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Uncertainty and Ambiguity and Their Association with Psychological Distress in Medical Students

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The practice of medicine is inherently uncertain. We sought to measure the level of psychological distress among medical students and to ascertain if an intolerance of uncertainty and ambiguity were associated with distress.


The authors conducted a cross-sectional study with a population consisting of 4th year undergraduate medical students at an Irish university. Psychological distress was measured with the GHQ-12 scale. The “tolerance of ambiguity” scale and the “Intolerance of Uncertainty Scale (IUS)-12” were used to measure the respective variables.


One hundred students (class size of 123) participated in this study giving a response rate of 81 %. A total of 27 % of the students met the criteria for psychological distress. Student psychological distress, as measured by GHQ-12 caseness, was associated with a higher intolerance of uncertainty (mean 31.70 (6.18)) compared with those who were not distressed (mean IUS score 26.66 (6.58)) (t (98) = −5.52, p < 0.001).


A relative lack of tolerance for uncertainty may prove to be an important predictor of psychological distress in undergraduates. There is an argument for designing appropriate interventions so that learners can come to recognize and embrace uncertainty rather than its remaining unacknowledged and potentially contributing to psychological morbidity.

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Correspondence to John Lally.

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Lally, J., Cantillon, P. Uncertainty and Ambiguity and Their Association with Psychological Distress in Medical Students. Acad Psychiatry 38, 339–344 (2014).

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