Is intolerance of uncertainty in preschool youngsters a danger issue for later nervousness?

Intolerance of uncertainty (IU) is a cognitive trait characterised by a bias in direction of perceiving unsure conditions as damaging and scary (Freeston et al., 1994). Analysis suggests IU is linked to nervousness in each youngsters and adults, with IU even impacting the success of therapy on-line (Osmanağaoğlu et al., 2018; Marcotte-Beaumier et al., 2021; learn Tyler’s Psychological Elf weblog right here). Though IU has been linked to nervousness inside childhood, most research are cross-sectional, limiting our perception into long-term results. Moreover, IU is related to each internalising (e.g., melancholy) and externalising signs (e.g., impulsive and damaging behaviours; Gramszlo et al., 2018; Mcevoy et al., 2019; Sadeh & Bredemeier, 2019) however its developmental course stays unclear.

This examine by Ryan and colleagues (2025) aimed to research the connection between IU and generalised nervousness (GA) in preschool youngsters. This examine additionally investigated how IU in preschool youngsters is related to the trajectory of generalised nervousness (GA) signs from early to center childhood and extra broadly, the trajectory of internalising and externalising signs.

People with excessive ranges of intolerance of uncertainty have difficulties dealing with each on a regular basis uncertainties and massive life uncertainties. This causes extreme fear and will increase danger for the presentation of tension problems.

Strategies

100 and eighty households had been recruited as half of a bigger longitudinal examine referred to as ‘Watch Them Develop’. Knowledge was collected at three time factors:

• Time-point 1 (TP1): 180 youngsters (aged 3.46 to 4.67 years) in 2017/2018
• Time-point 2 (TP2): 162 youngsters (aged 5.72 to 7.71 years) in Spring 2020
• Time-point 3 (TP3): 148 youngsters (aged 8.27 to 10.36 years) in Autumn 2022

Knowledge was collected utilizing parent-report questionnaires, together with:

• The Preschool Nervousness Scale (PAS; Spence et al., 2001) – GA at TP1
• The Spence Youngsters’s Nervousness Scale Guardian report (SCAS-P; Nauta et al., 2004) – GA at TP2 & TP3
• The Responses to Uncertainty and Low Environmental Construction questionnaire (RULES; Sanchez et al., 2017) – IU at TP1, TP2 & TP3
• Well being Behaviour Questionnaire (HBQ; Armstrong & Goldstein, 2003) – internalising/externalising signs at TP1, TP2 & TP3
• Trait scale of Y2 state-trait Nervousness stock (STAI-Y2; Speilberger et al., 1983) – mother or father trait nervousness at TP1, TP2 & TP3

Knowledge had been analysed utilizing correlations between RULES and different measures throughout all timepoints. Hierarchical progress curve analyses had been then used to discover if IU at TP1 predicted trajectories for GA, internalising signs, and externalising signs throughout timepoints.

Outcomes

IU and GA

There have been important reasonable to excessive optimistic correlations between IU and GA throughout all timepoints (TP1: r = 0.74, 95% CI [0.67 to 0.80]; TP2: r = 0.68, 95% CI [0.59 to 0.76]; TP3: r = 0.60, 95% CI [0.48 to 0.69]). A reasonable optimistic correlation was additionally discovered between IU at TP1 and GA at TP2 (r = 0.46, 95% CI [0.32 to 0.57], p < .001) and TP3 (r = 0.34, 95% CI [0.19 to 0.48], p < 0.001), indicating that increased IU scores at 3-4 years had been related to increased ranges of GA at 5-7 years and 8-10 years.

Relatedly, hierarchical progress curve analyses revealed that IU at TP1 was a major predictor of GA throughout time (p < .001). Additional exploration with plots indicated that for kids with increased IU scores, GA decreased between TP1 and TP2, after which barely elevated between TP2 and TP3. In distinction, youngsters with low IU scores confirmed small will increase in GA over time.

IU and internalising/externalising signs

Average to excessive optimistic correlations had been additionally discovered between IU and externalising and internalising signs at each timepoint apart from TP1 IU and TP3 externalising signs, which had been weakly correlated.

IU was a major predictor of internalising signs (p < 0.001), with a linear impact of time (p <0.001) and a major impact of parental nervousness (p < 0.001). Exploration by means of plots recognized that internalising signs had been comparatively secure throughout all three timepoints in youngsters with excessive IU, whereas youngsters with low IU confirmed a rise in internalising signs over time (though these symptom ranges had been nonetheless decrease than these with excessive IU).

IU at TP1 was additionally a major predictor of externalising signs (p < 0.001), though there was no impact of time. In contrast to different analyses, nonetheless, there was a major impact of parental nervousness (p < 0.001) and marital standing (p = 0.033).

Preschool youngsters who had better issue dealing with uncertainty had been extra more likely to exhibit increased nervousness and emotional and behavioural issues in later childhood.

Conclusions

The primary findings from this longitudinal examine by Ryan et al. (2025) point out that intolerance of uncertainty (IU) is expounded to generalised nervousness (GA) from preschool into center childhood, and that IU in preschool can predict tendencies in GA in early to center childhood, but it surely predicts a lower, not a rise as anticipated.

The authors recommend this will mirror diminished uncertainty through the pandemic, as youngsters weren’t attending college or participating in common actions. As the connection between excessive IU and nervousness already appears to be established in preschool youngsters, we can not conclude that IU precedes the onset of childhood nervousness; nonetheless, it seems to be strongly associated.

Intolerance of uncertainty seems to be strongly associated to childhood generalised nervousness. Nonetheless, additional analysis is required to grasp whether or not it precedes the onset of childhood nervousness or if there are different elements which might be extra essential.

Strengths and limitations

Strengths

A key power of this examine is the management for marital standing and parental nervousness, each of which had been discovered to have a major impact in relation to IU and externalising signs. Modifications in parental marital standing or household (e.g., parental separation, divorce) might be unsure and destabilising occasions in themselves that trigger important nervousness (Coe et al., 2017). Equally, nervousness is thought to have a powerful environmental transmission (Eley et al., 2015), so it was essential for the authors to account for parental nervousness and nervousness throughout the house setting to make sure this didn’t confound and affect the reliability of the outcomes.

One other power is the longitudinal design. That is the primary examine to look at IU and GA from early to center childhood, which permits researchers to trace the trajectories of tension over time inside a cohort. Attrition throughout timepoints was comparatively low, strengthening the validity and reliability of findings because it elevated statistical energy, which allowed for extra exact modelling of developmental patterns.

Limitations

A key limitation is the reliance on mother or father report measures of IU, notably because it has been instructed that mother or father and little one report measures of IU don’t all the time align (Osmanağaoğlu et al., 2021). The dearth of kid self-report or behavioural measures can be a limitation of the broader literature of IU inside early childhood. Whereas makes an attempt to create task-based IU measures for kids have been unsuccessful (Osmanağaoğlu et al., 2021), validated questionnaires for older youngsters do exist (Cromer et al., 2009) and will have been tailored to go with mother or father stories.

Moreover, though marital standing and parental nervousness had been managed for, an enormous variety of potential confounds weren’t thought of. For instance, peer relationships and bullying have each been proven to affect the presentation of emotional problems equivalent to nervousness (Gladstone et al., 2006). Subsequently, there’s a chance that such confounds could have interacted with IU to extend the degrees of tension noticed inside this pattern.

Lastly, the authors didn’t report whether or not any contributors had been receiving remedy all through examine information assortment, which may have impacted the degrees of tension noticed. Particularly, this might account for the sudden lower in nervousness between TP1 and TP2 in those that had excessive ranges of IU at TP1. Nonetheless, nervousness did then enhance once more between TP2 and TP3, suggesting that any potential therapeutic results weren’t long-lasting.

Though this longitudinal examine managed for confounders equivalent to marital standing and parental nervousness, further related variables may have been thought of, like peer relationships and bullying.

Implications for apply

The present examine suggests a nuanced relationship between intolerance of uncertainty (IU) and generalised nervousness (GA). IU was related to better GA at baseline but additionally predicted a lower in nervousness over time; this implies a posh developmental trajectory of tension that must be higher understood throughout the short- and long-term, with extra analysis into the position IU performs. It’s notably essential that this analysis is completed outdoors of the COVID context, which the authors recognise may have impacted their findings.

The authors recommend {that a} follow-up into adolescence would additional our understanding of the position IU has in later nervousness growth. Adolescence is a key danger interval for the emergence of emotional problems as a result of important developmental adjustments, which are sometimes characterised by uncertainty (Casey et al., 2010; Copeland et al., 2014; Rapee et al., 2019). Earlier cross-sectional analysis has discovered that IU is correlated with nervousness problems inside adolescence (Ye et al., 2023), however and not using a longitudinal design, there are limits to the conclusions that may be drawn.

Moreover, as IU was discovered to be strongly associated to GA in early childhood, it signifies a potential avenue for future interventions concentrating on IU in preschool youngsters. In recent times, interventions have been developed that focus on potential danger elements for nervousness, equivalent to behavioural inhibition (Chronis-Tuscano et al., 2022). Behavioural inhibition is a temperamental attribute that refers to a bent to be cautious, shy, or restrained in new conditions (Kagan et al., 1984). Not solely is it a danger issue for nervousness, however additionally it is instructed that IU and behavioural inhibition overlap in definition and are associated (Zedbik et al., 2018). Proof means that behavioural inhibition packages are efficient at lowering nervousness inside childhood (Chronis-Tusano et al., 2022; Ooi et al., 2022), and it might be fascinating to see if an intervention concentrating on IU would have the same impact. Nonetheless, it’s nonetheless essential to recognise that these findings and options come from one examine, with limits to figuring out causality; way more analysis is required previous to intervention growth.

Lastly, from a apply perspective, it is crucial for clinicians to recognise the constant affiliation between IU and GA throughout childhood, in addition to the connection between IU and internalising and externalising signs. IU is probably going concerned in a variety of psychopathologies and subsequently could also be current throughout instances, with various affect. Relying on the service person, IU could also be one thing that must be addressed throughout therapy, although the potential affect of IU on therapy in youngsters remains to be unclear.

Though intolerance of uncertainty is strongly related to childhood nervousness in preschool youngsters, the way it impacts ranges of tension over time seems sophisticated and must be examined outdoors of the COVID-19 context.

Assertion of pursuits

None.

Hyperlinks

Major paper 

Ryan, Z. J., Rayson, H., Morriss, J., & Dodd, H. F. (2025). Does intolerance of uncertainty predict little one generalised nervousness? A longitudinal examine. Journal of Nervousness Issues, 112, 103004. https://doi.org/10.1016/j.janxdis.2025.103004

Different references

Armstrong, J. M., & Goldstein, L. H. (2003). The MacArthur Well being and Conduct Questionnaire (HBQ 1.0).

Casey, B. J., Duhoux, S., & Cohen, M. M. (2010). Adolescence: What Do Transmission, Transition, and Translation Need to Do with It? Neuron, 67(5), 749–760. https://doi.org/10.1016/j.neuron.2010.08.033

Chronis‐Tuscano, A., Novick, D. R., Danko, C. M., Smith, Okay. A., Wagner, N. J., Wang, C. H., Druskin, L., Dougherty, L. R., & Rubin, Okay. H. (2021). Early intervention for inhibited younger youngsters: a randomized managed trial evaluating the Turtle Program and Cool Little Children. Journal of Baby Psychology and Psychiatry, 63(3), 273–281. https://doi.org/10.1111/jcpp.13475

Coe, J. L., Davies, P. T., & Sturge-Apple, M. L. (2016). The Multivariate Roles of Household Instability and Interparental Battle in Predicting Youngsters’s Representations of Insecurity within the Household System and Early College Adjustment Issues. Journal of Irregular Baby Psychology, 45(2), 211–224. https://doi.org/10.1007/s10802-016-0164-6

Copeland, W. E., Angold, A., Shanahan, L., & Costello, E. J. (2014). Longitudinal Patterns of Nervousness From Childhood to Maturity: The Nice Smoky Mountains Research. Journal of the American Academy of Baby & Adolescent Psychiatry, 53(1), 21–33. https://doi.org/10.1016/j.jaac.2013.09.017

Eley, T. C., McAdams, T. A., Rijsdijk, F. V., Lichtenstein, P., Narusyte, J., Reiss, D., Spotts, E. L., Ganiban, J. M., & Neiderhiser, J. M. (2015). The Intergenerational Transmission of Nervousness: A Youngsters-of-Twins Research. The American Journal of Psychiatry, 172(7), 630–637. https://doi.org/10.1176/appi.ajp.2015.14070818

Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do folks fear? Character and Particular person Variations, 17(6), 791–802. https://doi.org/10.1016/0191-8869(94)90048-5

Gladstone, G. L., Parker, G. B., & Malhi, G. S. (2006). Do Bullied Youngsters Turn into Anxious and Depressed Adults? The Journal of Nervous and Psychological Illness, 194(3), 201–208. https://doi.org/10.1097/01.nmd.0000202491.99719.c3

Gramszlo, C., Fogleman, N. D., Rosen, P. J., & Woodruff-Borden, J. (2017). Intolerance of uncertainty in youngsters with attention-deficit/hyperactivity dysfunction. ADHD Consideration Deficit and Hyperactivity Issues, 10(3), 189–197. https://doi.org/10.1007/s12402-017-0244-7

Hughes, T. (2022). Videoconference delivered CBT for nervousness problems: working alliance and intolerance of uncertainty. The Psychological Elf.

Kagan, J., Reznick, J. S., Clarke, C., Snidman, N., & Garcia-Coll, C. (1984). Behavioral Inhibition to the Unfamiliar. Baby Growth, 55(6), 2212. https://doi.org/10.2307/1129793

Marcotte-Beaumier, G., Bouchard, S., & Dugas, M. J. (2020). Intolerance of Uncertainty Mediates the Affiliation Between Working Alliance and Remedy End result in CBT Delivered by Videoconference for GAD (Preprint). JMIR Psychological Well being. https://doi.org/10.2196/24541

McEvoy, P. M., Hyett, M. P., Shihata, S., Worth, J. E., & Strachan, L. (2019). The affect of methodological and measurement elements on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Scientific Psychology Assessment, 73, 101778. https://doi.org/10.1016/j.cpr.2019.101778

Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parent-report measure of youngsters’s nervousness: psychometric properties and comparability with child-report in a clinic and regular pattern. Behaviour Analysis and Remedy, 42(7), 813–839. https://doi.org/10.1016/s0005-7967(03)00200-6

Ooi, J., Dodd, H. F., Meiser-Stedman, R., Hudson, J. L., Bridges, J., & Move, L. (2022). The efficacy of interventions for behaviourally inhibited preschool-aged youngsters: A meta-analysis. Journal of Nervousness Issues, 88, 102559. https://doi.org/10.1016/j.janxdis.2022.102559

Osmanağaoğlu, N., Creswell, C., & Dodd, H. F. (2018). Intolerance of Uncertainty, nervousness, and fear in youngsters and adolescents: A meta-analysis. Journal of Affective Issues, 225, 80–90. https://doi.org/10.1016/j.jad.2017.07.035

Osmanağaoğlu, N., Creswell, C., & Dodd, H. F. (2021). Growth of a behavioural measure of Intolerance of Uncertainty in preadolescent youngsters: Adaptation of the beads process. Journal of Conduct Remedy and Experimental Psychiatry, 72, 101654. https://doi.org/10.1016/j.jbtep.2021.101654

Rapee, R. M., Oar, E. L., Johnco, C. J., Forbes, M. Okay., Fardouly, J., Magson, N. R., & Richardson, C. E. (2019). Adolescent growth and danger for the onset of social-emotional problems: A evaluate and conceptual mannequin. Behaviour Analysis and Remedy, 123(103501), 103501. https://doi.org/10.1016/j.brat.2019.103501

Sadeh, N., & Bredemeier, Okay. (2019). Participating in Dangerous and Impulsive Behaviors to Alleviate Misery Mediates Associations Between Intolerance of Uncertainty and Externalizing Psychopathology. Journal of Character Issues, 35(3), 1–16. https://doi.org/10.1521/pedi_2019_33_456

Sanchez, A. L., Cornacchio, D., Chou, T., Leyfer, O., Coxe, S., Pincus, D., & Comer, J. S. (2017). Growth of a scale to judge younger youngsters’s responses to uncertainty and low environmental construction. Journal of Nervousness Issues, 45, 17–23. https://doi.org/10.1016/j.janxdis.2016.11.006

Speilberger, C. D., Gorsuch, R., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Guide for the state-trait nervousness stock. Palo Alto, CA: Consulting Psychologists.

Spence, S. H., Rapee, R., McDonald, C., & Ingram, M. (2001). The construction of tension signs amongst preschoolers. Behaviour Analysis and Remedy, 39(11), 1293–1316. https://doi.org/10.1016/s0005-7967(00)00098-x

Steinsbekk, S., Ranum, B., & Wichstrøm, L. (2021). Prevalence and course of tension problems and signs from preschool to adolescence: A 6‐wave neighborhood examine. Journal of Baby Psychology and Psychiatry, 63(5), 527–534. https://doi.org/10.1111/jcpp.13487

Ye, H., Chen, C., Chen, S., Jiang, N., Cai, Z., Liu, Y., Li, Y., Huang, Y., Yu, W., You, R., Liao, H.-P., & Fan, F. (2023). Profiles of Intolerance of Uncertainty Amongst 108,540 Adolescents: Associations with Sociodemographic Variables and Psychological Well being. Baby Psychiatry & Human Growth. https://doi.org/10.1007/s10578-023-01603-z

Picture credit