Out with the old and in with the new: The role of intolerance of uncertainty in reversal of threat and safety

Intolerance of uncertainty (IU) is associated with difficulty in updating contingencies from threatening to safe during extinction learning. However, it is unknown whether high IU individuals have difficulty (1) generally with updating threat to safe associations when contingencies change or (2) specifically with updating threat to safe associations during extinction learning, where direct threat is omitted. To address this question, we recorded IU, expectancy ratings, and skin conductance in 44 healthy participants during an associative learning paradigm, where threat and safety contingencies were reversed. During acquisition and reversal, we observed larger skin conductance response (SCR) magnitude and expectancy ratings for threat versus safety cues. However, during reversal, higher IU was associated with larger SCR magnitude to new threat versus new safety cues, compared with lower IU. These results were specific to IU-related variance, over shared variance with trait anxiety (State-Trait Anxiety Inventory, Trait Version). Overall, these findings suggest that individuals high in IU are able to reverse threat and safety associations in the presence of direct threat. Such findings help us understand the recently revealed link between IU and threat extinction, where direct threat is absent. Moreover, these findings highlight the potential relevance of IU in clinical intervention and treatment for anxiety disorders.