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

Purpose: Intolerance of uncertainty (IU) is associated with poorer emotional wellbeing and worse prognosis of chronic physical health and pain conditions (CHPCs). Our current understanding of IU in CHPCs is siloed within the literatures on specific CHPCs. 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 CHPCs and how they respond to uncertainty across health and everyday contexts. Primary Results: Higher acceptance of illness and perceived social support were related to lower IU and anxiety among people with CHPCs. 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 ambiguous contexts are not limited to health scenarios and require management in diverse ways; 2) interference of CHPCs 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 emotionalphysiological response that hinders or promotes coping. Conclusions: IU significantly impacts the lives of those with CHPCs and holds potential as a transdiagnostic target for early prevention and intervention. By tailoring therapeutic approaches to acknowledge the importance of health-related cues while increasing tolerance of uncertainty, people with CHPCs will likely experience improved prognosis, wellbeing, and fulfillment. Keywords: intolerance of uncertainty, anxiety, chronic health, chronic pain, transdiagnostic, context, mixed-methods