Pilot Intervention to Promote Tolerance for Uncertainty in Early Multiple Sclerosis

• Published in: Rehabilitation psychology 2019-08, Vol.64 (3), p.339-350
• Main Authors: Molton, Ivan R., Koelmel, Emily, Curran, Mary, von Geldern, Gloria, Ordway, Anne, Alschuler, Kevin N.
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Attitude to Health; Cognitive Behavioral Therapy - methods; Diagnosis; Emotional Adjustment; Female; Future; Human; Humans; Intervention; Male; Multiple Sclerosis; Multiple Sclerosis - psychology; Pilot Projects; Tolerance; Tolerance for Ambiguity; Uncertainty
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000275

Purpose/Objective: The ability to tolerate uncertainty about the future may be foundational to positive psychological adjustment. Conversely, intolerance of uncertainty (IU) has been shown to be a vulnerability factor for anxiety and depression. One stressor with a very high degree of uncertainty about the future is a new diagnosis of multiple sclerosis (MS). However, few psychological interventions in MS have directly targeted IU. Research Method/Design: Forty-eight participants with early MS and moderate levels of distress were randomized to receive either 6 sessions of a brief psychological intervention designed to improve the ability to tolerate uncertainty (n = 23) or treatment as usual (TAU; n = 25). Measures of mood, IU, and MS acceptance were administered at baseline and about 8 weeks later. Intervention effects were tested via linear regression controlling for baseline levels. Results: Participants were primarily Caucasian (85%) women (73%) and had lived with an MS diagnosis for an average of 376.3 days. Groups did not differ at baseline on most demographic or outcome variables. The intervention was well-tolerated, and most participants (82.6%) completed all 6 sessions and reported benefit. Postintervention, those in the intervention group demonstrated lower levels of IU and more MS acceptance relative to the TAU group. There was no effect of the intervention on global anxiety. Decreases in IU were associated with increases in MS acceptance (r = −.63). Effect sizes for these changes were moderate. Conclusions/Implications: These pilot results demonstrate that IU is responsive to a brief psychological intervention, and improvement with IU is associated with positive psychological outcomes. Impact and Implications People living with a recent diagnosis of multiple sclerosis (MS) are faced with a great deal of uncertainty about the future. The ability to tolerate this uncertainty is partly dispositional and is an important transdiagnostic protective factor for adjustment. Despite this, there are to date no published studies describing interventions designed to target intolerance of uncertainty (IU) in medical populations. This pilot study is the first to report on an intervention designed to specifically address IU in people recently diagnosed with MS. Findings from this study indicate that a six-session intervention can improve IU as well as acceptance of an MS diagnosis in individuals with early MS. The intervention was well tolerated by most partic