Materials & Downloads

Measures that we found useful for our study and regular clinical practice. Questionnaires are available in English, Italian, and Spanish.

The IUS-5 is the 5-item version of the Intolerance of Uncertainty Scale (IUS; Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994), the gold standard measure for IU. It has two versions, the original 27-item and the 12-item (IUS-12; Carleton, Norton, & Asmundson, 2007). Our research team has developed an even shorter version of the IUS, both psychometrically sound and quicker to administer, which would increase its utility in research studies with an elevated number of measures.

More information are available in this preprint:

Bottesi, G., Mawn L., Nogueira-Arjona, R., Romero-Sanchiz, P., Simou, M., Simos, G., Tiplady, A., Freeston, M. H., & UNiCORN (2020, June 2). A short-form version of the Intolerance of Uncertainty Scale: Initial development of the IUS-5. PsyArXiv, Preprint. https://doi.org/10.31234/osf.io/b62wf.

The IUBEL was developed to assess a range of behaviours people may use in response to uncertain situations. Repertoires of behavioural strategies are highly idiosyncratic, both across situations and between people. Behaviours may be deployed according to specific characteristics of the situation, sequentially as a function of the imminence of the situation, or as a function of current mood state. The questionnaires can capture a range of behaviours which can inform formulation. There are two versions, General, and Situational.

Materials that we are using to help our patients. All materials are available in English, Italian, and Spanish.

The uncertainty distress model is a trans-diagnostic and trans-situational framework to understand how threat and uncertainty can lead to distress including, but not limited to, anxiety. The model is available here (open access):

Freeston, M. H., Tiplady, A., Mawn, L., Bottesi, G., & Thwaites, S. (2020). Towards a model of uncertainty distress in the context of Coronavirus (Covid-19). the Cognitive Behaviour Therapist, 13, 2000029X. http://dx.doi.org/10.1017/s1754470x2000029x

On this page, you can find links to some materials that we have developed to support interventions that target different parts of the model.

This worksheet addresses the role of information and how it contributes to perceptions of threat and uncertainty. This intervention is predicated on the assumption that many people are receiving a vast amount of information. The information may or may not be helpful, will vary in quality, and may contribute to distress. There are many different ways unhelpful information consumption could be addressed; this worksheet provides one possibility with a worked case example.

This resource sheet provides a way of thinking about different types of information, the possible effects on people, and what to do about it. It is designed primarily for therapists to understand the different types of information and their effects, rather than as a worksheet to use for patients.

One of the key features of CBT is the use of “between session interventions” which are commonly known as homework. An important step in the use of any exercise or task is to complete the loop: review what was attempted, whether there were any difficulties in implementing the plan, reflect on what happened, summarize any key learning, and then plan any changes. This worksheet provides one way of following up previous homework. It is designed to be used with any homework task.

One of the first steps to tolerating uncertainty is to notice the behaviours used to help manage the uncomfortable feelings associated with uncertainty. This worksheet provides the therapist with an introduction to certainty seeking behaviours and how they can be identified. It also includes a worksheet to use with clients and two completed examples.

To work with uncertainty in the room, the worksheet helps to investigate the subjective experience as a bodily felt sense. Avoiding the sensations and bodily reactions to unknown situations is part of ‘keeping a lid’ on the experience and hampers the process of tolerating uncertainty-related discomfort. The interoceptive worksheet supports the experience of being with, sitting with and beginning to relate to the feeling states arising in the face of uncertainty.

Interesting readings to better understand the foundations of our research.

The first is a pre-pandemic background paper on the psychology of conspiracy theories from a team with a very strong track record of theory and research in this area. The abstract states: “Belief in conspiracy theories appears to be driven by motives that can be characterized as epistemic (understanding one’s environment), existential (being safe and in control of one’s environment), and social (maintaining a positive image of the self and the social group)”. The pandemic provides a fruitful environment for epistemic and existential motivations.

Douglas, K. M., Sutton, R. M., & Cichocka, A. (2017). The psychology of conspiracy theories. Current Directions in Psychological Science, 26(6), 538-542.       https://doi.org/10.1177%2F0963721417718261.

The second paper emphasizes the importance of measurement issues in assessing the prevalence and/or strength of belief, this time in the context of the pandemic.

Sutton, R. M., & Douglas, K. M. (2020). Agreeing to disagree: reports of the popularity of Covid-19 conspiracy theories are greatly exaggerated. Psychological Medicine, 1-3. https://doi.org/10.1017/S0033291720002780.

Our understanding of distress in response to the pandemic (and other life-disrupting situations) is that the distress (often, but not exclusively, anxiety) is due to both threat or danger as found in CBT models of anxiety, and uncertainty which is not a main component of most CBT models. The distinction is more familiar in other fields such as economics, although the language may be different. What we would call threat, they may call risk. This is a brief article from July 2020 in the field of marketing that nicely sums up some of the issues and the differential weighting between scenarios: “Extreme measures are justified to save lives, but very high standards are set for the evaluation and use of a potentially useful drug”.

Stewart, D. W. (2020). Uncertainty and Risk Are Multidimensional: Lessons from the COVID-19 Pandemic. Journal of Public Policy & Marketing, 0743915620930007. https://doi.org/10.1177%2F0743915620930007.

In a similar vein, the “misinfodemic” has been well documented. The following example from risk communication researchers argues that misinformation should be viewed as a risk in its own right or “meta-risk” and “interacts with and complicates publics’ perceptions of the original risk”. The authors conceptualize fact-checking as a form of risk communication, but also identify the challenges of fact-checking in the pandemic, namely, Problems of trust; The limits of knowledge, and Fact-checking a state of uncertainty.

Krause, N. M., Freiling, I., Beets, B., & Brossard, D. (2020). Fact-checking as risk communication: the multi-layered risk of misinformation in times of COVID-19. Journal of Risk Research, 1-8. https://doi.org/10.1080/13669877.2020.1756385.

This paper illustrates the intimate connection between body and emotion and how discrete feeling states are associated with distinct patterns of experienced bodily sensations. The significance of embodied sensations for daily life inspires our research to capture bodily signals underlying and interacting with the felt-sense of unknownness which constitutes the lived experience of uncertainty. Furthermore, it informs our conceptualisation of a treatment design to encompass body-integrative elements in order to befriend and embrace uncertainty.

Lauri Nummenmaa, L., Glerean, E., Hari, R. and Hietanen, J.K. (2014) Bodily maps of emotions. PNAS, 111 (2), 646-651. https://doi.org/10.1073/pnas.1321664111.

The views expressed in these links do not represent the individual or collective view of the members of UNiCORN. We have simply found them interesting.

• Brief and interesting piece about scientific communication, uncertainty and public expectations in the context of COVID-19:  https://questproject.eu/when-the-public-rejects-uncertainty-remember-to-engage-and-listen 

• This article explores the ideas of hope and transformation. Solnit considers activism, political revolution and natural disasters; she explores positive action and inspiration drawn from the freedom of not knowing what is going to happen:  https://www.theguardian.com/books/2016/jul/15/rebecca-solnit-hope-in-the-dark-new-essay-embrace-unknown 

• An unusual example of living with uncertainty; this article describes the residents of Sheerness currently living with 14000 unexploded WWII bombs just off their coast. Risk is considered, and the different responses to uncertainty at both an individual and governmental level are discussed:  https://www.vice.com/en/article/pky899/sheerness-14000-unexploded-bombs-ss-richard-montgomery