Motivation and emotion/Book/2023/Uncertainty and emotion

Overview
Have you ever felt unsure if you are going to pass a class at university? Worried about the weather and if it will rain tomorrow? Unsure if your job is secure due to the current economic instability?

Uncertainty is all around in everyday life, whether that concerns the global COVID-19 pandemic, finances, health, relationships or the weather. There are many elements and areas in life which are uncertain and this is difficult for humans as we crave security, connected to one's basic human need; survival (McLeod, 2018). Uncertainty is a fundamental aspect of the human experience and has a profound influence on the way individuals perceive, process, and express their emotions (McLeod, 2018).

This chapter delves into the cognitive and neurobiological aspects of emotions and offers a comprehensive perspective on the complex interplay between uncertainty and emotion. Through a synthesis of research and theoretical frameworks, it aims to explain the multifaceted ways in which uncertainty shapes human emotional experiences.

Focus questions:
 * What is uncertainty and where does it come from?
 * What are the major theories of uncertainty and emotion?
 * How does uncertainty influence emotion?

What is uncertainty?
Uncertainty has been described as a state when "details of a situation are ambiguous, complex, unpredictable, or probabilistic; when information is unavailable or inconsistent; and when people feel insecure in their own state of knowledge or the state of knowledge in general" (Brashers, 2001). Uncertainty is an integral part of life and individuals constantly deal with uncertainty if that is in ambiguous situations, unresolved questions, or unforeseen events (see Figure.2). This can be from many aspects of life such as finances, job security, the COVID-19 pandemic and more. The term uncertainty has also been used interchangeably with 'risk' as they both deal with uncertainty.

The more people understand an event— what it is, why it occurred, how it fits into their self-concepts—the more quickly they adapt to it (Bar-Anan, Wilson & Gilbert, 2009). Therefore, anything that impedes understanding, including uncertainty about the nature of the event, will prolong affective reactions to that event.


 * Case study

Sarah is experiencing uncertainty in her long-term relationship. She has been with her partner for five years and is contemplating whether to continue the relationship or explore other possibilities. Sarah is struggling with doubts about her compatibility and long-term future with her partner, causing emotional distress, anxiety, and a sense of uncertainty in her relationship. She seeks guidance from a counsellor to assist her in navigating uncertainty.

Tip: Uncertainty vs Risk

Uncertainty and risk are commonly used interchangeably as they both are related to actions, events or outcomes that are not yet known. However it is important to differentiate the two. Risk involves probabilities of occurrence that are predictable, and outcomes that can be estimated with some degree of confidence. However uncertainty is a condition where there is no knowledge or probability on the outcome of future events (Park & Shapira, 2017).

Uncertainty in Illness
The uncertainty in illness theory was developed in 1988 by nursing theorist Merle Mishel (Zhang, 2017). The theory provides a framework for understanding how individuals and families cope with the challenges that arise when faced with a chronic illness (Zhang, 2017). The framework explains how patients and caregivers perceive uncertainty (see Figure 2). Since 1988, when it was created, researchers have used the theory to develop and test uncertainty management interventions in multiple populations of patients with cancer.

According to Mishel, uncertainty is a pervasive and distressing aspect of the illness experience. The theory suggests that individuals with chronic illnesses, such as cancer or diabetes, often face various uncertainties related to the course of their illness, the effectiveness of treatment, and the impact on their daily lives. The theory looks at four core components:

Mishel employed empirical and scientific evidence in crafting the Uncertainty in Illness Theory. The antecedents of this theory were formulated based on study findings related to uncertainty in illness, drawing on research in cognitive psychology and the uncertainty associated with various diseases. The development of the antecedent concept was further informed by clinical data and discussions with peers. She also used empirical evidence on stress and coping to develop the theory (Morris, 2020).
 * 1) Antecedents generating uncertainty - anything that occurs prior to the illness experience that affects the patient's thinking such as pain, prior experiences, and perception (Zhang, 2017).
 * 2) Appraisal of uncertainty - the cognitive process of determining whether a stressor is a danger or threat or an opportunity and to evaluate the availability of coping resources to respond to the stressor (Mishel, 1988).
 * 3) Coping with uncertainty - the mental and physical effort used to manage the stressor of uncertainty (Mishel, 1988).
 * 4) Adaptation to the illness - achieving new balance and adjusting to the new illness-related experience that triggered uncertainty (Mishel, 1988).

There are multiple limitations to the theory that should be considered:


 * The theory may not account for the wide variability of how people's respond to and cope with uncertainty. People may have different cognitive styles, coping mechanism and support systems.
 * The theory does not accommodate cultural or religious backgrounds that can impact people's coping strategies and health beliefs.
 * The theory may not extensively address the impact of healthcare system factors, such as the quality of communication between healthcare providers and patients, on uncertainty. Effective communication and support from healthcare professionals can significantly influence how individuals manage uncertainty.

Positive aspects of uncertainty
Research shows that uncertainty is predominantly associated with negative emotions (Morriss, 2022) however research suggests that positive emotions may emerge from uncertainty.

Being uncertain can help people become open-minded and creativity since it can encourage people to recognise that we are not in control of the situation or have all the answers (Kapoor, 2023). Embracing uncertainty allows individuals to develop personal growth and resilience, enabling them to navigate unforeseen challenges and learn from new experiences. According to research in positive psychology, embracing uncertainty is linked to increased psychological flexibility, which is associated with greater well-being and life satisfaction (Kapoor, 2023).

Furthermore, uncertainty can have positive impacts in the workforce. Uncertainty stimulates curiosity and innovation (Hreha, 2023). The exploration of unknown territories encourages creative thinking and problem-solving. Studies in organisational behavior suggest that a positive approach toward uncertainty can lead to enhanced creativity and entrepreneurial behavior within workplaces (Sutton, 2016). Uncertainty has also been found to promote flexibility in decision-making (Hreha, 2023). The ability to adapt to changing circumstances becomes a valuable skill, enhancing one's capacity to make more informed and agile choices (Bonanno, 2004).

Positive Uncertainty Theory
Another perspective that delves into the positive aspects of uncertainty is theorist H B Gelatt. Gelatt created the theory of Positive Uncertainty which looks at the positive aspects of uncertainty through decision making tool. Positive uncertainty refers to situations where there is some ambiguity or unpredictability, but the potential outcomes are seen as positive. It is a state of uncertainty that offers chances for development, education, and innovation (Gelatt, 2023). Gelatts theory focuses s on people finding the positive aspects of uncertainty. Gelatt quoted four guidelines that he stands by: subjectivity, open-mindedness, interconnectedness and uncertainty.


 * 1) Notice that beliefs become behavior - Subjectivity

"If you believe it will rain you carry an umbrella. Believing is seeing and seeing is doing. Beliefs are biology, psychology and prophecy. They influence your heartbeat, your thinking, and your predictions. Some beliefs have better behavioral consequences than others. What to believe is your most powerful option." (Gelatt, 2023).


 * 1) Become as capable of change as the environment - Open-mindedness

"It isn’t a crime to change your mind. Open-mindedness is the best teacher because an open mind is receptive to new and different ideas. A closed mind eliminates learning. Have the courage to challenge your convictions. Change happens to you and change happens by you. Changing your view changes you" (Gelatt, 2023).


 * 1) Keep your mind’s eye on what you don’t see - Interconnectedness.

"What you see is not all there is. We are participant observers, meaning that we only see what we pay attention to; what we don’t pay attention to is still there. And we are visually impaired observers, meaning we can’t see all the hidden wholeness. Try to imagine what you are not seeing" (Gelatt, 2023).


 * 1) Acknowledge the benefit of doubt - Uncertainty

"Know what you want and believe, but don’t be sure. Beware of your dogma. Treat truth as a hypothesis. Dogma is popular but doubt is practical — and beneficial. Certainty is what makes you comfortable, uncertainty is what makes you creative. Not knowing is now considered the norm" (Gelatt, 2023).

Gelatt's positive uncertainty theory was published in the Journal of Counseling Psychology entitled “Decision Making: A Conceptual Frame of Reference for Counseling” (Gelatt, 1962). Gelatt's theory has been used as a counselling method to assist people in positively evaluating and dealing with uncertainty (Gelatt, 2023).

Defining emotion
Emotions form a vital aspect of the human condition and consequently have significant implications for health and well-being (Davidson, 1998; LeDoux, 1998). Given the complex and multifaceted nature of emotion, there is substantial variation in the literature concerning conceptual definitions of emotional phenomena (Ekman and Davidson, 1994). However, there is a general consensus that emotions are a complex psychological state that involves physiological, subjective and behavioral responses to a particular situation (Cherry, 2023). Emotions play a vital role in human decision making, communication and overall wellbeing (Lerner, 2015).

Primary and secondary emotions
Primary emotions are the first emotions that one feels and secondary emotions are feelings one gets after a primary emotion. Research suggests that secondary emotions are typically stronger feelings that attempt to protect yourself in some way (Rich, 2023).

Neurobiology of emotions
Emotions stem from the activation of distinct neuronal clusters located within various regions of the cerebral cortex, including but not limited to the anterior cingulate, insular cortex, ventromedial prefrontal cortex, and subcortical structures like the amygdala, ventral striatum, putamen, caudate nucleus, and ventral tegmental area (Šimić, Tkalčić, Vukić,Mulc, Španić, Šagud, Olucha-Bordonau, Vukšić & Hof, 2021). The amygdala and the reward system play crucial roles in how the brain interprets and reacts to uncertainty, according to the neurological underpinnings of emotion (Šimić et al., 2021).

How does uncertainty influence emotion?
Research has found that uncertainty and emotions are integral components of our daily lives and play a significant role in our mental well-being (Morriss, Tupitsa, Dodd & Hirsch, 2022). Research has found that there is a link between uncertainty and mental health outcomes such as stress and anxiety (Cohen, 2011). The sense of not having control over a situation or not knowing what to anticipate is a common component of uncertainty which triggers primary emotions such as fear, anger or surprise and then results in secondary emotions such as anxiety, panic and stress (Cohen, 2011). Stress might result from lack of control because people may feel helpless and concerned about the repercussions of an unknown situation. In the field of psychology, the "loss of control" is a well-researched stressor (Cohen, 2011). Uncertainty goes against human natural desires, such as power, independence, acceptance, safety and tranquillity (Reiss, 2000). Brosschot and colleague's emphasises the perspective that the uncertainty of safety leads to stress as a survival response (Freeston & Komes, 2023).

According to empirical study, the behavioural inhibition system, which is in charge of negative emotional states like dread, frustration, sadness, and anxiety, is activated by uncertainty since it is unpleasant (Morriss, Goh, Hirsch & Dodd, 2023). Previous studies have verified the association between elevated physiological stress markers (Greco and Roger 2003) and response-to-threat characteristic cardiovascular patterns (Mendes et al. 2007) with emotions of doubt. The behavioural inhibition system (BIS), which regulates responses to conflicting, ambiguous, or unfamiliar inputs and is in charge of producing the anxiety felt in such circumstances, is one factor that is pertinent to the regulation of behaviour in uncertain situations (Morriss, Goh, Hirsch & Dodd, 2023). BIS activity raises arousal and attention while suppressing continuous behaviour, which aids in identifying which The activity of BIS inhibits ongoing behaviour and increases arousal and attention, which assists in determining which of incompatible or novel goals will dominate the course of action (Morriss, Goh, Hirsch & Dodd, 2023)

There is direct neuropsychological evidence connecting BIS with the feeling of uncertainty. For instance, Amodio et al. (2008) found a correlation between BIS and activity in the anterior cingulate cortex, a region involved in threat detection (Aston-Jones and Cohen 2005). A different study found that BIS is correlated with the activity of the right-posterior dorsolateral prefrontal cortex, which is sensitive to ambiguity and uncertainty (Aston-Jones and Cohen 2005). Unpredictability caused nervous responses on a behavioural level, like avoidance and increased focus on unpleasant stimuli (Herry et al. 2007). These findings demonstrate that uncertainty is an unpleasant and stressful experience that has a positive relationship with anxiety that is managed by BIS. BIS may be useful in decision making since it entails weighing potentially dangerous, innovative, or competing options and is inherently accompanied by uncertainty. Which information processing technique is most appropriate to lessen the ambiguity and anxiety felt when making decisions, nevertheless, remains unclear.

In late 2021, researchers from the King’s College in London conducted a major review on university student's mental health and the correlation between uncertainty. The findings drawn from a dataset of 82,682 respondents over seven years reported a positive association between higher levels of uncertainty and mental health problems. Uncertainty has been linked to worsened mental health outcomes, such as depression, anxiety, distress, and stress (King's College, 2023).

Researchers in 2022 conducted an online survey involving 231 participants to explore the influence of uncertainty on various negative and positive emotional states. The findings revealed that uncertainty is primarily linked to negative emotions, with fear and anxiety being the predominant emotional responses. Nevertheless, we observed that uncertainty also has the capacity to influence a range of other negative emotions, such as sadness, anger, and confusion, as well as positive emotions like surprise and enthusiasm. The nature of these emotional responses depended on factors such as the expected outcome (positive or negative) and the specific aspect of uncertainty such as risk or ambiguity (Morriss et al., 2022). The study also found that over a third of participants reported feeling fear, anxiety or worry when faced with uncertainty, despite the fact that uncertainty in the context of potential positive outcomes triggered more positive emotional states. Fear was the main emotion to be felt when experiencing uncertainty in situations. This can be explained by the fear of the unknown and the lack of information known about a situation.

Uncertainty specific impacts on mental health
As Stress: Commonly, uncertainty leads to tension. Numerous symptoms, including racing thoughts, forgetfulness, difficulty concentrating, change in appetite, perspiration, restlessness, nausea, physical discomfort in the body, irritability and fatigue, can be brought on by stress (Peter, 2017).

Anxiety: Another common response to uncertainty is anxiety as we lack control over the future (Grupe & Nitschke, 2013). One or more of the following symptoms of anxiety may also be present: racing thoughts, rapid heartbeat, sweating, restlessness, irritability, difficulty concentrating, tiredness, terror, and lack of sleep (Grupe & Nitschke, 2013).

Depression: Uncertainty can lead to the development of depression. Depression symptoms include continuous sorrow, loss of interest in or enjoyment from activities, low mood, irritability, sleep disturbances, weariness, changes in eating, lack of focus or motivation, and suicidal thoughts. (WHO, 2023).

Case study

Emily is dealing with a major life decision. She's been offered a high-paying job in a different city, but it requires her family to move and leave behind her current support network. Emily is torn between the prospect of financial security and the emotional impact of leaving her community. Her uncertainty about this decision is causing intense emotions. Emily is experiencing severe anxiety, sleepless nights, and high levels of stress. She's often irritable and overwhelmed by the uncertainty surrounding her choice, which is affecting her overall well-being and emotional stability.

Gaps in research
There is currently a gap in research around how individuals with mental health conditions are impacted and access uncertainty. As people's tolerance levels to uncertainty can be impacted if they suffer from mental health conditions such as depression and anxiety. Uncertainty may cause exacerbation of symptoms, circumstances may disrupt social connections with support systems, or one may find that established coping strategies are less effective. In comparison to an individual who does not suffer from a mental health condition and has a positive attitude toward dealing with uncertainty. This was emphasised in research in 2022 that found people with pre existing anxiety-related disorders exhibited higher COVID-related stress than those with no mental health disorder (Asmundson, Paluszek, Landry, Rachor, McKay & Taylor, 2020). As COVID-19 was an unprecedented and a significant time of uncertainty for people all around the world, further study around uncertainty and pre-existing health conditions would be valuable.

Uncertainty-Identity Theory
Uncertainty-identity theory was established by Hogg in 2007. Uncertainty-Identity psychology theory addresses one's uncertainty regarding self, life and the future. This theory focuses on the induced feeling of uncomfortableness and uncertainty regarding an individual's perceptions, attitudes, values or beliefs. Unlike other theories regarding uncertainty that focus on the implications of uncertainty from external factors such as the weather, covid or finances. This theory delves into uncertainty that a person can have within themselves (Hogg, 2007).. Uncertainty-identity theory is a theory that explains how people join groups to reduce their self-uncertainty. It is based on the idea that people need to have a clear and stable sense of who they are and what they stand for (Hogg, 2007). As groups can provide this by offering shared values, norms, and goals (Hogg, 2007).

Uncertainty Tolerance
A psychological concept known as "uncertainty tolerance" refers to how well a person processes, feels, and behaves in response to uncertainty. The effects of uncertainty tolerance are not constrained by cultural norms or socioeconomic constraints. Rather, people of all ages and from all areas of life are affected by the phenomenon. In addition to having an impact on a wide range of individuals, uncertainty tolerance's fluidity allows its effects to adapt to different contexts and levels of skill (Stephens, Rees & Lazarus, 2020). Because of this, the consequences of a person's uncertainty tolerance vary greatly based on their situation and self-control systems (Garrison et al., 2016).

According to Guo et al. (2020), uncertainty tolerance (UT) is a psychological term that describes a cognitive bias that affects how a person perceives and reacts to uncertainty. Furthermore[spelling?], according to Hillen et al. (2017), 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". An online survey was used to investigate if IU elicits and modulates a variety of good (such as happiness/joy, excitement/enthusiasm, surprise/interest) and negative (such as fear/anxiety, sadness/upset, anger/frustration, and disgust) emotional states. Results from a community sample (n = 231) showed that those with higher IU levels indicate that: (1) ambiguity in general and ambiguity-related uncertainty are more likely to elicit negative feelings and less likely to evoke positive emotional states, (2) that uncertainty under risk is less likely to evoke positive emotional states, and (3) that uncertainty heightens existing negative emotional states and dampens existing positive emotional states (Guo et al., 2023).  {What is uncertainty?}

- It involves probabilities of occurrence that are predictable, and outcomes that can be estimated with some degree of confidence - A strong belief in one's own judgment + A condition where there is no knowledge or probability on the outcome of future events - A state of complete clarity and certainty - None of the above

{What is the most common emotion to feel whilst experiencing uncertainty?}

- Anger + Fear - Excitement

Conclusion
Uncertainty is a constant companion on our life's journey, shaping our emotions, responses, and well-being. While it can lead to stress and anxiety, it also presents opportunities for personal growth and resilience. We all encounter dealing with uncertainty, and more investigation of this relationship may provide important new understandings about the nature of the human psyche and mental health. There remains a significant research gap concerning how individuals with pre-existing mental health conditions navigate uncertainty. For these individuals, the tolerance for uncertainty or uncertain events can potentially exacerbate symptoms. The use of Positive uncertainty theory to navigate uncertainty needs further research and implementation in the health care system. Understanding the correlation between uncertainty and emotions is vital for comprehending human behavior, decision-making, and overall well-being. It offers practical insights for fields like mental health, education, and business, guiding strategies to cope with stress, support individuals facing challenges, and enhance leadership effectiveness. Recognising how uncertainty triggers emotions enables the development of informed approaches to navigate uncertainties in personal, professional, and societal contexts, encouraging resilience and better decision-making.


 * Reflection
 * Congratulations! You have finished the chapter. Now you have learnt more about uncertainty and it's influence on emotions, can you recall another time when you have been effected by uncertainty?
 * What caused it?
 * How did you feel while experiencing uncertainty?
 * How did you overcome it?