viernes, 28 de septiembre de 2018

Why can Uncertainty Cause Stress?

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By Liji Thomas, MDReviewed by Susha Cheriyedath, MSc

Uncertainty about the future makes us less capable of coping with negative events when they happen. It also disables us from taking effective and efficient steps to avoid them. This negative reaction is actually a maladaptation of the intrinsic ability of the human brain to predict the future, based on knowledge and past experience.

This ability helps humans to deal with possible negative outcomes or to avoid them, and to maximize the chances of a positive outcome. A critical level of certainty seems to be required in order to achieve this kind of processing. Below this level, individuals become uncertain as to whether a desired event will happen, and to the setting of that event in time and in life situations.

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This uncertainty breeds indecisiveness and poor ability to prepare for it, as well as inability to tolerate the possibility that it will not happen. This in turn leads to anxiety and stress.

Uncertainty and Stress

Research has shown that anxiety-related stress is separate from fear. When faced with an adverse situation, or with the clear and impending threat of such a situation, fear is the usual response. This acts out as the flight or fight scenarios.

However, when the situation dreaded is in the far and uncertain future, the observed result is anxiety, which is seen as a tendency to constantly assess the risk level. Intolerance of uncertainty is seen in some individuals who tend to be over-anxious.

Fear is usually short-lived and occurs in response to a definite threat. On the other hand, anxiety produces a sustained stressful response to an uncertain and unpredictable threat. Thus, the ability to predict a threat to some degree causes a clear reduction in the level of negative stress associated with the dreaded situation.

It has been observed in patients with cancer that those with intolerance to uncertainty develop behavior or thought patterns which help them avoid the deeply negative fears of the possibility they dread, or prepare intensively for it. In the process, they slip deeper into mental distress.

Mechanisms of Uncertainty-Induced Stress

Some of the ways in which uncertainty produces stress and anxiety are:

Uncertainty generates a dilemma as to the intensity of action one should take to prepare for the future. On the one hand, it is possible to make a plan to handle the situation at the most efficient level, but at the cost of it being found inadequate if the situation exceeds one’s expectation. On the other hand, one may over-prepare, with abundant precautions and coping mechanisms, only to find that they were not required and were not cost-effective.
Uncertainty is also a hindrance to being able to feel in control of a possible situation, because the exact nature and level of threat is unknown, making adequate preparation impossible.

The primary actions of uncertainty in creating stress and anxiety comprise:

Falsely high anticipations of the impact and the odds of the threat occurring, because of one-sided assessments of the situation leading to scary predictions.
Increased alertness to the threat to an abnormally high level so that a range of stimuli is interpreted as indicating danger.
Avoidance of the threat, in terms both of behavior and of mental processing such as worrying. Worrying often carries a kind of reward with it; the threats that are potentially seen and prepared for by worrying usually do not happen, leading to a false belief that the worry actually staved off the threat. This leads to reinforcement of the worrying behavior.
Poor knowledge about safety leads to ignoring even reliable cues in the environment which indicate that the level of threat is extremely low.
Higher levels of jitteriness regarding the situation that is dreaded, even startling at cues that indicate safety, indicate a loss of objective assessment of the stimulus itself and increased anticipation of a negative situation

These attitudes and actions need to be explored and corrected in order to enable uncertainty to be tolerated and coped with successfully.