Is It Safe Now? Intolerance of Uncertainty as a Pre-treatment Predictor of Exposure Outcome

Safety learning is considered to be a key aspect in attaining symptom reduction for patients with anxiety disorders. While treatment based on safety learning principles is highly effective in general, individual differences exist in the speed and retention of fear reduction. An individual difference variable that has been demonstrated to be associated with difficulties in safety learning in laboratory paradigms is intolerance of uncertainty, or the incapacity to endure the absence of key information and the corresponding perception of uncertainty. In this study, we sought to determine if intolerance of uncertainty is associated with the course and outcome of an exposure intervention. Intolerance of uncertainty was assessed in 104 subclinical spider-fearful participants, prior to a 30-minute exposure session in virtual reality. While the exposure session was found to be successful in modifying spider fear and avoidance, we failed to find significant correlations between intolerance of uncertainty and any of the outcome measures. Exploratory analyses assessed if intolerance of uncertainty was associated with reductions in physiological arousal during the exposure session itself. No significant correlations were found between intolerance of uncertainty and arousal reduction within the exposure exercises or throughout the session. In conclusion, deviating from some of the findings in extinction research, we failed to find evidence for associations between intolerance of uncertainty and the outcome and course of exposure. Still, additional research is needed to assess the replicability of these findings.