Threat-Related Interpretation Biases and Intolerance of Uncertainty in Individuals Exposed to Trauma

Interpretation biases are a form of cognitive bias in which ambiguous information is resolved in a consistent manner; threat-related interpretation biases are documented across a range of psychiatric disorders. Intolerance of uncertainty (IU) is the tendency to perceive uncertainty as threatening. Despite the relevance of IU to threat-related interpretation biases, relatively little work has examined the associations between these constructs, particularly in the context of posttraumatic stress disorder (PTSD).

This study examined the associations between IU, PTSD, and threat-related interpretation biases among 342 trauma-exposed adults (n = 156; 45.6% with provisional PTSD). Participants completed an online survey, including the Prospective IU and Inhibitory IU subscales of the Intolerance of Uncertainty Scale-12 (IUS-12), the PTSD Checklist for DSM-5 (PCL-5), and the Interpretation Bias Index for PTSD (IBIP). Responses to the IBIP were summed to capture explicit biases (i.e., the extent to which ambiguous sentences were perceived as threatening). Additionally, timing data were collected and used as an exploratory metric of implicit biases (i.e., the speed with which participants resolved threat-related ambiguity).

PTSD symptom severity was associated with both explicit and implicit threat biases. Prospective and inhibitory IU were each robustly associated with explicit threat biases, whereas only inhibitory IU was associated with implicit biases toward threat.

Results indicate that PTSD symptoms and IU are each associated with threat-related interpretation biases among trauma-exposed individuals.