Can intolerance of uncertainty & anxiety impact the lives we lead? Understanding lived experiences of people with chronic physical health and pain conditions

Abstract

Intolerance of uncertainty (IU) is associated with poorer emotional wellbeing and worse prognosis of chronic physical health and pain conditions (CPHPCs). Our current understanding of IU in CPHPCs is siloed within the literature on specific CPHPCs. However, IU is consistently identified as a risk factor for anxiety and depressive disorders. In this exploratory study, we used a mixed methods design to better understand the role of IU and anxiety in people’s (n = 139) lived experiences of their CPHPCs and how they respond to uncertainty across health and everyday contexts. Higher acceptance of illness and perceived social support were related to lower IU and anxiety among people with CPHPCs. Higher IU and anxiety were also related to lower scores on many domains of quality of life. Our reflexive thematic analysis resulted in four primary themes: 1) distressing contexts characterized by uncertainty are not limited to health scenarios and require management in diverse ways; 2) interference of CPHPC affects multiple domains of life beyond physical health; 3) navigating uncertainty for a chronic period changes coping abilities and identity development; and 4) responsivity to uncertainty is a multifaceted cognitive-behavioural and emotional-physiological response that hinders or promotes coping. IU plays an important contextual role in the lives of those with CPHPCs and holds potential as a transdiagnostic target for early prevention and intervention. Therapeutic approaches that acknowledge the role of health-related cues and cultivate comfort with uncertainty may provide a more supportive trajectory for those with CPHPCs.