scholarly journals I doubt it is safe: A meta-analysis of self-reported intolerance of uncertainty and threat extinction training

2021 ◽  
Author(s):  
Jayne Morriss ◽  
Shannon Jade Wake ◽  
Charlotte Elizabeth ◽  
Carien M. van Reekum
Keyword(s):  
Trait Anxiety ◽  
Skin Conductance ◽  
Skin Conductance Response ◽  
Meta Analysis ◽  
Intolerance Of Uncertainty ◽  
Mental Health Disorders ◽  
Extinction Training ◽  
The Self ◽  
Target Uncertainty ◽  
Health Disorders

Intolerance of uncertainty (IU), the tendency to find uncertainty distressing, is an important transdiagnostic dimension in mental health disorders. Higher self-reported IU has been linked to poorer threat extinction training (i.e., the updating of threat to safe associations), a key process that is targeted in exposure-based therapies. However, it remains to be seen whether IU-related effects during threat extinction training are reliably and specifically driven by the IU construct or a particular subcomponent of the IU construct over other self-reported measures of anxiety. A meta-analysis of studies from different laboratories (experiment n = 18; sample n = 1006) was conducted on associations between different variants of self-reported IU (i.e., 27-item, 12-item, inhibitory and prospective subscales), trait anxiety and threat extinction training via skin conductance response. The specificity of IU and threat extinction training was assessed against measures of trait anxiety. All of the self-reported variants of IU, but not trait anxiety, were associated with threat extinction training via skin conductance response (i.e., continued responding to the old threat cue). Specificity was observed for the majority of self-reported variants of IU over of trait anxiety. The findings suggest that the IU construct broadly accounts for difficulties in threat extinction training and is specific over other measures of self-reported anxiety. These findings demonstrate the robustness and specificity of IU-related effects during threat extinction training and highlight potential opportunities for translational work to target uncertainty in therapies that rely on threat extinction principles such as exposure therapy.

scholarly journals An examination of intolerance of uncertainty effects on subjective, psychophysiological, and neural markers during uninstructed and instructed threat acquisition and extinction training

2021 ◽  
Author(s):  
Julia Wendt ◽  
Jayne Morriss
Keyword(s):  
Skin Conductance ◽  
Skin Conductance Response ◽  
Secondary Analysis ◽  
Intolerance Of Uncertainty ◽  
Extinction Training ◽  
Fmri Data ◽  
Future Research ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Tentative Evidence

Individuals who score high in self-reported Intolerance of Uncertainty (IU) tend to find uncertainty aversive. Prior research has demonstrated that under uncertainty individuals with high IU display difficulties in updating learned threat associations to safety associations. Importantly, recent research has shown that providing contingency instructions about threat and safety contingencies (i.e. reducing uncertainty) to individuals with high IU promotes the updating of learned threat associations to safety associations. Here we aimed to conceptually replicate IU and contingency instruction-based effects by conducting a secondary analysis of self-reported IU, ratings, skin conductance, and functional magnetic resonance imaging (fMRI) data recorded during uninstructed/instructed blocks of threat acquisition and threat extinction training (n = 48). Self-reported IU was not associated with differential responding to learned threat and safety cues for any measure during uninstructed/instructed blocks of threat acquisition and threat extinction training. There was some tentative evidence that higher IU was associated with greater ratings of unpleasantness and arousal to the safety cue after the experiment and greater skin conductance response to the safety cue during extinction generally. Potential explanations for these null effects and directions for future research are discussed.

scholarly journals Out with the old and in with the new: The role of intolerance of uncertainty in reversal of threat and safety

2019 ◽  
Vol 10 (1) ◽  
pp. 204380871983445 ◽  
Author(s):  
Jayne Morriss ◽  
Francesco Saldarini ◽  
Catherine Chapman ◽  
Miriam Pollard ◽  
Carien M. van Reekum
Keyword(s):  
Trait Anxiety ◽  
Skin Conductance ◽  
Skin Conductance Response ◽  
Clinical Intervention ◽  
Intolerance Of Uncertainty ◽  
Anxiety State ◽  
Extinction Learning ◽  
Healthy Participants ◽  
Direct Threat

Intolerance of uncertainty (IU) is associated with difficulty in updating contingencies from threatening to safe during extinction learning. However, it is unknown whether high IU individuals have difficulty (1) generally with updating threat to safe associations when contingencies change or (2) specifically with updating threat to safe associations during extinction learning, where direct threat is omitted. To address this question, we recorded IU, expectancy ratings, and skin conductance in 44 healthy participants during an associative learning paradigm, where threat and safety contingencies were reversed. During acquisition and reversal, we observed larger skin conductance response (SCR) magnitude and expectancy ratings for threat versus safety cues. However, during reversal, higher IU was associated with larger SCR magnitude to new threat versus new safety cues, compared with lower IU. These results were specific to IU-related variance, over shared variance with trait anxiety (State-Trait Anxiety Inventory, Trait Version). Overall, these findings suggest that individuals high in IU are able to reverse threat and safety associations in the presence of direct threat. Such findings help us understand the recently revealed link between IU and threat extinction, where direct threat is absent. Moreover, these findings highlight the potential relevance of IU in clinical intervention and treatment for anxiety disorders.

Dialectical Behaviour Therapy Skills Training Groups for Common Mental Health Disorders: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Chantal P Delaquis ◽  
Kayla M. Joyce ◽  
Maureen Zalewski ◽  
Laurence Katz ◽  
Julia Sulymka ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Meta Analysis ◽  
Skills Training ◽  
Mental Health Disorders ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Transdiagnostic Treatment ◽  
Training Groups ◽  
Health Disorders

Context: Emotion regulation deficits are increasingly recognized as an underlying mechanism of many disorders. Dialectical behaviour therapy (DBT) holds potential as a transdiagnostic treatment for disorders with underlying emotion regulation deficits.Objective: Systematically review the evidence for DBT skills training groups as a transdiagnostic treatment for common mental health disorders via meta-analysis. Study Selection: Randomized control trials (RCTs) of DBT skills training groups for adults with common mental health disorders, and no comorbid personality disorder, were included. Data Synthesis: Twelve RCTs met inclusion criteria (N = 425 participants). DBT had a moderate-to-large effect on symptom reduction (g = 0.79, 95% CI [0.52, 1.06], p < .0001). Improvements in emotion regulation yielded a small-to-moderate effect (g = 0.48, 95% CI [0.22, 0.74], p < .01). Results showed significant effects of DBT on depression (g = 0.50, 95% CI [0.25, 0.75], p = .002), eating disorders (g = 0.83, 95% CI [0.49, 1.17], p = .001) and anxiety (g = 0.45, 95% CI [0.08, 0.83], p = .03).Conclusions: Findings suggest DBT is an effective treatment for common mental health disorders and may be considered as a promising transdiagnostic therapy.

scholarly journals Examining the Association and Directionality between Mental Health Disorders and Substance Use among Adolescents and Young Adults in the U.S. and Canada—A Systematic Review and Meta-Analysis

2018 ◽  
Vol 7 (12) ◽  
pp. 543 ◽  
Author(s):  
Sarvenaz Esmaeelzadeh ◽  
John Moraros ◽  
Lilian Thorpe ◽  
Yelena Bird
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Young Adults ◽  
Meta Analysis ◽  
Mental Health Disorders ◽  
Adolescents And Young Adults ◽  
Health Disorders ◽  
The U.S

Background: The purpose of this systematic review was to examine the association and directionality between mental health disorders and substance use among adolescents and young adults in the U.S. and Canada. Methods: The following databases were used: Medline, PubMed, Embase, PsycINFO, and Cochrane Library. Meta-analysis used odds ratios as the pooled measure of effect. Results: A total of 3656 studies were screened and 36 were selected. Pooled results showed a positive association between depression and use of alcohol (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.24–1.83), cannabis (OR = 1.29, 95% CI: 1.10–1.51), and tobacco (OR = 1.65, 95% CI: 1.43–1.92). Significant associations were also found between anxiety and use of alcohol (OR = 1.54, 95% CI: 1.19–2.00), cannabis (OR = 1.36, 95% CI: 1.02–1.81), and tobacco (OR = 2.21, 95% CI: 1.54–3.17). A bidirectional relationship was observed with tobacco use at baseline leading to depression at follow-up (OR = 1.87, CI = 1.23–2.85) and depression at baseline leading to tobacco use at follow-up (OR = 1.22, CI = 1.09–1.37). A unidirectional relationship was also observed with cannabis use leading to depression (OR = 1.33, CI = 1.19–1.49). Conclusion: This study offers insights into the association and directionality between mental health disorders and substance use among adolescents and young adults. Our findings can help guide key stakeholders in making recommendations for interventions, policy and programming.

scholarly journals The role of intolerance of uncertainty in the acquisition and extinction of reward

2020 ◽  
Author(s):  
Jayne Morriss ◽  
Nicolo Biagi ◽  
Tina B. Lonsdorf ◽  
Marta Andreatta
Keyword(s):  
Associative Learning ◽  
Conceptual Understanding ◽  
Skin Conductance Response ◽  
Intolerance Of Uncertainty ◽  
Acquisition Training ◽  
Learning Task ◽  
Partial Reward ◽  
Extinction Training ◽  
Corrugator Supercilii

AbstractIndividuals, who score high in self-reported intolerance of uncertainty (IU), tend to find uncertainty anxiety-provoking. IU has been reliably associated with disrupted threat extinction. However, it remains unclear whether IU would be related to disrupted extinction to other arousing stimuli that are not threatening (i.e., rewarding). We addressed this question by conducting a reward associative learning task with acquisition and extinction training phases (n = 58). Throughout the associative learning task, we recorded valence ratings (i.e. liking), skin conductance response (SCR) (i.e. sweating), and corrugator supercilii activity (i.e. brow muscle indicative or negative and positive affect) to learned reward and neutral cues. During acquisition training with partial reward reinforcement, higher IU was associated with greater corrugator supercilii activity to neutral compared to reward cues. IU was not related to valence ratings or SCR’s during the acquisition or extinction training phases. These preliminary results suggest that IU-related deficits during extinction may be limited to situations with threat. The findings further our conceptual understanding of IU’s role in the associative learning and extinction of reward, and in relation to the processing of threat and reward more generally.

scholarly journals Effects of intolerance of uncertainty on subjective and psychophysiological measures during fear acquisition and delayed extinction

2021 ◽  
Author(s):  
Maren Klingelhöfer-Jens ◽  
Jayne Morriss ◽  
Tina B Lonsdorf
Keyword(s):  
Fear Conditioning ◽  
Skin Conductance ◽  
Intolerance Of Uncertainty ◽  
Acquisition Training ◽  
Extinction Training ◽  
Future Directions ◽  
Psychophysiological Measures ◽  
Learned Fear ◽  
Startle Blink

Individuals who score high in self-reported Intolerance of Uncertainty (IU) tend to find uncertainty unacceptable and aversive. In recent years, research has shed light on the role of IU in modulating subjective (i.e. expectancy ratings) and psychophysiological responses (i.e. skin conductance) across different classical fear conditioning procedures, particularly that of immediate extinction. However, there remain gaps in understanding how IU, in comparison to other negative emotionality traits (STAI-T), impact different types of subjective and psychophysiological measures during different classical fear conditioning procedures. Here, we analyzed IU, STAI-T, subjective (i.e. fear ratings) and psychophysiological (i.e. skin conductance, auditory startle blink) data recorded during fear acquisition training and 24h-delayed extinction training (n = 66). Higher IU, over STAI-T, was: (1) significantly associated with greater fear ratings to the learned fear cue during fear acquisition training, and (2) at trend associated with greater fear ratings to the learned fear versus safe cue during delayed extinction training. Both IU and STAI-T were not related to skin conductance or auditory startle blink during fear acquisition training and delayed extinction training. These results add to and extend our current understanding of the role of IU on subjective and physiological measures during different fear conditioning procedures, particularly that of delayed extinction training. Implications of these findings and future directions are discussed.

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