The experience of intolerance of uncertainty for young people with a restrictive eating disorder: a pilot study

  • Anna KonstantellouEmail author
  • Lucy Hale
  • Lot Sternheim
  • Mima Simic
  • Ivan Eisler
Original Article
Part of the following topical collections:
  1. Personality and Eating and Weight disorders



Research is consistently reporting elevated levels of intolerance of uncertainty (IU) in individuals with an eating disorder (ED). Less is known about the phenomenology of uncertainty for this clinical group. The present study aims to advance our understanding of the relationship between IU and restrictive EDs by providing insight into young people’s subjective experiences of uncertainty.


Thirteen young people with a restrictive ED were recruited from multi-family therapy groups run within the Maudsley Centre for Child and Adolescent Eating Disorders at the South London and Maudsley NHS Foundation Trust. Three focus groups were conducted asking young people to discuss their views, experiences and coping strategies when faced with uncertainty.


Data were analysed using interpretative phenomenological analysis which yielded five superordinate themes: (1) young people perceived uncertainty as something negative; (2) high levels of anxiety and stress were identified as primary responses to uncertainty; (3) ED behaviours were given a functional role in reducing uncertainty; (4) need to control various aspects of young peoples’ lives was of high importance; (5) young people discussed how they struggled to find ways to cope with uncertainty and often used behaviours associated with the eating disorder psychopathology as coping strategies.


Young people’s experiences of what uncertainty is like for them revealed a dynamic interplay between ED symptoms and fear of uncertainty. Findings support IU as a relevant concept for young people suffering from a restrictive ED and indicate that further exploration of IU from both theoretical and clinical perspectives could be fruitful.

Level of evidence



Anorexia nervosa Adolescents Intolerance of uncertainty Qualitative research Eating disorders 



None required.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was granted ethical approval by the Joint South London and Maudsley and the Institute of Psychiatry NHS Research Ethics Committee (09/H0807/65). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. Young people gave written consent for discussions within the groups to be audio-recorded and used for research purposes only. Parental informed consent was sought for individuals under 16 years of age.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Maudsley Centre for Child and Adolescent Eating DisordersSouth London and Maudsley NHS Foundation TrustLondonUK
  2. 2.University of SurreyGuildfordUK
  3. 3.Department of Clinical PsychologyUtrecht UniversityUtrechtThe Netherlands

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