{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:56:15Z","timestamp":1791849375732,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cyclic vomiting syndrome (CVS) is an idiopathic disorder of gut\u2010brain interaction characterized by recurrent bouts of nausea and vomiting. Although CVS negatively impacts quality of life (QOL), the determinants of impaired QOL among adult CVS sufferers are not fully understood. The unpredictability of CVS attacks may generate anticipatory anxiety and worsen quality of life in a substantial proportion of patients with CVS. Intolerance to uncertainty (IU) is a cognitive trait in which individuals experience distress when faced with unpredictable situations, particularly those with potentially negative consequences. Higher trait IU is a well\u2010established vulnerability factor linked to the development of multiple psychiatric conditions, including anxiety. However, the extent to which higher IU is associated with impaired QOL in adults with CVS is not known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To explore this issue, we surveyed 118 adult CVS patients and obtained demographic information, clinical features, reported healthcare utilization, and standardized assessments of IU, anxiety and panic, and QOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Adult CVS patients with higher IU did not report a greater frequency of CVS attacks or overall CVS\u2010related healthcare utilization than those with lower IU. Yet, this group demonstrated substantially poorer physical and mental health\u2010related QOL and higher rates of anxiety\u2010spectrum disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Higher degrees of IU are associated with increased anxiety and reduced QOL in patients with CVS. IU is a malleable cognitive trait that can be targeted by cognitive behavioral therapy (CBT). Our results suggest that some CVS patients may benefit from non\u2010pharmacologic therapies such as CBT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14159","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T11:42:21Z","timestamp":1617882141000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Greater intolerance to uncertainty predicts poorer quality of life in adults with cyclic vomiting syndrome"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-8382","authenticated-orcid":false,"given":"David J.","family":"Levinthal","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, Hepatology, and Nutrition University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Romutis","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology, Hepatology, and Nutrition University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajai","family":"Rajalaban","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishnu C. 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