Fear of unknown is a risk factor for addiction.
The dictionary definition of uncertainty is experiencing an unknown, unpredictability, and unfamiliarity. We live in a world filled with uncertainty. It is hard to predict what will happen to us in the future.
The capacity to tolerate unknowns fuel the experience of anxiety and worry. Individuals with high intolerance of uncertainty (IU) are vulnerable to increased worry and distress in the face of uncertainty. Experiencing “what if” questions are common among those who experience severe anxiety, which is a source of impairments in their lives (Carleton, 2016).
Anxiety is an emotion caused by unpredictable potential threats that may occur in the future. Anxiety is potential harm rather than certain harm. Uncertainty impairs our ability to prepare for future events. Anxiety felt in the face of uncertainty can result in maladaptive behaviors such as impulsive decision making and unhealthy behaviors.
Intolerance of uncertainty is a cognitive bias that affects how a person perceives, interprets, and responds to uncertain situations. For example, if you have social anxiety, you are uncertain how you may look asking a question. The negative experience of uncertainty could lead you to exaggerate the threat (e.g., I am going to look stupid and will be humiliated). People who are the most intolerant of uncertainty are more likely to take efforts to try to control the situation or avoid uncertainty (McEvoy & Mahoney, 2012). This explains why a shy student may not volunteer to ask questions.
Higher IU is associated with a tendency to make hasty decisions to alleviate distress in stressful situations. Waiting in uncertain situations tends to be perceived as highly unpleasant, leading to poor choices (Luhmann et al., 2011). Not surprisingly, IU has been linked to indecisiveness.
Higher IU is a risk factor for developing an addiction if substance abuse is used as a way of coping in the face of unavoidable uncertainty. For example, drinking alcohol is used as an avoidance strategy to cope with worry and distress (Gorka, et al., 2016). Those who have the tendency to find uncertain outcomes distressing and unpleasant are likely to find alcohol use to be highly motivating which sets the stage for continued and escalated drinking (Kraemer et al., 2015).
IU can also lead to an eating disorder in attempts to control the anxiety (Kesby et al., 2109). For instance, women with Anorexia Nervosa (AN) experience significantly higher degrees of IU compared to women with other types of eating disorders. Food restriction in AN may, in part, represent an attempt to avoid the fear of gaining weight and/or obsession with thinness. Thus, the fear of the unknown in individuals with AN represents a vulnerability factor for the inflexible mindset.
The capacity to tolerate unknowns is likely to be determined and maintained by a complex interplay of many factors, such as genes, temperament, and self-efficacy (McEvoy and Mahoney, 2012). Intolerance to uncertainty is a personality trait that runs in the family. A meta-analysis found that 40% of individual differences in personality traits have genetic origins. It is possible that genetic factors predispose one to develop IU. These genes may also interact with environmental factors such as stressful life events, parental neglect, and abusive parenting styles.
The intolerance of uncertainty also varies with control (or self-efficacy). Control can be thought of as the belief that one has at one’s disposal a response that can influence the aversiveness of an event. People with a high level of fear of unknowns will likely have limited perceptions of self-efficacy, and a greater need for predictability.
In sum, the presence of uncertainty is often unpleasant, and individuals’ reactions vary along a continuum in terms of the extent to which they are comfortable with uncertainty. Research shows that treatments designed to increase acceptance of uncertainty and exposure to uncertainty are successful in increasing tolerance for uncertainty (Olatunji, 2019).
References: (1) Carleton RN (2016). Into the unknown: a review and synthesis of contemporary models involving uncertainty, Journal of Anxiety Disorders, vol. 39, pp. 30–43. (2) Gorka SM, Hee D, Lieberman L, Mittal VA, Phan KL, Shankman SA (2016) Reactivity to uncertain threat as a familial vulnerability factor for alcohol use disorder. Psychol Med 46:3349–3358. (3) Kesby, A., Maguire, S., Vartanian, L.R., Grisham, J.R (2018), Intolerance of uncertainty and eating disorder behaviour: Piloting a consumption task in a non-clinical sample. Journal of Behavior Therapy and Experimental Psychiatry; 65:101492. (4) Kraemer KM, McLeish AC, O’Bryan EM (2105). The role of intolerance of uncertainty in terms of alcohol use motives among college students. Addict. Behav. 42:162–166. (5) Luhmann C, Ishida K, Hajcak G (2011). Intolerance of uncertainty and decisions about delayed, probabilistic rewards. Behav Ther. 42(3):378. (6) McEvoy PM, Mahoney AEJ (2012). To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behav Ther.;43(3):533–45. (7) Olatunji BO (2019). The Cambridge Handbook of Anxiety and Related Disorders. Cambridge University Press.
This article is originally written by Shahram Heshmat, who is an associate professor emeritus of health economics of addiction at the University of Illinois at Springfield. This article is republished here from psychology today under common creative licenses