Intolerance of Uncertainty Predicts Anxiety and Depression

There are ways to manage this risk factor for anxiety and depression

STUDY: Ye H et al, Epidemiology and Psychiatric Sciences 2026;35:e27

STUDY TYPE: Prospective cohort study

FUNDING: National Natural Science Foundation of China

Background

Intolerance of uncertainty, also called the “phobia of the unknown,” is when people find the absence of clear information stressful, threatening, or intolerable. It is known to drive anxiety, avoidance, and rumination, and this study further clarifies those links in teens.

The Study Design

5,291 Chinese adolescents ages 10–18 completed self-report measures of intolerance of uncertainty, generalized anxiety (GAD-7), and depression (PHQ-9) at baseline, 6 months, and 12 months. Regression models examined whether baseline intolerance of uncertainty predicted symptom severity, above-threshold scores, and new-onset or persistent symptoms over time — controlling for baseline symptom levels throughout.

The Results

• Teens with more intolerance of uncertainty were 55-60% more likely to develop generalized anxiety and major depressive disorders.
• They were also more likely to stay with those problems if they already had them.
• The effects were modest in size but consistent.

Practice Implications

1. Look for this trait in clients and open up a discussion.
2. The problem is not just the trait, but the ways that people cope with it, like avoidance and rumination.
3. Through therapy, people can find new ways to manage this trait. Mindfulness, behavioral activation, and CBT are a good start.