Metabolic alterations in Snyder-Robinson syndrome lymphoblasts are ameliorated by phenylbutyrate treatment.

Decisions pervade every day of our lives. In the area of food alone—an admittedly important, but only partial section of our daily decisions—an average of over 200 decisions and micro‐decisions are made per day (Wansink and Sobal ). Extrapolating this estimate to all life domains results in an enormous number of choices each day. A mental disorder that has a negative impact on decision‐making ability will therefore likely interfere severely with psychological functioning. The present study focuses on one important aspect influencing decision making, namely uncertainty. More specifically, it investigates how handling uncertainty causally influences decision‐making difficulties in people with anxiety‐related mental disorders. Dispositional difficulties in coping with uncertainty are referred to as intolerance of uncertainty (IU) and are defined as “an individual's dispositional incapacity to endure the aversive response triggered by the perceived absence of salient, key, or sufficient information, and sustained by the associated perception of uncertainty” (Carleton , p. 31). Individuals with higher IU levels show altered responses to uncertainty across multiple levels (for an overview, see Morriss et al. ; Tanovic et al. ): neurobiologically (e.g., increased reactivity to uncertainty in the anterior insula, a brain region thought to contribute to anticipatory responses, Gorka et al. ); physiologically (e.g., increased electrodermal response in extinction learning involving uncertain threat, Morriss et al. ); behaviorally (e.g., increased checking of uncertain stimuli, Wake et al. ); and emotionally (e.g., increased negative affect and reduced positive affect in response to uncertainty, Morriss et al. ). Together, these findings show that elevated IU is associated with difficulties in effectively dealing with uncertain situations. Decision‐making is a domain that inherently requires the management of uncertainty, as choices often must be made in the face of incomplete or ambiguous information. In line with this, IU is thought to have negative implications for decision‐making (Koerner et al. ; Rassin et al. ) and empirical findings support this view: According to behavioral studies, IU is associated with potentially disadvantageous patterns in decision‐making (Carleton et al. ). For example, in a gambling task, Luhmann et al. () found IU was linked to a preference for immediately available but smaller and less probable rewards over larger, more probable rewards that were only available after a delay, likely to avoid waiting time and the associated uncertainty. IU is also connected to other decision‐related phenomena such as reduced confidence in decisions (Jensen et al. ), or increased attempts to reduce decisional uncertainty (Jacoby et al. ).