{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:00:04Z","timestamp":1792166404221,"version":"4.4.0"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2024YFC3606805"],"award-info":[{"award-number":["2024YFC3606805"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["23y11906000"],"award-info":[{"award-number":["23y11906000"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["202240266"],"award-info":[{"award-number":["202240266"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"publisher","award":["2024YFC3606805"],"award-info":[{"award-number":["2024YFC3606805"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"publisher","award":["23y11906000"],"award-info":[{"award-number":["23y11906000"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"publisher","award":["202240266"],"award-info":[{"award-number":["202240266"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["2024YFC3606805"],"award-info":[{"award-number":["2024YFC3606805"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["23y11906000"],"award-info":[{"award-number":["23y11906000"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["202240266"],"award-info":[{"award-number":["202240266"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>To explore the correlation of intolerance of uncertainty (IU) and emotion regulation (ER) in patients with generalized anxiety disorder (GAD), a total of 108 GAD patients and 115 healthy participants were recruited. The intolerance of uncertainty scale (IUS) was used to evaluate the level of IU. The emotion regulation questionnaire (ERQ) was used to evaluate participants\u2019 preference for emotion regulation strategies. The Hamilton anxiety scale (HAMA) and generalized anxiety disorder scale (GAD-7) were used to assess the degree of anxiety symptoms. Spearman correlation analysis and linear regression analysis were performed on participants\u2019 scores. The scores of the IUS subscales, ERQ subscales, and HAMA in the GAD group were different from those in healthy controls (HC group) (p \u2264 0.001). IUS subscales were correlated with ERQ subscales, and inhibitory IU was significantly correlated with expression suppression strategies (p &lt; 0.01). The level of IU is correlated with the selection of emotion regulation strategies in patients with GAD. Moderating effect analysis shows that emotion regulation strategies partially moderate the relationship between IU level and anxiety symptoms. This study underscores the critical role of intolerance of uncertainty and emotion regulation in shaping anxiety severity in GAD, highlighting the potential for targeted interventions that address both cognitive and emotional dimensions.<\/jats:p>","DOI":"10.3390\/bs15091238","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T14:23:50Z","timestamp":1757600630000},"page":"1238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intolerance of Uncertainty and Emotion Regulation in Generalized Anxiety Disorder: The Role of Reappraisal and Suppression"],"prefix":"10.3390","volume":"15","author":[{"given":"Letao","family":"Sun","sequence":"first","affiliation":[{"name":"Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China"},{"name":"School of Psychology, Shanghai Jiao Tong University, Shanghai 200240, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haochen","family":"Zou","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China"},{"name":"School of Psychology, Shanghai Jiao Tong University, Shanghai 200240, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoyan","family":"Pang","sequence":"additional","affiliation":[{"name":"School of Government, Shanghai University of 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disorders\u2013republished article","volume":"47","author":"Barlow","year":"2016","journal-title":"Behavior Therapy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.jad.2022.12.064","article-title":"Intolerance of uncertainty and anxiety: The role of beliefs about emotions","volume":"324","author":"Becerra","year":"2023","journal-title":"Journal of Affective Disorders"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1002\/jclp.21965","article-title":"Intolerance of uncertainty: A common factor in the treatment of emotional disorders","volume":"69","author":"Boswell","year":"2013","journal-title":"Journal of Clinical Psychology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S0005-7967(01)00092-4","article-title":"The intolerance of uncertainty scale: Psychometric properties of the English version","volume":"40","author":"Buhr","year":"2002","journal-title":"Behaviour Research and Therapy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1586\/ern.12.82","article-title":"The intolerance of uncertainty construct in the context of anxiety disorders: Theoretical and practical perspectives","volume":"12","author":"Carleton","year":"2012","journal-title":"Expert Review of Neurotherapeutics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.janxdis.2012.01.011","article-title":"Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression","volume":"26","author":"Carleton","year":"2012","journal-title":"Journal of Anxiety Disorders"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.janxdis.2006.03.014","article-title":"Fearing the unknown: A short version of the intolerance of uncertainty scale","volume":"21","author":"Carleton","year":"2007","journal-title":"Journal of Anxiety Disorders"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"324374","DOI":"10.1155\/2014\/324374","article-title":"Emotional regulation and depression: A potential mediator between heart and mind","volume":"2014","author":"Compare","year":"2014","journal-title":"Cardiovascular Psychiatry and Neurology"},{"key":"ref_9","unstructured":"Gross, J. J., and Ford, B. Q. (2024). Expressive suppression: Understanding the regulation of emotional behavior. Handbook of emotion regulation, The Guilford Press. [3rd ed.]."},{"key":"ref_10","first-page":"282","article-title":"Emotion regulation therapy for generalized anxiety disorder","volume":"20","author":"Fresco","year":"2013","journal-title":"Clinical Psychology & Psychotherapy"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.cpr.2018.01.007","article-title":"Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment","volume":"60","author":"Gillett","year":"2018","journal-title":"Clinical Psychology Review"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1037\/1089-2680.2.3.271","article-title":"The emerging field of emotion regulation: An integrative review","volume":"2","author":"Gross","year":"1998","journal-title":"Review of General Psychology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1080\/1047840X.2015.989751","article-title":"The extended process model of emotion regulation: Elaborations, applications, and future directions","volume":"26","author":"Gross","year":"2015","journal-title":"Psychological Inquiry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1037\/0022-3514.74.1.224","article-title":"Antecedent- and response-focused emotion regulation: Divergent consequences for experience, expression, and physiology","volume":"74","author":"Gross","year":"1998","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1037\/0022-3514.85.2.348","article-title":"Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being","volume":"85","author":"Gross","year":"2003","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.2044-8341.1959.tb00467.x","article-title":"The assessment of anxiety states by rating","volume":"32","author":"Hamilton","year":"1959","journal-title":"British Journal of Medical Psychology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton","year":"1960","journal-title":"Journal of Neurology, Neurosurgery and Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S2215-0366(18)30511-X","article-title":"Prevalence of mental disorders in China: A cross-sectional epidemiological study","volume":"6","author":"Huang","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Abramowitz, J. S., and Blakey, S. M. (2020). Intolerance of uncertainty. Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms, American Psychological Association.","DOI":"10.1037\/0000150-000"},{"key":"ref_20","first-page":"179","article-title":"How is \u201cintolerance of uncertainty\u201d (IU) measured? A systematic review of assessment tools for IU and the psychometric properties of IU questionnaires","volume":"31","author":"Lin","year":"2024","journal-title":"Clinical Psychology: Science and Practice"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Maftei, A., and L\u00e3z\u00e3rescu, G. (2022). Times are harsh, be kind to yourself! anxiety, life satisfaction, and the mediating role of self-compassion. Frontiers in Psychology, 13.","DOI":"10.3389\/fpsyg.2022.915524"},{"key":"ref_22","unstructured":"Reinecke, M. A., and Clark, D. A. (2004). Focusing on the regulation of emotion a new direction for conceptualizing and treating generalized anxiety disorder. Cognitive therapy over the lifespan evidence and practice, Cambridge University Press."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.janxdis.2016.05.001","article-title":"Intolerance of uncertainty in emotional disorders: What uncertainties remain?","volume":"41","author":"Shihata","year":"2016","journal-title":"Journal of Anxiety Disorders"},{"key":"ref_24","first-page":"1","article-title":"Successful implementation of cognitive reappraisal: Effects of habit and situational factors","volume":"36","author":"Simon","year":"2022","journal-title":"Cognition & Emotion"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Archives of Internal Medicine"},{"key":"ref_26","first-page":"3","article-title":"Reliability and validity of the emotion regulation scale","volume":"16","author":"Wang","year":"2007","journal-title":"Chinese Journal of Behavioral Medicine and Brain Science"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.janxdis.2016.04.011","article-title":"Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth","volume":"41","author":"Wright","year":"2016","journal-title":"Journal of Anxiety Disorders"},{"key":"ref_28","first-page":"92","article-title":"Reliability and validity of the intolerance of uncertainty scale-short form in university students","volume":"2","author":"Zhang","year":"2017","journal-title":"Chinese Journal of Clinical Psychology"},{"key":"ref_29","first-page":"119","article-title":"Evaluation method of emotion regulation","volume":"51","author":"Zhao","year":"2014","journal-title":"Journal of Northwest Normal University (Social Sciences)"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/9\/1238\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:44:09Z","timestamp":1760035449000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/9\/1238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["bs15091238"],"URL":"https:\/\/doi.org\/10.3390\/bs15091238","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]}}}