Intolerance of Uncertainty and Anxiety:A Perspective Based on Conditioned Fear

Wu Qi; Cao Mingxue; Wang Jinxia; Huang Lihui; Lei Yi

doi:10.16719/j.cnki.1671-6981.20250308

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Journal of Psychological Science ›› 2025, Vol. 48 ›› Issue (3) : 589-598. DOI: 10.16719/j.cnki.1671-6981.20250308

General Psychology，Experimental Psychology & Ergonomics

Intolerance of Uncertainty and Anxiety:A Perspective Based on Conditioned Fear

Wu Qi, Cao Mingxue, Wang Jinxia, Huang Lihui, Lei Yi

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Abstract

Intolerance of uncertainty (IU) has emerged as a critical transdiagnostic vulnerability factor across various anxiety disorders. This review constructs an integrated theoretical framework encompassing IU, conditioned fear, and anxiety, and explores how IU may predispose individuals to anxiety by influencing conditioned fear processes. The synthesis of the current literature reveals a complex interplay between these constructs, offering new insights into the mechanisms underlying anxiety disorders. Extensive research consistently demonstrates a significant positive correlation between IU and anxiety disorder symptoms, with IU predicting treatment outcomes. Individuals with high IU exhibit distinctive patterns in conditioned fear tasks, including enhanced fear acquisition, persistent fear expression, slower extinction, and more extensive generalization.
The relation between IU and conditioned fear has been examined in a variety of paradigms. During fear acquisition, high IU individuals show heightened physiological responses and subjective ratings of fear to conditioned stimuli, particularly in ambiguous or unpredictable contexts. This hypersensitivity may lower the threshold for fear activation and increase false alarms, contributing to maladaptive anxiety responses. Fear extinction studies reveal persistent fear responses in high IU individuals even in the absence of threat, suggesting difficulties in learning safety cues. Moreover, fear generalization research indicates that high IU individuals tend to generalize fear responses to a broader range of stimuli resembling the original threat, potentially leading to overgeneralized anxiety and avoidance behaviors. Contextual conditioning studies further demonstrate that high IU is linked to enhanced contextual anxiety, underlying the pervasive apprehension characteristic of disorders such as generalized anxiety disorder.
Neuroimaging studies provide crucial support for the proposed integrated model and elucidate the neural mechanisms underlying the relationship between IU, conditioned fear, and anxiety. High IU individuals exhibit heightened amygdala and anterior cingulate cortex activation when facing uncertain threats, mirroring patterns observed in anxiety disorder patients. IU levels negatively correlate with prefrontal cortex activation during fear extinction, potentially explaining difficulties in fear inhibition. Altered connectivity between the amygdala and prefrontal regions suggests disrupted fear regulatory networks, providing a mechanistic basis for understanding how IU influences conditioned fear processes and contributes to anxiety vulnerability.
The proposed integrative model elucidates how IU may increase anxiety vulnerability by modulating conditioned fear processes. This modulation results in enhanced threat detection, impaired safety-threat discrimination, persistent fear expression, extinction resistance, and overgeneralization of fear responses. These alterations collectively contribute to the development and maintenance of anxiety symptoms, creating a self-reinforcing cycle of heightened fear and anxiety. Furthermore, the model suggests that individual differences in IU may explain variations in susceptibility to anxiety disorders and treatment responsiveness. These findings have significant implications for both theory and practice in anxiety research and treatment. Theoretically, it provides a comprehensive framework bridging cognitive and learning theories, offering a nuanced explanation for the development and maintenance of anxiety. Clinically, targeting IU may enhance treatment outcomes by addressing fundamental fear learning processes, potentially improving the efficacy of exposure-based therapies and informing personalized interventions for high IU individuals.
In conclusion, this review demonstrates the critical role of IU in modulating conditioned fear processes and influencing anxiety vulnerability. The proposed integrative model offers a new theoretical foundation for understanding anxiety disorders' pathogenesis and developing targeted interventions. Future research should focus on longitudinal studies to clarify causal relationships between IU, conditioned fear, and anxiety development. Additionally, investigating the impact of IU-focused interventions on conditioned fear responses could inform novel treatment approaches. Multimodal neuroimaging studies may further elucidate the neural network mechanisms by which IU influences conditioned fear and anxiety, and potentially identify new targets for intervention. These research directions will refine our understanding of the role of IU in anxiety disorders and pave the way for more effective, personalized treatment approaches. Ultimately, this integrative perspective on IU, conditioned fear, and anxiety promises to advance both our theoretical understanding and clinical management of anxiety disorders, offering hope for improved outcomes in this pervasive and debilitating class of mental health conditions.

Key words

intolerance of uncertainty / fear condition / anxiety disorder

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Wu Qi, Cao Mingxue, Wang Jinxia, Huang Lihui, Lei Yi. Intolerance of Uncertainty and Anxiety:A Perspective Based on Conditioned Fear[J]. Journal of Psychological Science. 2025, 48(3): 589-598 https://doi.org/10.16719/j.cnki.1671-6981.20250308

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