Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-19T01:39:37.527Z Has data issue: false hasContentIssue false
  • English
  • Français

The relevance of uncertainty and goal conflict to mental disorders, their prevention and management: a unifying approach

Published online by Cambridge University Press:  06 December 2016

Danielle A. Einstein  and
Warren Mansell
Danielle A. Einstein*
Affiliation:
Department of Psychology, Macquarie University, NSW, Australia
Warren Mansell
Affiliation:
School of Psychological Sciences, University of Manchester, Manchester, UK
*
*Address for correspondence: Dr D. A. Einstein, Honorary Associate, Department of Psychology, Macquarie University, NSW 2109, Australia (email: danielle.einstein@mq.edu.au).
Get access Rights & Permissions [Opens in a new window]

Abstract

Intolerance of Uncertainty (IU) has been shown to underlie a range of disorders. Technological advances have produced a decline in our development of an ability to wait in the face of uncertainty. The paper provides an update on empirical, theoretical and neural research in IU. Einstein's extended trandiagnostic model of IU is described. This model is based on control theory. The research update and IU model propose specific tools which can be implemented within transdiagnostic treatment approaches.

Keywords

Goal conflictintolerance of uncertaintytransdiagnostictreatment
Type
Review
Information
the Cognitive Behaviour Therapist , Volume 9 , 2016 , e36
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Carleton, RN (2016). Into the unknown: a review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders 39, 30–43.Google Scholar

References

Alsawy, S, Mansell, W, Carey, TA, McEvoy, P, Tai, SJ (2014). Science and practice of transdiagnostic CBT: a Perceptual Control Theory (PCT) approach. International Journal of Cognitive Therapy 7, 334–359.Google Scholar
Beck, A, Clark, D (1997). An information processing model of anxiety: automatic and strategic processes. Behaviour Research and Therapy 35, 49–58.Google Scholar
Bishop, SR, Lau, M, Shapiro, S, Carlson, L, Anderson, ND, Carmody, J, Segal, ZV, Abbey, S, Speca, M, Velting, D, Devins, G (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice 11, 230–241.Google Scholar
Buhr, K, Dugas, MJ (2009). The role of fear of anxiety and intolerance of uncertainty in worry: An experimental manipulation, Behaviour Research and Therapy 47, 215–223.CrossRefGoogle ScholarPubMed
Carey, TA (2006). The Method of Levels: How to do Psychotherapy without Getting in the Way. Living Control Systems Publishing: Chicago.Google Scholar
Carey, TA (2011). Exposure and reorganization: the what and how of effective psychotherapy. Clinical Psychology Review 31, 236–248.Google Scholar
Carey, TA, Mansell, W, Tai, SJ (2014). A biopsychosocial model based on negative feedback and control. Frontiers in Human Neuroscience 8, Chicago.Google Scholar
Carleton, RN (2012). The intolerance of uncertainty construct in the context of anxiety disorders: theoretical and practical perspectives. Expert review of Neurotherapeutics 12, 937–947.Google Scholar
Carleton, RN (2016). Into the unknown: a review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders 39, 30–43.CrossRefGoogle ScholarPubMed
Carleton, RN, Norton, PJ, Asmundson, GJG (2007). Fearing the unknown: a short version of the Intolerance of Uncertainty Scale (IUS-12). Journal of Anxiety Disorders 21, 105–117.Google Scholar
Chan, KYC, Lovibond, PF (1996). Expectancy bias in trait anxiety. Journal of Abnormal Psychology 105, 637–647.Google Scholar
Critchley, HD, Mathias, CJ, Dolan, RJ (2001). Neural activity in the human brain relating to uncertainty and arousal during anticipation. Neuron 29, 537–545.CrossRefGoogle ScholarPubMed
Einstein, DA (2014). Extension of the transdiagnostic model to focus on intolerance of uncertainty: a review of the literature and implications for treatment. Clinical Psychology: Science and Practice 21, 280–300.Google ScholarPubMed
Einstein, DA, Garradd, A, Boulton, K, Farkash, L (2016). Is intolerance of uncertainty adequately addressed in intervention programs? Paper presented at the 8th World Congress of Behavioural and Cognitive Therapies, Melbourne, June, 2016.Google Scholar
Einstein, DA, Menzies, RG (2007). The treatment of magical ideation. In: Innovations and Advances in Cognitive Behaviour Therapy (ed. Einstein, D. A.), pp. 19–35. Brisbane: Australian Academic Press.Google Scholar
Gilbert, DT, Wilson, TD (2009). Why the brain talks to itself: sources of error in emotional prediction. Philosophical Transactions of the Royal Society of London, Series B: Biological Sciences 364, 1335–1341.Google Scholar
Gray, JA (1982). The Neuropsychology of Anxiety: An Enquiry in to the Functions of the Septo-hippocampal System. Oxford: Oxford University Press.Google Scholar
Grupe, DW, Nitschke, JB (2013). Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nature Reviews of Neuroscience 14, 488–501.Google Scholar
Hayes, SC, Wilson, KG, Gifford, EV, Follette, VM, Strosahl, K (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology 64, 1152–1168.Google Scholar
Higginson, S, Mansell, W, Wood, AM (2011). An integrative mechanistic account of psychological distress, therapeutic change and recovery: the Perceptual Control theory approach. Clinical Psychology Review 31, 249–259.Google Scholar
Krain, AL, Gotimer, K, Hefton, S, Ernst, M, Castellanos, FX, Pine, DS, Milham, MP (2008). A functional magnetic resonance imaging investigation of uncertainty in adolescents with anxiety disorders. Biological Psychiatry 63, 563–568.CrossRefGoogle ScholarPubMed
Mahoney, AEJ, McEvoy, PM (2011). A transdiagnostic examination of intolerance of uncertainty across anxiety and depressive disorders. Cognitive Behavior Therapy. Published online: 28 October 2011. doi:10.1080/16506073.2011.622130 Google Scholar
Mansell, W (2005). Control theory and psychopathology: an integrative approach. Psychology and Psychotherapy: Theory, Research and Practice 78, 141–178.Google Scholar
Mansell, W, Carey, TA, Tai, S (2015). Classification of psychopathology and unifying theory: the ingredients of a Darwinian paradigm shift in research methodology. Psychopathology Review 2, 129–153.Google Scholar
Mansell, W, Harvey, A, Watkins, E, Shafran, R (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy 23, 6–19.Google Scholar
McHugh, RK, Murray, HW, Barlow, DH (2009). Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: the promise of transdiagnostic interventions. Behaviour Research and Therapy 47, 946–953.Google Scholar
McNaughton, N, Gray, JA (2000). Anxiolytic action on the behavioural inhibition system implies multiple types of arousal contribute to anxiety. Journal of Affective Disorders 61, 161–176.CrossRefGoogle ScholarPubMed
Newby, JM, McKinnon, A, Kuyken, W, Gilbody, S, Dalgleish, T (2015). Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical Psychology Review 40, 91–110.Google Scholar
Pearl, SB, Norton, PJ (2016). Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: a meta-analysis. Journal of Anxiety Disorders. Published online: 16 July 2016. doi:10.1016/j.janxdis.2016.07.004.Google Scholar
Powers, WT (1973). Feedback: beyond behaviourism: stimulus-response laws are wholly predictable within a control-system model of behavioural organisation. Science 179, 351–356.CrossRefGoogle Scholar
Reiss, S (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review 11, 41–153.Google Scholar
Richards, JM, Gross, JJ (1999). Composure at any cost? The cognitive consequences of emotion suppression. Personality and Social Psychology Bulletin 25, 1033–1044.Google Scholar
Robichaud, M, Dugas, MJ (2006). A cognitive behavioral treatment targeting intolerance for uncertainty. In: Worry and its Psychological Disorders (ed. Davey, G. & Wells, A.), pp. 289–304. Wiley: Chichester.Google Scholar
Rubio, A, Oudenhove, LV, Pellissier, S, Giao, H, Dupont, P, Micheaux, HL, Tack, J, Dantzer, C, Delon-Martin, C, Bonaz, B (2015). Uncertainty in anticipation of uncomfortable rectal distension is modulated by the autonomic nervous system – a fMRI study in healthy volunteers. NeuroImage 107, 10–22.CrossRefGoogle ScholarPubMed
Shankman, SA, Gorka, SM, Nelson, BD, Fitzgerald, DA, Phan, KL, O'Daly, O (2014). Anterior insula responds to temporally unpredictable aversiveness: an fMRI study. Neuroreport 25, 596–600.Google Scholar
Simmons, A, Matthews, SC, Paulus, MP, Stein, MB (2008). Intolerance of uncertainty correlates with insula activation during affective ambiguity. Neuroscience Letters 430, 92–97.Google Scholar
Singer, T, Critchley, HD, Preuschoff, K (2009). A common role of insula in feelings, empathy and uncertainty. Trends in Cognitive Sciences 13, 334–340.Google Scholar
Wells, A (2002). GAD, metacognition, and mindfulness: an information processing analysis. Clinical Psychology: Science and Practice 9, 95–100.Google Scholar
Whittal, ML, McLean, PD (2002). Group cognitive behavioural therapy for obsessive compulsive disorder. In Cognitive Approaches to Obsessions and Compulsions: Theory, Assessment and Treatment (ed. Frost, R. O. & Steketee, G.), pp. 417–434. Amsterdam: Pergamon.Google Scholar
Williams, LE, Oler, JA, Fox, AS, McFarlin, DR, Rogers, GM, Jesson, MAL, Davidson, RJ, Pine, DS, Kalin, NH (2015). Fear of the unknown: uncertain anticipation reveals amygdala activation in childhood anxiety disorders. Neuropsychopharmacology 40, 1428–1435.Google Scholar
Submit a response

Comments

No Comments have been published for this article.