Examining the Role of Intolerance of Uncertainty in the Experience of Pain
Abstract
The pain experience is impacted by physical, psychological, and social factors
(Asmundson & Wright, 2004). Symptoms of anxiety and related disorders have been
associated with varied pain syndromes, particularly chronic pain (i.e., pain lasting longer
than 3 months [International Association for the Study of Pain, 1994]; Asmundson,
Norton, & Vlaeyen, 2004a). Chronic pain models implicate pain-related fear and anxiety
as leading to activity avoidance, impeded healing, and prolonged pain (Asmundson et al.,
2004a; Vlaeyen & Linton, 2000). Indeed, researchers have focused on pain-related fear
and anxiety, and anxiety sensitivity (AS) as key risk factors for chronic pain (Carleton &
Asmundson, 2012). Contemporary research and theory has underscored intolerance of
uncertainty (IU) as a key construct underlying anxiety and AS (Carleton, 2012; Hong &
Cheung, 2015), implying a possible relationship with chronic pain (Carleton &
Asmundson, 2012); nevertheless, little research has explored the role of IU in pain
experiences. The present study examined IU and chronic pain experiences. Online
participants (n = 470) with chronic lower back pain (CLBP) or no history of chronic pain
completed self-report measures of pain-related constructs online, as well as a behavioural
task to assess response to risk and uncertainty. Participants’ responses on the behavioural
task and self-report measures were compared to evaluate between-group differences
based on the presence of CLBP. The degree of uncertainty participants report about their
pain was considered as well. IU was associated with pain characteristics, such that
participants with CLBP exhibited higher IU. Risk-taking behaviour did not differ
between groups. The risk task used may have an ecological validity limitation with
respect to pain. IU contributed unique variance to reported pain. Significant positive
correlations among IU, pain, AS, and pain-related anxiety were identified. The results
have implications for understanding chronic pain, and for treatment research to explore
whether mitigating uncertainty or IU may reduce pain and pain-related anxiety.