PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of archneuroNöro Psikiyatri Arşivi
 
Noro Psikiyatr Ars. 2015 December; 52(4): 400–405.
Published online 2015 December 1. doi:  10.5152/npa.2015.8779
PMCID: PMC5353115

Intolerance of Uncertainty and Coping Mechanisms in Nonclinical Young Subjects

Abstract

Introduction

We aimed to explore the relationship between intolerance of uncertainty (IU) and coping mechanisms in a nonclinical sample with the same age and educational level.

Methods

The Coping Orientations to Problems Experienced (COPE) scale was used to evaluate the coping mechanisms. The IU scale was used to evaluate IU situations.

Results

We found that the negative impact of uncertainty on the action in female students was greater than males. While female students used more planning, instrumental support, reinterpretation, religion, emotional support, venting, and mental disengagement coping styles, male students used more humor, denial, and alcohol/drug abuse coping styles. Subjects with psychological problems had higher IU scores and used some more coping mechanisms (restraint, acceptance, behavioral disengagement, and alcohol/drug abuse) than the others.

Conclusion

Our results suggest that healthy subjects use different coping styles and respond differently to uncertainty in both genders.

Keywords: Coping mechanisms, intolerance of uncertainty, healthy populations, psychological problems, university students

INTRODUCTION

Intolerance of uncertainty (IU) is described as a dispositional characteristic resulting from negative beliefs about uncertainty and its implications (1). IU is generally thought of as a trait characteristic that can be altered following a significant life experience (2). Individuals who show IU have a cognitive bias that affects how a person perceives, interprets, and responds to uncertain situations on a cognitive, emotional, and behavioral level (3). They experience the possibility of negative future events as threatening and unacceptable, regardless of the probability of the events actually occurring (4).

Intolerance of uncertainty has been associated with different anxiety disorders (1,4). For example, it was found to be more strongly related to obsessive compulsive disorder (OCD) symptoms and worry than with health anxiety and hypochondriacal concerns (3). In fact, modern anxiety disorder models implicitly include IU as a critical component for the development and maintenance of these pervasive social and economic concerns. IU primarily represents the fear of the unknown, which is a long-recognized, deep-seated fear identified in normative and pathological samples (5). In addition, a recent meta-analysis revealed that IU was more strongly related to generalized anxiety disorders (GAD) than to OCD when the GAD-specific definition of IU was used (6).

Individual differences for IU have not only been associated with heightened anxiety but also with approach-oriented coping (7). Coping mechanisms are defined as the processes that individuals use to deal with negative events and control internal threats induced by stress. Coping mechanisms have two basic dimensions. First are problem-focused coping strategies, defined as efforts to recognize, modify, or eliminate the impact of a stressor or cognitive activity (e.g., problem solving, cognitive restructuring). Second are emotion- and avoidant-focused coping strategies, defined as efforts to regulate emotional states that are associated with exposure to stress (e.g., distancing, seeking social support) (2,8,9). It has been suggested that emotion-focused coping was significantly related to IU (2).

It is controversial whether or not coping strategies show differences with respect to age, gender, and education level. Some studies did not report any relationship between genders and coping mechanisms, whereas others found gender differences in coping mechanisms (10). While males were more likely to use problem-solving strategies, females preferred emotional distraction strategies (11). Moreover, males were more likely to report physical activity and substance use, whereas females were more likely to engage in a conversation (12,13).

The Present Study

Although a considerable amount of evidence shows the relationship between IU and stressful events (24,1417), the associations between the coping mechanisms and IU have not been adequately studied in nonclinical samples. Also, the effect of gender on this relationship is controversial. Thus, the main objective of the present study was to explore the relationship between IU and coping mechanisms, particularly with respect to gender in a nonclinical sample with the same age and educational level. The first hypothesis states that IU would be highly related to coping strategies, particularly emotion-focused ones. The second hypothesis shows that subjects with psychological problems would have more IU levels and use different coping mechanisms. The final hypothesis states that there would be gender differences in the prevalence of specific coping mechanisms and IU.

METHODS

Sample

The sample consisted of 323 randomly chosen university students, studying in various departments at the Karabük University in Turkey. Participation in the study was voluntary. They were requested to fill in a socio-demographic data questionnaire and two assessment instruments that are mentioned below.

Measurements

Coping Orientations to Problems Experienced (COPE) Scale

Coping styles were measured using the COPE scale (18), a 60-item self-report designed to examine various coping styles used in response to stressful events. The scale consists of 15 subscales, each divided into clusters of four items, with scores from 1 (not at all) to 4 (a lot). Five of the subscales measured problem-focused coping strategies (active coping, planning, suppression of competing activities, restraint coping, and seeking social support for instrumental reasons), five measured emotion-focused coping (seeking social support for emotional reasons, focus on and venting of emotions, positive reinterpretation, acceptance, and turning to religion), and five measured dysfunctional coping (focusing on problem-revealing emotions, denial, behavioral disengagement, mental disengagement, and alcohol/drug disengagement). A sum score was calculated for each subscale; a high sum score indicates more use of that particular coping style. It was adapted for use with the Turkish population and found a reliable instrument for assessing coping strategies (19).

Intolerance of uncertainty (IU) Scale

IU is a 27-item scale. It has been developed to evaluate the uncertain status given to the cognitive, emotional, and behavioral reactions by Freestone (20). It is a 5-point Likert scale ranging from 1 (not at all characteristic of me) to 5 (entirely characteristic of me). The reliability and validity of the Turkish versions of the IU scale were examined by Sari (21,22) in 2007. The subjects of the preliminary and main studies included university students for reliability and validity analyses. The internal consistency was satisfactory. The factor analysis revealed a four-factor solution: “uncertainty is stressful and upsetting,” “negative self-assessment about uncertainty,” “disturbing thoughts about the uncertainty of future,” and “uncertainty keeps me from acting” (21,22).

Statistical Analysis

Statistical analysis was performed using the Statistical Package for the Social Sciences 15.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were given as mean, standard deviation, minimum and maximum value, frequency, and percentage. The chi-square test was used to compare discrete variables between groups. Student’s t-test was used to compare continuous variables. Partial Pearson’s correlation analysis was performed to determine the correlation between the COPE and IU scales. A statistical significance level was accepted as p<.05.

RESULTS

The sample consisted of 323 randomly chosen university students. There were 152 (47.1%) female and 171 (52.9%) male students. The mean age of the students was 20.8±1.8 years (range: 18–30 years). The mean number of siblings was 2.6±1.7 (range: 0–11). The economic status of 29 (9.0%) participants was low, 250 (77.4%) was medium, and 44 (13.6%) was high. Seven (2.2%) participants were married, whereas 316 (97.8%) were single. Of the total participants, 83 (25.7%) used alcohol beverages (14 subjects used alcohol at least once a week) and seven (2.2%) used non-legal substances (two used them at least every other day). Of the participants, 66 (20.4%) reported that they suffer from psychological problems, but only seven (10.6%) of those were undergoing treatment. The 28 students who reported psychological problems used alcohol or non-legal substance (9 students used alcohol at least once a week, 19 used alcohol less than once a week, and 2 also used non-legal substances once in a while).

The socio-demographic characteristics, including age, economic status, number of siblings, and presence of psychological problems, were similar when compared in terms of gender. Alcohol and substance use in males were at a higher rate than in females (p<.05) (Table 1).

Table 1
General demographic and clinical characteristics

“Uncertainty keeps someone from acting” subscale scores of IU in female students were higher than those in males (p<.05). Female students used more planning, instrumental support, reinterpretation, religion emotional support, venting, and mental disengagement coping styles than males when we considered the COPE scale. In contrast, male students reported that they used more humor, denial, and alcohol/drug abuse coping styles than female students (p<.05) (Table 2).

Table 2
Comparison of intolerance of uncertainty and coping mechanisms in terms of gender

With respect to the presence of psychological problems, there were no differences between both genders (χ2=2.806, p=.062) and the ages (F=2.148; t=.753; p=.452). Students with psychological problems had a higher total IU and some of its subtest scores than the others (p<.05). They also used some more coping mechanisms (restraint; acceptance; dysfunctional cluster, including behavioral disengagement; and alcohol/drug abuse) than students without psychological problems (p<.05) (Table 3).

Table 3
Comparison of intolerance of uncertainty and coping mechanisms in terms of psychological problems

When considering age, gender, and presence of psychological problems, some coping styles were mild to moderately associated with IU (r>.25 and p<.05) (Table 4).

Table 4
Correlations between Intolerance of Uncertainty and COPE scalesa

DISCUSSION

In this cross-sectional nonclinical study, we investigated whether or not coping styles and IU are different and associated with gender in healthy university students. We found that the negative impact of uncertainty on the action in female students was greater than that in males. While female students used more planning, instrumental support, reinterpretation, religion emotional support, venting, and mental disengagement coping styles, male students used more humor, denial, and alcohol/drug abuse coping styles. Subjects with psychological problems had higher IU scores and used some more coping mechanisms (restraint; acceptance; dysfunctional cluster, including behavioral disengagement, and alcohol/drug abuse) than the others. In addition, some coping styles were from mild to moderately associated with IU.

Almost 20% of all participants reported having psychological problems, but only 10.6% of those were undergoing treatment. Similarly, Gultekin and Dereboy (23) described that approximately 15% of university students have psychological problems and expressed that very few of them take the treatment. In another study, 36% of subjects showed psychological problems (22). Our rate is thought to be similar to that found in the literature. An important point in these results is the low rate of treatment and this should be focused on.

In our study, we found the rates of alcohol and substance use were 25.7% and 2.2%, respectively. Similar studies have suggested similar results. For example, Gultekin and Dereboy (23) suggested that the rates of alcohol and non-legal substance use were 28% and 1.1%, respectively. The content and amount of alcohol and substances have not been investigated. Therefore, it is difficult to form a general conclusion in these matters.

“Uncertainty keeps someone from acting” subscale scores in females were higher than those in males in our study. This result indicates that IU shows different results according to gender. The role of gender has not been studied in several clinical studies (1,3,16,17,24). In a study conducted in Turkey (22), “uncertainty is stressful and upsetting” subscale scores in females were higher than those in males. The reason for the differences of IU could be studied in samples of different universities and education levels and whose socio-demographic data differs from each other. However, these two studies support the gender differences.

We found that male and female students had different coping mechanisms from each other. For example, male students used more humor, denial, and alcohol/drug coping styles. Coping mechanisms has been defined as the process that individuals use to modify the adverse aspects of their environment as well as to minimize the internal threat induced by stress. There is no single and universally accepted definition of coping. Coping styles constitute an important component of the individual’s adaptation to the impact of different stressors, including extreme psychological trauma. It seems that it is not the stressor alone that leads to a serious outcome, but the manner in which a person perceives and responds to it (8).

With respect to gender, it is controversial whether or not coping strategies are distinct from each other. Although Gurkan and Dirik (10) suggested that there was no relationship between gender and coping strategies in university students, some studies have shown that there are gender differences in coping strategies (18,25,26). Austenfeld and Stanton (25) suggested that young women who cope through emotional processing evidence more adaptive personality resources, whereas emotional processing is less related to personality dispositions in young men. Schiltz et al. (26) also pointed to gender differences. Carver et al. (18) also suggested that there were several significant gender differences with respect to the use of various coping strategies. The largest and most reliable of these differences were with respect to the tendencies to focus on and vent emotions and to seek social support, both for instrumental and emotional reasons. These tendencies were all greater among women than among men, consistent with gender role stereotypes. The only tendency that was stronger among men than women was the use of alcohol or drugs as a coping mechanism (18). In addition, it was reported that venting emotion on others was more prevalent in females than males (13). The results of our study are consistent with those in the literature.

We found that some coping styles were mild to moderately associated with IU. Similarly, it was reported that subjects with high IU scores were likely to rely on maladaptive behaviors and cognitive strategies as a coping mechanism when faced with uncertain and potentially aversive situations (14). Women who could not tolerate uncertainty were more likely to use emotion-focused coping, which was related to greater depressive symptoms (2).

A limitation of the present study was that all assessments were self-reports, which depend on the respondent’s ability to correctly understand the question and make accurate self-assessments, which was critical in the current study. However, we found that the measures were completed in a reliable fashion. Other limitations included an almost entirely similar sample population of the same age group and education level, which limits generalizations.

In conclusion, our results suggest that healthy subjects use different coping styles and respond differently to uncertainty in both genders; there is the mild-moderate relationship between coping strategies and IU. Gender should be considered in studies investigating these factors. In addition, IU may be changed while intervening to coping mechanisms.

Footnotes

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study has received no financial support.

REFERENCES

1. Carleton RN, Mulvogue MK, Thibodeau MA, McCabe RE, Antony MM, Asmundson GJ. Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression. J Anxiety Disord. 2012;26:468–479. http://dx.doi.org/10.1016/j.janxdis.2012.01.011. [PubMed]
2. Taha SA, Matheson K, Anisman H. Everyday experiences of women posttreatment after breast cancer: the role of uncertainty, hassles, uplifts, and coping on depressive symptoms. J Psychosoc Oncol. 2012;30:359–379. http://dx.doi.org/10.1080/07347332.2012.664259. [PubMed]
3. Boelen PA, Carleton RN. Intolerance of uncertainty, hypochondriacal concerns, obsessive-compulsive symptoms, and worry. J Nerv Ment Dis. 2012;200:208–213. http://dx.doi.org/10.1097/NMD.0b013e318247cb17. [PubMed]
4. McEvoy PM, Mahoney AE. Achieving certainty about the structure of intolerance of uncertainty in a treatment-seeking sample with anxiety and depression. J Anxiety Disord. 2011;25:112–122. http://dx.doi.org/10.1016/j.janxdis.2010.08.010. [PubMed]
5. Carleton RN. The intolerance of uncertainty construct in the context of anxiety disorders: theoretical and practical perspectives. Expert Rev Neurother. 2012;12:937–947. http://dx.doi.org/10.1586/ern.12.82. [PubMed]
6. Gentes EL, Ruscio AM. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clin Psychol Rev. 2011;31:923–933. http://dx.doi.org/10.1016/j.cpr.2011.05.001. [PubMed]
7. Rosen NO, Ivanova E, Knauper B. Differentiating intolerance of uncertainty from three related but distinct constructs. Anxiety Stress Coping. 2014;27:55–73. http://dx.doi.org/10.1080/10615806.2013.815743. [PubMed]
8. Amir M, Kaplan Z, Efroni R, Kotler M. Suicide risk and coping styles in posttraumatic stress disorder patients. Psychother Psychosom. 1999;68:76–81. http://dx.doi.org/10.1159/000012316. [PubMed]
9. Lazarus RS. Coping theory and research: past, present, and future. Psychosom Med. 1993;55:234–247. http://dx.doi.org/10.1097/00006842-199305000-00002. [PubMed]
10. Gürkan B, Dirik G. Üniversite öğrencilerinde intihar düşünce ve davranışları ile ilişkili faktörler: Yaşamı sürdürme nedenleri ve baş etme yolları Türk Psikoloji Yazıları 2009;12:58–69.
11. Baker JP, Berenbaum H. Emotional approach and problem-focused coping: A comparison of potentially adaptive strategies. Cognition & Emotion. 2007;21:95–118. http://dx.doi.org/10.1080/02699930600562276.
12. Goodwin RD. Association between coping with anger and feelings of depression among youths. Am J Public Health. 2006;96:664–669. http://dx.doi.org/10.2105/AJPH.2004.049742. [PubMed]
13. Kim SM, Han DH, Trksak GH, Lee YS. Gender differences in adolescent coping behaviors and suicidal ideation: findings from a sample of 73,238 adolescents. Anxiety Stress Coping. 2014;27:439–454. http://dx.doi.org/10.1080/10615806.2013.876010. [PubMed]
14. Zlomke KR, Jeter KM. Stress and worry: examining intolerance of uncertainty’s moderating effect. Anxiety Stress Coping. 2014;27:202–215. http://dx.doi.org/10.1080/10615806.2013.835400. [PubMed]
15. Berenbaum H, Bredemeier K, Thompson RJ. Intolerance of uncertainty: Exploring its dimensionality and associations with need for cognitive closure, psychopathology, and personality. J Anxiety Disord. 2008;22:117–125. http://dx.doi.org/10.1016/j.janxdis.2007.01.004. [PubMed]
16. Boelen PA, Reijntjes A. Intolerance of uncertainty and social anxiety. J Anxiety Disord. 2009;23:130–135. http://dx.doi.org/10.1016/j.janxdis.2008.04.007. [PubMed]
17. Bailey DE, Jr, Landerman L, Barroso J, Bixby P, Mishel MH, Muir AJ, Strickland L, Clipp E. Uncertainty, symptoms, and quality of life in persons with chronic hepatitis C. Psychosomatics. 2009;50:138–146. http://dx.doi.org/10.1176/appi.psy.50.2.138. [PMC free article] [PubMed]
18. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989;56:267–283. http://dx.doi.org/10.1037/0022-3514.56.2.267. [PubMed]
19. Ağargün MY, Beşiroğlu L, Kıran ÜK, Özer OA, Kara H. The psychometric properties of the COPE inventory in Turkish sample: a preliminary research. Anatolian Journal of Psychiatry. 2005;6:221–226.
20. Freeston M, Rhéaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Pers Individ Differ. 1994;17:791–802. http://dx.doi.org/10.1016/0191-8869(94)90048-5.
21. Sarı S, Dağ I. Belirsizliğe Tahammülsüzlük ölçeği, endişe ile ilgili olumlu inançlar ölçeği ve endişenin sonuçları ölçeği’nin Türkçe’ye uyarlanması, geçerliliği ve güvenilirliği. Anatolian Journal of Psychiatry. 2009;10:261–270.
22. Sarı S. Unpublished Master Thesis. Hacettepe Univ., Institute of Social Sciences, Psychology Dept; Ankara, Turkey: 2007. The Investigation of intolerance of uncertainty, beliefs about worry and locus of control as predictors of trait anxiety. (In Turkish)
23. Gultekin BK, Dereboy IF. Prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students. Türk Psikiyatri Dergisi. 2011;22:150–158. [PubMed]
24. Boswell JF, Thompson-Hollands J, Farchione TJ, Barlow DH. Intolerance of uncertainty: a common factor in the treatment of emotional disorders. J Clin Psychol. 2013;69:630–645. http://dx.doi.org/10.1002/jclp.21965. [PMC free article] [PubMed]
25. Austenfeld JL, Stanton AL. Coping through emotional approach: a new look at emotion, coping, and health-related outcomes. J Pers. 2004;72:1335–1363. http://dx.doi.org/10.1111/j.1467-6494.2004.00299.x. [PubMed]
26. Schiltz L, Ciccarello A, Ricci-Boyer L, Schiltz J. Defence mechanisms and coping strategies in men and women: a comparative and structural study based on the artistic production of people suffering from a break-up of their life project. Bull Soc Sci Med Grand Duche Luxemb. 2013:7–24. [PubMed]

Articles from Archives of Neuropsychiatry are provided here courtesy of Turkish Neuropsychiatric Society