Speakers - 2026

Title: Executive dysfunction, intolerance of uncertainty, and maladaptive decision-making in anxiety-driven addictive behaviors among young adults

Abstract

Anxiety-related cognitive vulnerabilities are increasingly recognised as critical contributors to the onset and persistence of addictive behaviours in young adults. This presentation explores how executive dysfunction and intolerance of uncertainty (IU) intersect to shape maladaptive decision-making patterns that heighten addiction risk. Executive functions including working memory, inhibitory control, and cognitive flexibility are essential for regulating attention, evaluating consequences, and engaging in goal-directed behaviour. However, individuals with elevated anxiety often exhibit reduced cognitive flexibility, diminished attentional control, and overload in working memory processes, making them more susceptible to emotionally driven and short-term choices.

Complementing these deficits is intolerance of uncertainty, a transdiagnostic cognitive bias characterised by difficulty coping with ambiguous or unpredictable situations. IU amplifies vigilance, avoidance, and the urge to seek immediate emotional relief. Within this cognitive landscape, addictive behaviours become highly reinforcing because they provide rapid, predictable, and easily accessible reduction in distress. Whether through substance use or behavioural addictions such as binge-watching or compulsive digital engagement, these behaviours temporarily soothe anxiety while simultaneously strengthening maladaptive neural pathways associated with reward and habit learning.

Drawing upon Attentional Control Theory and the Intolerance of Uncertainty Model, this presentation synthesises current evidence from cognitive neuroscience, addiction psychology, and clinical research to propose an integrated framework explaining why anxious young adults disproportionately rely on addictive behaviours as both coping and avoidance strategies. The model highlights a cyclical process: anxiety heightens distress; executive dysfunction weakens regulatory capacities; IU magnifies perceived threat; and maladaptive decision-making drives reliance on high-reward behaviours that reinforce the addiction loop.

Understanding these mechanisms has significant implications for clinical practice. Cognitive remediation training, uncertainty-focused CBT, metacognitive therapy, and decision-modulation interventions can target the underlying cognitive vulnerabilities, helping individuals build resilience and reduce dependence on addictive behaviours. By bridging theoretical models with applied therapeutic strategies, this presentation provides clinicians, educators, and researchers with a structured framework to better identify, assess, and intervene in anxiety-driven addiction pathways.

What will the audience take away from your presentation?

• A deeper understanding of how anxiety, executive dysfunction, and IU interact to drive addictive behaviours.
• A cognitive-affective model linking decision-making impairments with addiction vulnerability.
• Neuropsychological insights into reward processing and habitual responding in addiction.
• Evidence-based therapeutic techniques that specifically target uncertainty intolerance and cognitive rigidity.
• Practical strategies to improve treatment planning, relapse prevention, and early identification of high-risk individuals.

Explain how the audience will be able to use what they learn:
The framework enables clinicians to identify cognitive vulnerabilities during assessment, design interventions that enhance executive functioning, and integrate uncertainty-focused CBT into their practice. Researchers can use the model to design studies examining cognitive mechanisms in addiction, while educators may incorporate the concepts into academic curricula.

How will this help the audience in their job?
Professionals will gain a clearer understanding of cognition-driven addiction pathways, improving diagnostic accuracy, intervention precision, and relapse forecasting. Faculty can expand research and teaching based on a theoretically grounded and clinically relevant model. The insights can simplify treatment planning and improve behavioural outcomes in young adults.