3390/ijerph18062894]
70. Fassett-Carman A, Hankin BL, Snyder HR. Appraisals of dependent stressor controllability and severity are associated with depression and anxiety symptoms in youth. Anxiety Stress Coping. 2019; 32: 32-49. [PMID: 30303017 PMCID: PMC6709974 DOI: 10.1080/10615806.2018.1532504]
71. Kovacs M. Children’s Depression Inventory-2. North Tonawanda, NY: Multi-Health Systems, 2010.
72. Rodriguez CM, Pu DF, Foiles AR. Cognitive-affective pathways to child depressive and anxious symptoms: Role of children’s discipline attributions. Child Psychiatry Hum Dev. 2019; 50: 163-171. [PMID: 30019223 DOI: 10.1007/s10578-018-0831-7]
73. Gladstone TR, Kaslow NJ, Seeley JR, Lewinsohn PM. Sex differences, attributional style, and depressive symptoms among adolescents. J Abnorm Child Psychol. 1997; 25: 297-306. [PMID: 9304446
DOI: 10.1023/a:1025712419436]
74. Hayward L, Vartanian LR, Kwick C, Newby JM. How might child adversity predict adult psychological distress? Applying the Identity Disruption Model to understanding depression and anxiety disorders. J Aff Disord. 2020; 765:112-119.
[doi:10.10167/jad.2020.01.036]
75, Cai RY, Richdale AL, Dissanayake C, Uljarević M. Brief report: Inter-relationship between emotion regulation, intolerance of uncertainty, anxiety, and depression in youth with autism spectrum disorder. J Autism Dev Disord. 2018; 48: 316-325. [PMID: 28980172
DOI: 10.1007/s10803-017-3318-7]
76, Neil L, Olsson NC, Pellicano E. The relationship between intolerance of uncertainty, sensory sensitivities, and anxiety in autistic and typically developing children. J Autism Dev Disord. 2016; 46: 1962-1973. [PMID: 26864157 PMCID: PMC4860201
DOI: 10.1007/s10803-016-2721-9]
77. Hodgson AR, Freeston MH, Honey E, Rodgers J. Facing the unknown: Intolerance of uncertainty in children with autism spectrum disorders. J App Res Intell Disab. 2016; 1-9 [doi:10.1111/12245]
78. Wigham S, Rodgers J, South M, McConachie H, Freeston M. The interplay between sensory processing abnormalities, intolerance of uncertainty, anxiety and restricted and repetitive behaviours in autism spectrum disorder. J Autism Dev Disord. 2015; 45: 943-952 [PMID: 25261248 DOI 10.1007/s10803-014-2248-x]
79. Stuart L, Grahame V, Honey E, Freeston M. Intolerance of uncertainty and anxiety as explanatory frameworks for extreme demand avoidance in children and adolescents. Child Adolesc Ment Health. 2020; 25: 59-67. [PMID: 32307839 DOI: 10.1111/camh.12336]
80. Stice E, Bohan C. Eating disorders. In: Beauchaine, TP, Hinshaw, SP, eds. Child and adolescent psychopathology, 2nd ed. New York: John Wiley, 2013: 715-738.
81. Bijsterbosch JM, Keizer A, Boelen PA, Van den Brink F, Danner UN, Sternheim LC. How deep is your thought? The relations between intolerance of uncertainty, worry and weight and shape concerns in adolescent girls with anorexia nervosa. J Eat Disord. 2021; 9: 164. [PMID: 34930469 PMCID: PMC8686596
DOI: 10.1186/s40337-021-00523-4]
82. Brosof LC, Egbert AH, Reilly EE, Wonderlich JA, Karam A, Vanzhula I, et al. Intolerance of uncertainty moderates the relationship between high personal standards but not evaluative concerns perfectionism and eating disorder symptoms cross-sectionally and prospectively. Eat Behav. 2019; 35: 101340. [PMID: 31731235
DOI: 10.1016/j.eatbeh.2019.101340]
83. Giles S, Toohey M, Hughes EK, Fuller-Tyszkiewicz M, Krug I. Do orthorexia and intolerance of uncertainty mediate the relationship between autism spectrum traits and disordered eating symptoms? Eat Weight Disord. 2021; 26: 2309-2316. [PMID: 33389701 DOI: 10.1007/s40519-020-01094-0]
84. Reilly EE, Perry TR, Brown TA, Wierenga CE, Kaye WH. Intolerance of uncertainty and eating disorder symptoms over the course of intensive treatment. Behav Ther. 2021; 52: 698-708. [PMID: 33990243
DOI: 10.1016/j.beth.2020.09.002]
85. Konstantellou A, Hale L, Sternheim L, Simic M, Eisler I. The experience of
intolerance of uncertainty for young people with a restrictive eating disorder: A pilot study. Eat Weight Disord. 2019; 24: 533-540. [PMID: 30778868 DOI: 10.1007/s40519-019-00652-5]
86. Schaumberg K, Reilly EE, Gorrell S, Levinson CA, Farrell NR, Brown TA, Smith KM, Schaefer LM, Essayli JH, Haynos AF, Anderson LM. Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research. Clin Psychol Rev. 2021; 83: 101952 [PMID: 33221621 PMCID: PMC7868093 DOI: 10.1016/j.cpr.2020.101952]
87. Kesby A, Maguire S, Brownlow R, Grisham JR. Intolerance of uncertainty in eating disorders: An update on the field. Clin Psychol Rev. 2017; 56: 94-105 [PMID: 28710918 DOI:
10.1016/j.cpr.2017.07.002]
88. Sternheim L, Harrison A. The acceptability, feasibility and possible benefits of a group-based intervention targeting intolerance of uncertainty in adolescent inpatients with anorexia nervosa. Cogent Psychol. 2018; 5: 1441594.
[DOI: 10.1080/23311908.2018.1441594]
89. Palitz SA, Rifkin LS, Norris LA, Knepley M, Fleischer NJ, Steinberg L, Kendall PC. But what will the results be?: Learning to tolerate uncertainty is associated with treatment-produced gains. J Anxiety Disord. 2019; 68: 102146. [PMID: 31669785
DOI: 10.1016/j.janxdis.2019.102146]
90. Beck AT. Cognitive therapy and the emotional disorders. 2nd ed. New York: International University Press; 1976
91. Beck AT, Clark DA. Anxiety and depression: An information processing perspective. Anxiety Stress Coping. 1998; 1: 23-36.[DOI: 10.1080/10615808808248218]
92. Ghahramanlou-Holloway M, Wenzel A, Lou K, Beck AT. Differentiating cognitive content between depressed and anxious outpatients. Cogn Behav The.r 2007; 36: 170-178. [PMID: 17852174
DOI: 10.1080/16506070701374256]
93. Ingram RE, Kendall PC. Cognitive clinical psychology: Implications of an information processing perspective. In: Ingram, RE, ed. Information processing approaches to clinical psychology. Orlando, FL: Academic Press, 1986: 3-21.
94. Sanchez AL, Cornacchio D, Chou T, Leyfer O, Coxe S, Pincus D, et al. Development of a scale to evaluate young children’s responses to uncertainty and low environmental structure. J Anxiety Disord. 2017; 45: 17-23. [PMID: 27907833
DOI: 10.1016/j.janxdis.2016.11.006]
95. Osmanağaoğlu N, Creswell C, Snuggs S, Stuijfzand S, Dodd HF. Evaluating the psychometric properties of the intolerance of uncertainty scale for children in a preadolescent sample. J Anxiety Disord. 2021; 77: 102343. [PMID: 33310446 DOI: 10.1016/j.janxdis.2020.102343]
96. Tiller-Ormord J, Korte C, Friedberg RD. Helping pediatric patients tolerate uncertainty during unprecedented times: Translating findings from new research on developmental psychopathology and two promising measures. J Trans Sci .2021; 7: 1-5. [DOI: 10.15761]
97. Einstein DA. Extension of the transdiagnostic model to focus on intolerance of uncertainty: A review of the literature and implications for treatment. Clin Psychol.2014; 21: 280-300. [PMID: 25400336 PMCID: PMC4204511 DOI: 10.1111/cpsp.12077].
98. Wahlund T, Andersson E, Jolstedt M, Perrin S, Vigerland S, Serlachius E. Intolerance of uncertainty-focused treatment for adolescents with excessive worry: A pilot feasibility study. Cogn Behav Pract. 2020; 27: 215-230. [DOI: 10.1016/j.cbpra.2019.06.002]
99. Chorpita BF, Weisz JR. MATCH-ADTC: Modular approach to therapy for children with anxiety, depression, trauma, or conduct problems. Satellite Beach, FL: PracticeWise; 2009
100. Friedberg RD, Paternostro JK. Cognitive behavioral therapy with youth: Essential foundations and elementary practices. In: Friedberg RD, Paternostro JK, eds. Handbook of cognitive behavioral therapy for pediatric medical conditions New York; Springer Nature, 2019:87-102.
101. Friedberg RD, Thordarson MA. Cognitive behavioral therapy. In: Matson J. ed. Handbook of child psychopathology and developmental disabilities treatment. New York: Springer, 2018: 43-62.
102. McClure JM, Friedberg RD, Thordarson MA, Keller M. CBT express: Effective 15-minute techniques for treating children and adolescents. New York: Guilford Press, 2019.
103. Hebert EA, Dugas MJ. Behavioral experiments for intolerance of uncertainty: Challenging the unknown in the treatment of generalized anxiety disorder. Cogn Behav Pract. 2019; 26:421-436.
[DOI: 10.1016/j.cbpra.2018.07.007]
104. Kendall PC, Hedtke KA. Coping cat workbook. Ardmore, PA: Workbook Publishing, 2006.
105. Stallard P. Think good, feel good. A cognitive behavioural therapy workbook for children and young people. New York: John Wiley, 2002.
106. Friedberg RD, McClure JM. Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. 2nd ed. New York: Guilford, 2015.
107. McGuire JF, Storch EA. An inhibitory learning approach to cognitive-behavioral therapy for children and adolescents. Cogn Behav Pract. 2019; 26: 214-224. [PMID: 31205406 PMCID: PMC6570488 DOI: 10.1016/j.cbpra.2017.12.003]
108. Ale, CM, McCarthy, DM, Rothchild, LM, Whiteside, SPH. Components of cognitive behavioral therapy related to outcome in childhood anxiety disorders. Clin Child Family Rev. 2015; 18: 240-251. [PMID: 26001645 DOI: 10.1007/s10567-015-0184-8]
109. Banneyer, KN, Bonin, L, Price, K, Goodman, WK, Storch, EA. Cognitive behavioral therapy for childhood anxiety disorders: a review of recent advances. Curr Psychiatr Rep. 2018; 20: 65. [PMID: 30056623 DOI: 10.1007/s11920-018-0924-9]
110. Silk, JS, Tan, PZ, Ladoucuer, CD, Meller, S, Siegle, CJ, McMakin, DL, Forbes, EE, Dahl RE, Kendall PC Mannarino, A, Ryan, ND. A randomized clinical trial comparing individual CBT and child-centered therapy for child anxiety disorders. J Clin Child Adolesc Psychol. 2018; 47:542-554 [PMID: 26983904 DOI: 10.1080/15374416.2016.1138408]
111. Bergez, KC, Ramirez, AC, Grebe, SC, Perez, MI, Viana, AG, Storch, EA, et al. Efficacy of exposure-based therapy for youth anxiety and obsessive compulsive disorder. In Exposure therapy for children with anxiety. Peris, TS, Storch, EA, McGuire, JF eds. New York: Academic Press, 2020.
112. Higa-McMillan, CK, Francis, SE, Rith-Najarian, L, Chorpita, BF. Evidence-based update: 50 years of research on treatment for child and adolescent anxiety, J Clin Child Adolesc Psychol. 2015; 45:91-113 [PMID: 26087438
DOI: 10.1080/15374416.2015.1046177]
Research domain criteria (RDoC): Toward a new classification framework for research on
mental disorders. Am J Psychiatr. 2010; 167: 748-751. [PMID: 20595427
DOI: 10.1176/appi.ajp.2010.09091379}
2. McEvoy PM, Erceg-Hurn DM. The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty. J Anxiety Disord. 2016; 41: 96-107. [PMID: 26898177 DOI: 10.1016/j.janxdis.2016.02.002]
3. Correa KA, Liu H, Shankman SA. The role of intolerance of uncertainty in current and remitted internalizing and externalizing psychopathology. J Anxiety Disord. 2019; 62: 68-76. [PMID: 30639836
DOI: 10.1016/j.janxdis.2019.01.001]
4. DeSerisy M, Hirsch E, Stratterman J, Silverman M, Roy A. Intolerance of uncertainty and risk for anxiety: Neural mechanisms and cross-cultural implications. Behavr Therapist. 2021; 44, 346-356.
5. Carleton RN. Into the unknown: A review and synthesis of contemporary models involving uncertainty. J Anxiety Disord. 2016; 39: 30-43.
[PMID: 26945765 DOI: 10.1016/j.janxdis.2016.02.007]
6. Comer JS, Roy AK, Furr JM, Gotimer K, Beidas RS, Dugas MJ, Kendall PC. The Intolerance of Uncertainty Scale for Children: A psychometric evaluation. Psychol Assess. 2009; 21: 402-411. [PMID: 19719351 PMCID: PMC2952545
DOI: 10.1037/a0016719]
7. Dugas MJ, Hedayati M, Karavidas A, Buhr K, Francis K, Phillips NA. Intolerance of uncertainty and information processing: Evidence of biased recall and Interpretations. Cogn Behav The.r 2005; 29: 57-70. [DOI: 10.1007/s10608-005-1648-9]
8. Freeston M, Tiplady A, Mawn L, Bottesi G, Thwaites S. Towards a model of uncertainty distress in the context of coronavirus (COVID-19). Cogn Behav Ther..2020; 13:e 31 .[PMID: 34191941 PMCID: PMC7426588 DOI: 10.1017/S1754470X2000029X]
9. Geronimi EMC, Richards A, Gramszlo C, Woodruff-Borden J. A preliminary investigation of cognitive features associated with worry among Africa American youth. J Black Psychol. 2019; 45: 518-539. [DOI: 10.1177/0095798419870076]
10. Gillette CB, Bilek EL, Hanna GL, Fitzgerald KD. Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment. Clin Psychol Rev. 2018; 60: 100-108[PMID:29426573 DOI: 10.1016/j.cpr.2018.01.007]
11. Hearn CS, Donovan CL, Spence SH, March S, Holmes MC. What’s the worry with social anxiety? Comparing cognitive processes in children with generalized anxiety disorder and social anxiety disorder. Child Psychiatry Hum Dev. 2017; 48: 786-795. [PMID:
27917455 DOI: 10.1007/s10578-016-0703-y]
12. Kendall, PC, Norris, LA., Rabner, JC, Crane, ME, Rifkin, LS. (2020). Intolerance of uncertainty and parental accommodation: Promising targets for personalized intervention for youth anxiety. Curr Psychiatr Rep. 2020; 22: 1-8.[DOI: 10.1007/s11920-020-01170-3
13. Pinciotti CM, Riemann BC, Abramowitz JS. Intolerance of uncertainty and obsessive-compulsive disorder dimensions. J Anxiety Disord. 2021; 81: 102417. [PMID: 33991818 DOI: 10.1016/j.janxdis.2021.102417]
14. Read KL, Comer JS, Kendall PC. The Intolerance of Uncertainty Scale for Children
(IUSC): Discriminating principal anxiety diagnoses and severity. Psychol Assess. 2013; 25: 722-729.
[PMID: 23647032 DOI: 10.1037/a0032392]
15. Rettie H, Daniels J. Coping and tolerance of uncertainty: Predictors and mediators of mental health during the COVID-19 pandemic. Am Psychol. 2020; 76: 427-437. [PMID: 32744841 DOI: 10.1037/amp0000710]
16, Rifkin LS, Kendall PC. Intolerance of uncertainty in youth: Psychometrics of the Intolerance of Uncertainty Index-A for Children. J Anxiety Disord. 2020; 71: 102197. [PMID: 32126335 DOI: 10.1016/j.janxdis.2020.102197
17. Shihata S, McEvoy PM, Mullan BA, Carleton RN. Intolerance of uncertainty in emotional disorders: What uncertainties remain? J Anxiety Disord. 2016; 41: 115-124. [PMID: 27212227
DOI: 10.1016/j.janxdis.2016.05.001]
18. Watts R, Cossar J, Ferreira N. Applicability of the intolerance of uncertainty model to generalized anxiety disorder symptoms in young people. Mediterr J Clin Psychol. 2021; 9: 1-20. [DOI: 10.13129/2282-1619/mjcp-2978]
19. Wheaton MG, Messner GR, Marks JB. Intolerance of uncertainty as a factor
linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of
the novel coronavirus (COVID-19) in the United States. J Obsessive Compuls Relat Disord. 2021; 28: 100605. [PMID: 33251098 PMCID: PMC7681070
DOI: 10.1016/j.jocrd.2020.100605]
20. Wright KD, Adams Lebell MAN, Carleton RN. Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth. J Anxiety Disord. 2016; 41: 35-42. [PMID: 27302203 DOI: 10.1016/j.janxdis.2016.04.011]
21. Milne S, Lomax C, Freeston MH. A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety. Cogn Behav Ther. 2019; 12: 1-18. [DOI: 10.1017/S1754470X19000230]
22. Bottesi G, Marchetti I, Sica C, Ghisi M. What is the internal structure of intolerance of uncertainty? A network analysis approach. J Anxiety Disord. 2020; 75: 102293. [PMID: 32827868
DOI: 10.1016/j.janxdis.2020.102293]
23. Vasa, RA, Kreiserm NL, Keefer,A, Singh, V, Mostofsky, SH. Relationships between Autism Spectrum Disorder and intolerance of uncertainty. Autism Re.s 2018; 11: 636-644. [PMCID PMC: 5903967
DOI: 10.1002/aur1916]
24. Sankar R, Robinson L, Freeston M. ‘We know intolerance of uncertainty is a transdiagnostic factor but we don’t know what it looks like in everyday life’: A systematic review of intolerance of uncertainty behaviours. Clin Psychol Forum. 2017; 296: 10-15.
25. Hawes MT, Farrell MR, Cannone JL, Finsaas MC, Olino TM, Klein DN. Early childhood temperament predicts intolerance of uncertainty in adolescence. J Anxiety Disord. 2021; 80: 102390. [PMID: 33857835 DOI: 10.1016/j.janxdis.2021.102390]
26. Jenkinson, R, Milne, E, Thompson, A. The relationship between the intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis. Autism. 2020; 24: 1933-1944. [PMCID 7539603 doi:10.1177/136236 320932437}
27 Osmanağaoğlu N, Creswell C, Dodd HF. Intolerance of uncertainty, anxiety, and worry in children and adolescents: A meta-analysis. J Affect Disord. 2018; 225: 80-90. [PMID: 28802117 DOI: 10.1016/j.jad.2017.07.035]
28. Stevens K, Rogers T, Campbell M, Björgvinsson T, Kertz S. A transdiagnostic examination of decreased intolerance of uncertainty and treatment outcome. Cog Behav Ther. 2018; 47: 19-33. [PMID: 28650777
DOI: 10.1080/16506073.2017.1338311]
29. Korte C, Friedberg RD, Wilgenbusch T, Paternostro JK, Brown K, Kakolu A, et al. Intolerance of uncertainty and health-related anxiety in youth amid the COVID-19 pandemic: Understanding and weathering the continuing storm. J Clin Psychol Med Settings. 2022; 29:645 653. [PMID: 34478037 PMCID: PMC8414950 DOI: 10.1007/s10880-021-09816-x]
30, Geok ET, Lee KYC, Sündermann O. An experimental investigation of intolerance of uncertainty and its impact on sub-clinical psychopathology. J Behav Ther Exp Psychiatry. 2022;75: 101718.
[PMID: 35081482 DOI: 10.1016/j.jbtep.2021.101718]
31. McEvoy PM, Hyett MP, Shihata S, Price JE, Strachan L. The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clin Psychol Rev. 2019; 73: 101778.
[PMID: 31678816 DOI: 10.1016/j.cpr.2019.101778]
32. Beauchaine TP, Gatze-Kopp LM. Genetic and environmental influences on behavior. In: Beauchaine, TP, Hinshaw, SP eds. Child and adolescent psychopathology. 2nd ed.. New York: John Wiley; 2013: 111-142.
33. DeSerisy M, Musial A, Comer JS, Roy AK. Functional connectivity of the anterior insula associated with intolerance of uncertainty in youth. Cogn Affect Behav Neurosci. 2020; 20: 493-502.
[PMID: 32124254 PMCID: PMC7272284 DOI: 10.3758/s13415-020-00780-x]
34. Beesdo-Baum K, Jenjahn E, Höfler M, Lueken U, Becker ES, Hoyer J. Avoidance, safety behavior, and reassurance seeking in generalized anxiety disorder. Depress Anxiety. 2012; 29:948-957. [PMID: 22581482 DOI: 10.1002/da.21955]
35. Satici B, Saricali M, Satici SA, Griffiths MD. Intolerance of uncertainty and mental wellbeing: Serial mediation by rumination and fear of COVID-19. Int J Ment Health Addict. 2020; 1-12. [PMID: 32427165 PMCID: PMC7228430 DOI: 10.1007/s11469-020-00305-0]
36. Petrongolo JL, Zelikovsky N, Keegan RM, Furth SL, Knight A. Examining uncertainty in illness in parents and children with chronic kidney disease and systemic lupus erythematosus: A mediational model of internalizing symptoms and health-related quality of life. J Clin Psychol Med Settings. 2020; 27: 31-40. [PMID: 30989366 DOI: 10.1007/s10880-019-09617-3]
37. Baker AE, Galván A. Threat or thrill? The neural mechanisms underlying the development of anxiety and risk taking in adolescence. Dev Cogn Neurosci. 2020; 45: 100841.
[PMID: 32829216 PMCID: PMC7451699
DOI: 10.1016/j.dcn.2020.100841]
38. Fialko L, Bolton D, Perrin S. Applicability of a cognitive model of worry to children and adolescents. Behav Res Ther. 2012; 50: 341-349. [PMID: 22459733
DOI: 10.1016/j.brat.2012.02.003].
39. Goupil L, Romand-Monnier M, Kouider S. Infants ask for help when they know they don’t know. Proc Natl Acad Sci. USA 2016; 113: 3492-3496.
[PMID: 26951655 PMCID: PMC4822620
DOI: 10.1073/pnas.1515129113].
40. Lyons KE, Ghetti S. I don’t want to pick! Introspection on uncertainty supports early strategic behavior. Child Dev. 2013; 84: 726-736. [PMID: 23278486
DOI: 10.1111/cdev.12004]
41. Dekkers LMS, Jansen BRJ, Salemink E, Huizenga HM. Intolerance of Uncertainty Scale: Measurement invariance among adolescent boys and girls and relationships with anxiety and risk taking. J Behav Ther Exp Psychiatry. 2017; 55: 57-65. [PMID: 27914319 DOI: 10.1016/j.jbtep.2016.11.009]
42. Thielsch C, Andor T, Ehring T. Metacognitions, intolerance of uncertainty, and worry: An investigation in adolescents. Pers Individ Dif. 2015; 74: 94-99. [DOI: 10.1016/j.paid.2014.10.004]
43. Weissman DG, Rodman AM, Rosen ML, Kasparek S, Mayes M, Sheridan MA, Lengua MA, et al.Contributions of emotional regulation and brain structure to adolescent internalizing problems and stress vulnerability during the COVID-19 pandemic: A longitudinal study. Bio Psychiatr. 2021; 1: 272-282 [DOI: 10.1016/j.bpsgps.2021.06.001]
44. Reizer A, Geffen L, Koslowski M. Life under the COVID-19 lockdown: On the relationship between intolerance of uncertainty and psychological distress. Psychol Trauma. 2021; 13: 432-437, [PMID: 33539162 DOI: 10.1037/tra0001012]
45, Racine N, McArthur BA, Cooke JE, Eirich R., Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A meta-analysis. JAMA Pediatr. 2021; 175: 1142–1150.
[doi: 10.1001/jamapediatrics.2021.2482]
46. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child Adolesc Health. 2020; 4: 347-349. [PMID: 32224303 PMCID: PMC7118598 DOI: 10.1016/S2352-4642(20)30096-1]
47. Paluszek MM, Asmundson AJN., Landry CA, McKay D, Taylor S, Asmundson GJG. Effects of anxiety sensitivity, disgust, intolerance of uncertainty on the COVID stress symdrome: a longitudinal assessment of the transdiagnostic constructs and the behavioral immune system. Cogn Behav Ther., 2021; 3, [10.1080/16506073.2021.1877339]
48. American Psychological Association. Stress in America™ 2020: A national mental crisis. Washington, DC: American Psychological Association 2020.
49. Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depress Anxiety. 2020; 37: 706-714. [PMID: 32627255 PMCID: PMC7362150
DOI: 10.1002/da.23071]
50, Office of the Surgeon General (OSG). Protecting youth mental health: The U.S. Surgeon General's advisory. Washington, DC: US Department of Health and Human Services 2021. [PMID: 34982518]
51. Haig-Ferguson A, Cooper K, Cartwright E, Loades ME, Daniels J. Practitioner review: Health anxiety in children and young people in the context of the COVID-19 pandemic. Behav Cogn Psychother. 2021; 49: 129-143. [PMID: 32829718 PMCID: PMC7503041
DOI: 10.1017/S1352465820000636]
52. Gee DG, Odriozoloa P. When uncertainty is a certainty: Optimizing exposure-based therapies. Biol Psychiatry. 2021 1:166-167. [DOI: 10.1016/j.bpsgos.2021.08.001]
53. Donovan CL, Holmes MC, Farrell LJ. Investigation of the cognitive variables associated with worry in children with generalised anxiety disorder and their parents. J Affect Disord. 2016; 192: 1-7. [PMID: 26702733
DOI: 10.1016/j.jad.2015.12.003]
54. Donovan CL, Holmes MC, Farrell LJ, Hearn CS. Thinking about worry: Investigation of the cognitive components of worry in children. J Affect Disord 2017; 208: 230-237. [PMID: 27792968
DOI: 10.1016/j.jad.2016.09.061]
55. Panarello B, Bukowski WM. Young adolescent experiences with the intolerance of uncertainty, worry, and anxious arousal across contexts. Can J Behav Sci. 2021; 53: 514-521. [DOI: 10.1037/cbs0000262]
56. Songco A, Hudson JL, Fox E. A cognitive model of pathological worry in children and adolescents: A systematic review. Clin Child Fam Psychol Rev. 2020; 23: 229-249. [PMID: 31989444 PMCID: PMC7192867 DOI: 10.1007/s10567-020-00311-7]
57 Cowie J, Clementi MA, Alfano CA. Examination of the intolerance of uncertainty construct in youth with generalized anxiety disorder. J Clin Child Adolesc Psychol. 2018; 47: 1014-1022.
[PMID: 27654145 PMCID: PMC7364664 DOI: 10.1080/15374416.2016.1212358]
58. Lee AH, Woodruff-Borden J. Roles of emotional reactivity, intolerance of uncertainty, and negative problem orientation on developing childhood worry. Pers Individ Dif. 2018; 135: 25-30.
[DOI: 10.1016/j.paid.2018.06.048]
59. Khan AN, Bilek E, Tomlinson RC, Becker-Haimes EM. Treating social anxiety in an era of social distancing: Adapting exposure therapy for youth during COVID-19. Cogn Behav Pract. 2021; 28: 669-678. [PMID: 33564222 PMCID: PMC7862041
DOI: 10.1016/j.cbpra.2020.12.002]
60. Oliver AM, Wright KD, Kakadekar A, Pharis S, Pockett C, Bradley TJ, Tomczak CR, Erlandson MC. Health anxiety and associated constructs in children and adolescents with congenital heart disease: A CHAMPS cohort study. J Health Psychol. 2020; 25: 1355-1365. [PMID: 29402140
DOI: 10.1177/1359105318755263]
61. Sauer KS, Jungmann, SM, Witthoft, M. Emotional and behavioral consequences of the COVID-19 pandemic: The role of health anxiety, intolerance of uncertainty, and distress (in) tolerance. Intl J Environ Res Public Health. 2020; 17:7241. [doi:10.3390/ijerph 17197241]
62. Cervin, M, Perrin, S, Olsson E, Aspvall K, Geller, DA, Wilhem S, et al. The centrality of doubting and checking in the network structure of obsessive-compulsive symptoms in youth. J Am Acad Child Adolesc Psychiatr. 2020; 95: 880-887.
[doi; 10.1016/j.aac.2019.06.018 PMCID: 7219532]
63. Pozza A, Albert U, Dèttore U. Perfectionism and intolerance of uncertainty are predictors of OCD symptoms in children and early adolescents: A prospective, cohort, one-year, follow-up study. Clin Neuropsychiatry. 2019; 16: 53-61. [PMID: 34908939
PMCID: PMC8650182]
64. Sperling J. The role of intolerance of uncertainty in treatment for pediatric anxiety disorders and obsessive-compulsive disorder. Evid Based Pract Child Adol Ment Hlth. 2022. [DOI: 10.1080/23794925.2022.2051215]
65. Cummings CM, Caporino NE, Kendall PC. Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull. 2014; 140: 816-845. [PMID: 24219155 PMCID: PMC4006306
DOI: 10.1037/a0034733]
66. Yao N, Qian M, Jiang Y, Elhai JD. The influence of intolerance of uncertainty on anxiety and depression symptoms in Chinese-speaking samples: Structure and validity of the Chinese translation of the Intolerance of Uncertainty Scale. J Per Assess. 2021: 103:406-415. [doi:10.1080/0022.3891.2020.1739058 PMCID: 32216599]
67. Zhuo L, Wu, Q, Le H, Li, H, Zheng L, Ma G, Tao H. COVID-19 related intolerance of uncertainty and mental health among back-to-school students in Wuhan: The moderation effect of social support. Intl J Environ Res Public Health. 2021; 18: 981.
[doi: 10/3390/ijerpn18030981]
68. Evans SC, Blossom JB, Fite PJ. Exploring longitudinal mechanisms of irritability in children: Implications for cognitive-behavioral intervention. Behav Ther. 2020; 51: 238-252. [PMID: 32138935
DOI: 10.1016/j.beth.2019.05.006]
69. Li Q, Luo R, Zhang X, Meng G, Dai B, Liu X. Intolerance of uncertainty and negative emotions among Chinese adolescents: A moderated mediation model of risk perception, social exclusion, and perceived efficacy. Intl J Environ Public Health. 2021; 18:2864. [doi:10.3390/ijerph18062894]
70. Fassett-Carman A, Hankin BL, Snyder HR. Appraisals of dependent stressor controllability and severity are associated with depression and anxiety symptoms in youth. Anxiety Stress Coping. 2019; 32: 32-49. [PMID: 30303017 PMCID: PMC6709974 DOI: 10.1080/10615806.2018.1532504]
71. Kovacs M. Children’s Depression Inventory-2. North Tonawanda, NY: Multi-Health Systems, 2010.
72. Rodriguez CM, Pu DF, Foiles AR. Cognitive-affective pathways to child depressive and anxious symptoms: Role of children’s discipline attributions. Child Psychiatry Hum Dev. 2019; 50: 163-171. [PMID: 30019223 DOI: 10.1007/s10578-018-0831-7]
73. Gladstone TR, Kaslow NJ, Seeley JR, Lewinsohn PM. Sex differences, attributional style, and depressive symptoms among adolescents. J Abnorm Child Psychol. 1997; 25: 297-306. [PMID: 9304446
DOI: 10.1023/a:1025712419436]
74. Hayward L, Vartanian LR, Kwick C, Newby JM. How might child adversity predict adult psychological distress? Applying the Identity Disruption Model to understanding depression and anxiety disorders. J Aff Disord. 2020; 765:112-119.
[doi:10.10167/jad.2020.01.036]
75, Cai RY, Richdale AL, Dissanayake C, Uljarević M. Brief report: Inter-relationship between emotion regulation, intolerance of uncertainty, anxiety, and depression in youth with autism spectrum disorder. J Autism Dev Disord. 2018; 48: 316-325. [PMID: 28980172
DOI: 10.1007/s10803-017-3318-7]
76, Neil L, Olsson NC, Pellicano E. The relationship between intolerance of uncertainty, sensory sensitivities, and anxiety in autistic and typically developing children. J Autism Dev Disord. 2016; 46: 1962-1973. [PMID: 26864157 PMCID: PMC4860201
DOI: 10.1007/s10803-016-2721-9]
77. Hodgson AR, Freeston MH, Honey E, Rodgers J. Facing the unknown: Intolerance of uncertainty in children with autism spectrum disorders. J App Res Intell Disab. 2016; 1-9 [doi:10.1111/12245]
78. Wigham S, Rodgers J, South M, McConachie H, Freeston M. The interplay between sensory processing abnormalities, intolerance of uncertainty, anxiety and restricted and repetitive behaviours in autism spectrum disorder. J Autism Dev Disord. 2015; 45: 943-952 [PMID: 25261248 DOI 10.1007/s10803-014-2248-x]
79. Stuart L, Grahame V, Honey E, Freeston M. Intolerance of uncertainty and anxiety as explanatory frameworks for extreme demand avoidance in children and adolescents. Child Adolesc Ment Health. 2020; 25: 59-67. [PMID: 32307839 DOI: 10.1111/camh.12336]
80. Stice E, Bohan C. Eating disorders. In: Beauchaine, TP, Hinshaw, SP, eds. Child and adolescent psychopathology, 2nd ed. New York: John Wiley, 2013: 715-738.
81. Bijsterbosch JM, Keizer A, Boelen PA, Van den Brink F, Danner UN, Sternheim LC. How deep is your thought? The relations between intolerance of uncertainty, worry and weight and shape concerns in adolescent girls with anorexia nervosa. J Eat Disord. 2021; 9: 164. [PMID: 34930469 PMCID: PMC8686596
DOI: 10.1186/s40337-021-00523-4]
82. Brosof LC, Egbert AH, Reilly EE, Wonderlich JA, Karam A, Vanzhula I, et al. Intolerance of uncertainty moderates the relationship between high personal standards but not evaluative concerns perfectionism and eating disorder symptoms cross-sectionally and prospectively. Eat Behav. 2019; 35: 101340. [PMID: 31731235
DOI: 10.1016/j.eatbeh.2019.101340]
83. Giles S, Toohey M, Hughes EK, Fuller-Tyszkiewicz M, Krug I. Do orthorexia and intolerance of uncertainty mediate the relationship between autism spectrum traits and disordered eating symptoms? Eat Weight Disord. 2021; 26: 2309-2316. [PMID: 33389701 DOI: 10.1007/s40519-020-01094-0]
84. Reilly EE, Perry TR, Brown TA, Wierenga CE, Kaye WH. Intolerance of uncertainty and eating disorder symptoms over the course of intensive treatment. Behav Ther. 2021; 52: 698-708. [PMID: 33990243
DOI: 10.1016/j.beth.2020.09.002]
85. Konstantellou A, Hale L, Sternheim L, Simic M, Eisler I. The experience of
intolerance of uncertainty for young people with a restrictive eating disorder: A pilot study. Eat Weight Disord. 2019; 24: 533-540. [PMID: 30778868 DOI: 10.1007/s40519-019-00652-5]
86. Schaumberg K, Reilly EE, Gorrell S, Levinson CA, Farrell NR, Brown TA, Smith KM, Schaefer LM, Essayli JH, Haynos AF, Anderson LM. Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research. Clin Psychol Rev. 2021; 83: 101952 [PMID: 33221621 PMCID: PMC7868093 DOI: 10.1016/j.cpr.2020.101952]
87. Kesby A, Maguire S, Brownlow R, Grisham JR. Intolerance of uncertainty in eating disorders: An update on the field. Clin Psychol Rev. 2017; 56: 94-105 [PMID: 28710918 DOI:
10.1016/j.cpr.2017.07.002]
88. Sternheim L, Harrison A. The acceptability, feasibility and possible benefits of a group-based intervention targeting intolerance of uncertainty in adolescent inpatients with anorexia nervosa. Cogent Psychol. 2018; 5: 1441594.
[DOI: 10.1080/23311908.2018.1441594]
89. Palitz SA, Rifkin LS, Norris LA, Knepley M, Fleischer NJ, Steinberg L, Kendall PC. But what will the results be?: Learning to tolerate uncertainty is associated with treatment-produced gains. J Anxiety Disord. 2019; 68: 102146. [PMID: 31669785
DOI: 10.1016/j.janxdis.2019.102146]
90. Beck AT. Cognitive therapy and the emotional disorders. 2nd ed. New York: International University Press; 1976
91. Beck AT, Clark DA. Anxiety and depression: An information processing perspective. Anxiety Stress Coping. 1998; 1: 23-36.[DOI: 10.1080/10615808808248218]
92. Ghahramanlou-Holloway M, Wenzel A, Lou K, Beck AT. Differentiating cognitive content between depressed and anxious outpatients. Cogn Behav The.r 2007; 36: 170-178. [PMID: 17852174
DOI: 10.1080/16506070701374256]
93. Ingram RE, Kendall PC. Cognitive clinical psychology: Implications of an information processing perspective. In: Ingram, RE, ed. Information processing approaches to clinical psychology. Orlando, FL: Academic Press, 1986: 3-21.
94. Sanchez AL, Cornacchio D, Chou T, Leyfer O, Coxe S, Pincus D, et al. Development of a scale to evaluate young children’s responses to uncertainty and low environmental structure. J Anxiety Disord. 2017; 45: 17-23. [PMID: 27907833
DOI: 10.1016/j.janxdis.2016.11.006]
95. Osmanağaoğlu N, Creswell C, Snuggs S, Stuijfzand S, Dodd HF. Evaluating the psychometric properties of the intolerance of uncertainty scale for children in a preadolescent sample. J Anxiety Disord. 2021; 77: 102343. [PMID: 33310446 DOI: 10.1016/j.janxdis.2020.102343]
96. Tiller-Ormord J, Korte C, Friedberg RD. Helping pediatric patients tolerate uncertainty during unprecedented times: Translating findings from new research on developmental psychopathology and two promising measures. J Trans Sci .2021; 7: 1-5. [DOI: 10.15761]
97. Einstein DA. Extension of the transdiagnostic model to focus on intolerance of uncertainty: A review of the literature and implications for treatment. Clin Psychol.2014; 21: 280-300. [PMID: 25400336 PMCID: PMC4204511 DOI: 10.1111/cpsp.12077].
98. Wahlund T, Andersson E, Jolstedt M, Perrin S, Vigerland S, Serlachius E. Intolerance of uncertainty-focused treatment for adolescents with excessive worry: A pilot feasibility study. Cogn Behav Pract. 2020; 27: 215-230. [DOI: 10.1016/j.cbpra.2019.06.002]
99. Chorpita BF, Weisz JR. MATCH-ADTC: Modular approach to therapy for children with anxiety, depression, trauma, or conduct problems. Satellite Beach, FL: PracticeWise; 2009
100. Friedberg RD, Paternostro JK. Cognitive behavioral therapy with youth: Essential foundations and elementary practices. In: Friedberg RD, Paternostro JK, eds. Handbook of cognitive behavioral therapy for pediatric medical conditions New York; Springer Nature, 2019:87-102.
101. Friedberg RD, Thordarson MA. Cognitive behavioral therapy. In: Matson J. ed. Handbook of child psychopathology and developmental disabilities treatment. New York: Springer, 2018: 43-62.
102. McClure JM, Friedberg RD, Thordarson MA, Keller M. CBT express: Effective 15-minute techniques for treating children and adolescents. New York: Guilford Press, 2019.
103. Hebert EA, Dugas MJ. Behavioral experiments for intolerance of uncertainty: Challenging the unknown in the treatment of generalized anxiety disorder. Cogn Behav Pract. 2019; 26:421-436.
[DOI: 10.1016/j.cbpra.2018.07.007]
104. Kendall PC, Hedtke KA. Coping cat workbook. Ardmore, PA: Workbook Publishing, 2006.
105. Stallard P. Think good, feel good. A cognitive behavioural therapy workbook for children and young people. New York: John Wiley, 2002.
106. Friedberg RD, McClure JM. Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. 2nd ed. New York: Guilford, 2015.
107. McGuire JF, Storch EA. An inhibitory learning approach to cognitive-behavioral therapy for children and adolescents. Cogn Behav Pract. 2019; 26: 214-224. [PMID: 31205406 PMCID: PMC6570488 DOI: 10.1016/j.cbpra.2017.12.003]
108. Ale, CM, McCarthy, DM, Rothchild, LM, Whiteside, SPH. Components of cognitive behavioral therapy related to outcome in childhood anxiety disorders. Clin Child Family Rev. 2015; 18: 240-251. [PMID: 26001645 DOI: 10.1007/s10567-015-0184-8]
109. Banneyer, KN, Bonin, L, Price, K, Goodman, WK, Storch, EA. Cognitive behavioral therapy for childhood anxiety disorders: a review of recent advances. Curr Psychiatr Rep. 2018; 20: 65. [PMID: 30056623 DOI: 10.1007/s11920-018-0924-9]
110. Silk, JS, Tan, PZ, Ladoucuer, CD, Meller, S, Siegle, CJ, McMakin, DL, Forbes, EE, Dahl RE, Kendall PC Mannarino, A, Ryan, ND. A randomized clinical trial comparing individual CBT and child-centered therapy for child anxiety disorders. J Clin Child Adolesc Psychol. 2018; 47:542-554 [PMID: 26983904 DOI: 10.1080/15374416.2016.1138408]
111. Bergez, KC, Ramirez, AC, Grebe, SC, Perez, MI, Viana, AG, Storch, EA, et al. Efficacy of exposure-based therapy for youth anxiety and obsessive compulsive disorder. In Exposure therapy for children with anxiety. Peris, TS, Storch, EA, McGuire, JF eds. New York: Academic Press, 2020.
112. Higa-McMillan, CK, Francis, SE, Rith-Najarian, L, Chorpita, BF. Evidence-based update: 50 years of research on treatment for child and adolescent anxiety, J Clin Child Adolesc Psychol. 2015; 45:91-113 [PMID: 26087438
DOI: 10.1080/15374416.2015.1046177]