Intolerance of uncertainty, appraisals, coping, and anxiety: The case of the 2009 H1N1 pandemic

Objectives. Although ambiguous and uncertain situations, such as those dealing with the threat of widespread viral illness, may have pronounced psychological ramifications, there have been few studies that examined the factors that contributed to such outcomes. The purpose of the present investigation was to examine emotional reactions to a health threat. Design. A structural equation model examined the interplay between anxiety and intolerance of uncertainty, as sequentially mediated by appraisals and coping strategies. Methods. Adult participants over the age of 18 (N = 1,027) completed online self-report measures during the H1N1 pandemic in 2009. Results. Greater intolerance of uncertainty was related to lower appraisals of self- and other control, which predicted low levels of problem-focused coping and greater reports of H1N1-related anxiety. Additionally, individuals with a high intolerance of uncertainty were more likely to perceive the pandemic as threatening and also were more apt to use emotion-focused coping strategies, and both of these factors predicted elevated levels of anxiety. Conclusions. Together, these data indicate that threats, such as those related to a potential pandemic, not only have implications for physical health, but also for psychological distress, and that such outcomes vary with a constellation of appraisal and coping factors.