Living with Intolerance of Uncertainty
and How to Make Friends with Uncertainty

Mark Freeston, University of Newcastle

Intolerance of uncertainty (IU) is now recognized as a transdiagnostic factor that may contribute to the onset and maintenance of a range of mental health problems. The evidence is strongest for the anxiety disorders and OCD, but there is increasing evidence for a role in eating disorders, psychosis, body-dysmorphic disorder, body-focused repetitive behaviours, and perhaps externalizing behaviours. Likewise, there appears to be a clear role for IU in understanding anxiety among people with ASD and potentially ADHD. There is also a small but developing literature around IU in physical health problems. Research, mainly from the anxiety disorders, indicates that IU is modifiable.

The first part of this workshop considers the nature of IU, where it may come from, how it is experienced, and how it relates to familiar models of anxiety based on threat perception. The second part of the workshop considers how IU may be targeted in the context of anxiety disorders where anxiety and distress, by definition, is objectively excessive or disproportionate to the actual situation. The final part of the workshop considers IU in relation to situations where there may be high objective threat and high objective uncertainty. Although IU may still play an active role in distress, additional considerations come into play as to how and when it is approached. The workshop will use a range of approaches, including reflective exercises, work in pairs, developing IU interventions, plenary Q & A, etc.

Professor Mark Freeston is Professor of Clinical Psychology at the University of Newcastle. The basis of his work has been the understanding and treatment of anxiety disorders His particular interests are Obsessive Compulsive Disorder and Generalized Anxiety Disorder. Interestingly, his work has led to multidimensional models and multi-component treatments packages. With the emergence of transdiagnostic approaches and models, there is a natural extension of this work to separation anxiety disorder, psychosis, eating disorders, body-focused repetitive behaviours, and body-dysmorphic disorder. One such transdiagnostic process is intolerance of uncertainty (IU), a construct he was first working with in the early nineties at Université Laval in Quebec.

Specifically, he is interested how IU may operate within various populations to help explain some well-known shared and differential features of these disorders and, importantly, why some people find uncertainty so aversive. He is also testing single-strand treatments targeting IU in both individual and group settings.

From working within university and clinical settings Professor Freeston’s research is informed by clinical observation and has been developed and tested in collaboration with many collaborators.


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