Motivation and emotion/Book/2021/Uncertainty tolerance

Overview
Motivation conjures a realm of inspirational quotes and feelings, driven by hearts and minds entwined to live your best life. Well, not quite. Motivation, or studied as motivational science, encapsulates and questions the central idea of human behaviour and why people behave the way they do. Why do athletes exert their bodies to the maximum to perform for mere moments? Why do university students place singular importance on learning alone for years of their life?

The combination of energy, direction and persistence merge together to produce the internal process that is motivation. Human motivation can stem from external motives or internal motives, either from the external environment or events taking place from within an individual. These internal happenings include needs, cognitions and emotions.

Certainty, a state of being certain or factual, is an external factor which drives the motivation of many cultures globally. Likewise, uncertainty avoidance is often culturally adhered to, maintaining practices which are known and believed, and avoiding unknown influences. This, in turn, gives way to a phenomenon known as uncertainty tolerance. The motivation behind tolerating that which is unforeseeable.

And yet, humans face uncertainty each and every day. Without some kind of tolerance to the unknown, life would be extremely burdensome. Uncertainty tolerance is a psychological phenomenon which describes how an individual copes, cognitively, emotionally and behaviourally with uncertainty. The impacts of uncertainty tolerance are not limited by socio-economic restraints, nor cultural dynamics. Instead, the phenomenon extends to people from all walks of life, across all ages. Uncertainty tolerance not only influences this broad spectrum of people, but it's fluidity enables its affects to change between situations and expertise (Stephens, Rees & Lazarus, 2020). As such, the implications of an individuals uncertainty tolerance widely differs, depending on their circumstance and self-regulation mechanisms (Garrison et al., 2016).

Focus questions
 * What is uncertainty tolerance?
 * Who does uncertainty tolerance affect?
 * How can uncertainty tolerance be developed?
 * What are the implications of uncertainty tolerance?

What is uncertainty tolerance?


Uncertainty tolerance (UT); a psychological term expressing a cognitive bias which interprets how an individual perceives, and thus responds to uncertainty (Guo et al., 2020). Furrthermore, uncertainty tolerance is "the set of negative and positive psychological responses—cognitive, emotional, and behavioral—provoked by the conscious awareness of ignorance about particular aspects of the world" (Hillen et al., 2017). Individiual's with low uncertainty tolerance display emotional discomfort and negativity when faced with uncertainty provoking situations, perceiving uncertainty as ditrimental and often difficult to deal with (Guo et al., 2020). Adversely, people with a high tolerance for uncertainty are not confronted by this same negativity, however, are "tolerant" to situations unpredictable and uncertain in nature. This systematic response influences how an individual relates to cognitive, emotional and behavioural events (Guo et al., 2020). For example, an individual is awaiting the results of a recent job interview. Having been a few weeks since applying, a situation of uncertainty arises. Are they responding with negative emotions to this situation? Or are they remaining calm and optimistic despite the stressor? Uncertainty and the degree of importance of a situation can also positvely correlate, producing stress for individuals.

Defining uncertainty
A job interview is particularly specific, and albeit, rather mundane. Yet, life generates a vast multitude of stressors, creating situations that generate both minor and major emotional implications. Defining the spectrum of certainty and the consequential emotions is important to understanding its tolerance. "Uncertainty" and "tolerance" are broad words, and are deserving of more than a mere definition. The term "uncertainty" indicates a vast variety of unknown variables, ranging from life altering events to everyday life and routine, creating necessary distinction for defintion. Will an event occur? How will an event occur? What will be the consequences if it does and what behaviour will be neccary to deal with an occurence ? The sheer extent of this concept makes for ambiguity and ever more imperative for clear defintion.

Explicit definition
Due to the number of variations of uncertainty tolerance measurement, the definition of tolerance, and subsequent actions differ greatly (Hillen et al., 2017). Measurement variables range from “a period of anticipation” to the occurrence of a serious adverse event (Hillen et al., 2017). And yet, these definitions all share a commonality; “arising from the indeterminacy of future outcome” (Hillen et al., 2017).

Implicit definition
Not only does the explicit definition of uncertainty tolerance affect the scale of measurement, but the implicit varies immensely also. Uncertainty across measures can range from “unfamiliarity” to “tentativeness”, from unpredictability to the blanket term “uncertainty” (Hillen et al., 2017). Whilst these constructs do all accurately measure a dimension of uncertainty, the inconsistencies produced by the varying definitions of this psychological term can disrupt the face validity of research (Hillen et al., 2017). Furthermore, uncertainty produces both positive and aversive side effects, with the potential to inflence both physical and mental health (Hillen et al., 2017).

The implications of a definition
The definition and thus implications of uncertainty tolerance can morph when concerning differing situations. When regarding mood and anxiety disorders, it has been defined as a "cognitive vulnerability factor" (Sexton & Dugas, 2009). "Based on these findings, intolerance of uncertainty was proposed as a cognitive vulnerability factor for worry and GAD" (Sexton & Dugas, 2009). With this establishment of cognitive vulnerability, uncertainty tolerance, particularly low measuring, fulfils criteria to suggest itsː


 * manipulability
 * temporal antecedence regarding worry and stress
 * construct validity

However, it is important to note these findings fail to be consitently discerned, leaving room for further significant research (Sexton & Dugas, 2009).

Measuring uncertainty tolerance
In France, an inital measuring scale of uncertainty tolerance was developed to gauge emotional reactions to uncertainty, both past and present, and determined five contributing negative beliefs about uncertainty:
 * uncertainty is unacceptable and should be avoided
 * being uncertain reflects badly on a person;
 * uncertainty is frustrating;
 * uncertainty causes stress; and
 * uncertainty prevents action (Freeston et al., 1994; Sexton & Dugas, 2009).

This new research gave way to increased attention on this newly encompassed theory, and further study shortly followed. The assumption that this encapsulated intolerance was potentially not as unidimensional as first assumed triggered an exploratory factor analysis, resulting in a refurbished 27 item scale, a new Intolerance of Uncertainty Scale (IUS) (Freeston et al., 1994). Today, the Intolerance of Uncertainty Scale (IUS) is a commonly used assessment of this psychological phenomena (Sexton & Dugas, 2009).

These 27 items are scored in a likert styled scale, allowing particpants to answer items on a scale of 1, "not at all characteristic of me", to 5, "entirely chracteristic of me" (Protocol - intolerance of uncertainty scale (IUS) 2021).

Table 1. (Protocol - intolerance of uncertainty scale (IUS) 2021)

These 27 items represent and measure five core factors;
 * Unacceptability and Avoidance of Uncertainty
 * Negative Social Evaluation Caused by Uncertainty
 * Uncertainty-Related Frustration
 * Uncertainty Causes Stress
 * Uncertainty Preventing Action (Freeston et al., 1994)

Reactions to uncertainty
Just as people have varying levels of tolerance toward uncertainty, individuals react in response to uncertainty in many different ways. However, one thing remains the same amoungst most; individuals respond to uncertainty in a means to "minimize the negative effects and maximize the positive effects of uncertainty" (Hillen et al., 2017). Raections can include:
 * Seeking information
 * Ignore uncertainty by focusing attention elsewhere.
 * Become overwhelmed with fear and disempowered.
 * Some seek uncertainty and benefit from it (Hillen et al., 2017)

Conceptualisation of uncertainty tolerance
Uncertainty tolerance has been conceptualised time and time again by various research means. And yet, a single concrete concept has yet to emerge concerning the psychological phenomenon. As a result, a lot still remains in this field of research. A lack of agreement surrounding the extent to which uncertainty tolerance is impacted by individual’s character or external situations limits answers to empirical questions (Hillen et al., 2017).

Understanding an individuals response to this phenomenon is becoming increasingly important. Take health care for example. "The capacity of patients and health care professionals to tolerate uncertainty can affect the extent to which both parties form therapeutic relationships, seek and exchange information, and engage in shared decision making. Individual differences in uncertainty tolerance may influence health behaviors, the quality of health care, and health outcomes" (Hillen, Gutheil, Strout, Smets & Han, 2017).

Who does uncertainty tolerance affect?
Tolerance of uncertainty, and the subsequent reaction to inevitable unknowns, affects individuals on a daily basis cross-culturally and socio-economically. This reactance can affect individual's across the entireity of their life span, influencing career and prospects, development and can pertain specifically to particular career avenues.

Uncertainty Tolerance and Universityː A case study of Korean students
College and university students face a high level of uncertainty when seeking career prospects. With the younger population impacted most influentially by the rise in unemployment rates, this uncertainty for students is only amplified (Garrison et al., 2016). According to a report by the Organization for Economic Cooperation and Development (OECD, 2010), 30–40% college graduates in the world are at risk for unemployment upon entering the world of work (Garrison et al., 2016). Additionally, university acceptance rates in Korea are one of the highest globally (Garrison et al., 2016). And yet, the countries education system and consequential career outlet creates mass uncertainty for vulnerable students (Garrison et al., 2016). A culture of “cramming”, created through mass employment of tutoring institutions, sustains a severe competition against school attending youth to succeed in university entrance (Garrison et al., 2016). This educational system, “ipsi-jiok”, translating to “educational hell” and its desperation for success doesn’t end at university (Garrison et al., 2016). It’s competition results in a cyclic deficit in availability of suitable career roles, with this uncertainty ultimately resulting in wide spread symptoms of anxiety and psychological distress concerning these student’s futures (Garrison et al., 2016).

Research regarding tolerance of this uncertainty reveals an association between it and career identity (CI) (Garrison et al., 2016). “High levels of decisiveness” regarding career specificity to directly remove uncertainty was not associated with identity amongst students, whilst also creating higher levels of emotional distress (Garrison et al., 2016). Even more so, uncertainty tolerance amongst students highlighted “how young adults’ identity development tasks can be associated with their degree of maturity in responding to life’s inevitable uncertainty” (Garrison et al., 2016). “This may suggest that CI functions as a center of self-agency that enables the self to live in harmony with uncertain career environments” (Garrison et al., 2016).

Uncertainty Tolerance and Work life
Behaviour and emotions generated by an individuals career can continue to be influenced by uncertainty and individual tolerance well past their time in education, with tolerance directly affecting an individual’s self-efficacy concerning their career and life accomplishments (Kim et al., 2016). Tolerance of uncertainty is vital to perceiving satisfaction in work life, due to the fast-paced changing environment created by today’s society (Kim et al., 2016). Individual’s who pertain a high tolerance of uncertainty can cope better with ambiguous environments and undetermined future events (Kim et al., 2016). Thus, they are less likely to experience distress when confronted with career change and career development and opportunity (Kim et al., 2016).

A belief in a just world (BJW) is a measurable phenomenon which can influence how an individual copes with uncertainty. Research conducted by Nudelman, Otto and Dalbert, demonstrates the way in which BJW can perform as a buffer to negative emotions which low uncertainty tolerance can evoke when concerning career opportunities (Nudelman et al., 2016). BJW stems from the concept that good things will occur to good people, and likewise, bad things will happen to those who are bad (Nudelman et al., 2016). If a person is high in the belief that they are good, and thus goodness will come their way, they are more likely to cope well with uncertainty, due this perceived control and negative association with risk (Nudelman et al., 2016). Nudelman, Otto and Dalbert observed that “those threatened by worsening career chances with low uncertainty tolerance” displayed increased positivity in mood when BJW was also increased (Nudelman et al., 2016).

Specific career paths can lend themselves to extreme uncertainty. Healthcare, and those involved through it’s facilitation or receival can be affected by their personal tolerance of uncertainty. “Uncertainty is interwoven in daily life and in virtually all clinical situations experienced by patients and health professionals” (Hillen et al., 2017). Healthcare is a fast changing atmosphere, with new research giving way to new technologies faster than ever before (Hillen et al., 2017). Yet with this rapid development comes great uncertainty (Hillen et al., 2017). Do technologies outpace their relevant research (Hillen et al., 2017)? And if so, what are the requirements, risks and consequences of this renewing industry (Hillen et al., 2017)? These implications can influence health care staff in their decision making, manage communication and ultimately care for their patients.

Uncertainty tolerance beyond working life
After working lives end, uncertainty tolerance of individuals continues to impact day to day lives. As bodily functions decline after middle age, so do cognitive functions (Kachmaryk et al., 2020). Decision making processes and choice rationality are functions which are significantly impacted by aging, irrespective of cognitive-impacting disease (Kachmaryk et al., 2020). A study conducted by Kachmaryk, Grabovska, Ostrovska, and Syniev investigated the connection between uncertainty tolerance and the decision making decline within the elderly population (Kachmaryk et al., 2020). The sample used to conduct the research comprised of a high percentage of individuals with low uncertainty tolerance (75%)(Kachmaryk et al., 2020). The “absence of clear answers”, goals and objectives and the incompletion of tasks were decision measuring variables used as indicators of uncertainty tolerance, and those with low uncertainty tolerance were significantly more likely to react with negatively to these variables (Kachmaryk et al., 2020). Furthermore, amongst this elderly sample group, scale of uncertainty tolerance was found to inversely correlate with adaption techniques (Kachmaryk et al., 2020).

Origins
As a result of lack of scientific unity, the exact origin of an individual’s tolerance of uncertainty still remains unclear. "Is tolerance of uncertainty an individual characteristic (i.e. a static personality trait), or is it a complex construct (sometimes referred to as a state) resulting from, and modifiable by, the interplay between individuals and socio-cultural factors” (Hillen et al. 2017)? Research examining its fluidity unveils the argument of uncertainty tolerance development.

Fluid or static? Education's role in the development of Uncertainty Tolerance
While debate remains as to whether tolerance of uncertainty is changeable or static, the prevailing conceptual healthcare tolerance of uncertainty model (Hillen et al. in Soc Sci Med 180:62–75, 2017) suggests that individuals’ tolerance of uncertainty is influenced by so-called moderators” (Stephens, Rees & Lazarus, 2020). These moderators indicate the flexible nature of a modifiable state “a modifiable state, rather than a fixed personality trait” (Stephens, Rees & Lazarus, 2020).

The analysis of medical students, being specifically trained in techniques of handling stressful and uncertain situations, conducted by Health Science education researchers Stephens, Rees & Lazarus addresses the nature of uncertainty tolerance (Stephens, Rees & Lazarus, 2020). The study suggests the ability for visual art study to increase tolerance of uncertainty in medical students, with reflective writing could assisting students to mindfully express and tolerate uncertainty (Stephens, Rees & Lazarus, 2020). This adapting uncertainty tolerance demonstrates the fluid nature of the phenomenon, and the ability for individuals to personally modify reactions to uncertainty (Stephens, Rees & Lazarus, 2020).



Social Factors
Uncertainty tolerance of an individual can additionally be influenced by social factors. When peers and experts display levels of uncertainty tolerance, their emotional and behavioural reactions can facilitate the altering of that of the observer (Stephens, Rees & Lazarus, 2020). As witnessed by Stephens, Rees and Lazarus, teaching staff in universities have the ability to “facilitate or impede students development of tolerance of uncertainty depending on their approaches when responding to students’ expressions of uncertainty" (Stephens, Rees & Lazarus, 2020). The prevalence of expert advice and mastery understanding, increased tolerance of uncertainty, through the means of distraction or mere avoidance of acknowledgement of uncertain situations (Stephens, Rees & Lazarus, 2020).

What are the implications of uncertainty tolerance?
A broadly affecting psychological phenomenon, uncertainty tolerance affects humanity each and every day in varying measures of severity. As such, the implications tolerance of uncertainty are wide spread and deeply affecting.

Life Satisfaction
Life satisfaction; “the extent to which a person finds life rich, meaningful, full, or of high quality” https://dictionary.apa.org/life-satisfaction. A contributing factor to an individuals life satisfaction comes from self-regulation, and mechanisms which regulate this quality (Garrison et al., 2016). Generally, self-regulatory processes largely involve emotions and consequent behaviour (Garrison et al., 2016). However, the “controllability over embracement” of uncertainty is significantly influential to these mechanisms as well (Garrison et al., 2016). Control over uncertainty suggests a switch of power which individuals could harness, to thus improve reactions to the unknown. However, “a growing number of mental health researchers and practitioners have been emphasizing that control can cause psychological distress” (Garrison et al., 2016). In a study conducted by Garrison, tolerance of uncertainty is posed as a “central mediator” in the relationship between career identity and life satisfaction (Garrison et al., 2016). Career identity associated with tolerance for uncertainty, which in turn increases positive emotions, engagement and eagerness, such and minimises “anxiety and distress”, which successively improves elements of life satisfaction (Garrison et al., 2016).

The behaviour of college students highlights this reality. When presented with a career opportunity, college students are significantly more likely to accept a job opportunity than turn it down and encounter an ambiguous period (Garrison et al., 2016). However, this lack of selectivity does not display self-regulatory mechanisms, and ultimately avoids of tolerating uncertainty altogether (Garrison et al., 2016).



Impacts of Uncertainty Tolerance on Health care
Uncertainty tolerance plays a crucial role in health care, and the systems which support staff and patients. Its importance is further accentuated by the impacts uncertainty tolerance can directly evoke, both negative and positive (Hillen et al., 2017). “Uncertainty can be aversive; large bodies of research from multiple disciplines, both in and outside of the health care domain, have demonstrated that uncertainty provokes fear, worry and anxiety, perceptions of vulnerability, and avoidance of decision-making.” As a result, peoples intentionally act in a way to maximise all the positive reactions and reduce the negative outcomes (Hillen et al., 2017). Health behaviours, outcomes and overall health quality can be influenced by individual variations in uncertainty tolerance (Hillen et al., 2017). However, unfortunately due to a lack of unified research and conceptualisation, the measurement and thorough understanding on health care, particularly patient’s individual tolerances and the outcomes of such, is quite limited (Hillen et al., 2017). As global health care develops in complexity daily, the need for thorough conceptualisation and successive models of its impacts becomes more critical, requiring more attention and support in developing research (Hillen et al., 2017).

Conclusion
Uncertainty tolerance; a psychological phenomenon explaining an individuals cognitive, emotional and behavioural response to uncertainty. Due to it's widely-influential theory, it's impact can and has been observed in young and old. Despite it's largely unknown origins and complete implications, research has shown varying levels of tolerance to uncertainty can impact career identity and opportuniy, life satisfaction and social influence, with both positive and negative affect.

Despite previously completed studies, this area of psychology would benefit greatly from further research. Additional research concerning uncertainty tolerance and its cause and origin in individuals, and a concensus on it's conceptualisation would improve knowledge in this area, and consequent implications would benefit societies and systems globally.