[Show abstract][Hide abstract] ABSTRACT: Prior studies have utilized a variety of self-report and behavioral measures of distress tolerance to predict dysregulated
behaviors and other problematic outcomes. However, few studies have examined the concurrent associations among these various
measures, which may be assessing distinct constructs. The purpose of the present study was to evaluate the concurrent utility
of several self-report and behavioral distress tolerance measures in predicting two clinically-relevant outcomes: bulimic
symptoms and general impulsive behaviors. Results of hierarchical multiple regression analyses revealed that whereas only
self-reported emotional distress tolerance was significantly associated with bulimic symptom severity, self-reported emotional
and physical distress tolerance, as well as a behavioral measure of psychological distress tolerance, were significantly associated
with impulsive behaviors in general. These findings highlight the need for further explication of the conceptualization and
operationalization of the distress tolerance construct, as well as research examining the convergent and discriminant validity
of various distress tolerance assessments.
KeywordsDistress tolerance–Emotion dysregulation–Experiential avoidance–Bulimia–Disordered eating–Impulsive behaviors
Cognitive Therapy and Research 12/2011; 36(6):1-10. DOI:10.1007/s10608-011-9377-8 · 1.70 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present investigation examined mask disturbance behavior in the context of a biological challenge.
Participants included 128 adults (63.3% women; M(age) = 23.2, SD = 8.9) who underwent a 10% carbon dioxide-enriched air challenge.
Mask disturbance behavior, including complete or partial mask removal, was common during the challenge. Moreover, mask removal behavior during the challenge was significantly related to a greater increase in anxiety pre- to post-challenge, as well as greater levels of self-reported avoidance of a future challenge administration. However, mask touching and lifting behaviors were not related to other challenge criterion variables.
The current study consisted primarily of young adults and did not include individuals with a panic disorder diagnosis. Replication and extension of the current findings is recommended.
Results suggest that mask removal behavior during the challenge may represent a possible behavioral marker of panic-relevant risk, although further work is necessary to determine its usefulness as a challenge measure.
Journal of Behavior Therapy and Experimental Psychiatry 09/2011; 42(3):253-7. DOI:10.1016/j.jbtep.2011.01.004 · 2.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This investigation first examined the incremental validity of distress tolerance in terms of alcohol use coping motives within a trauma-exposed community sample of adults, beyond the variance contributed by posttraumatic stress symptom severity, difficulties in emotion regulation, alcohol
consumption, and other (noncriterion) alcohol use motives. Secondly, the potential mediating role of distress tolerance in the association between posttraumatic stress symptom severity and alcohol use coping motives was tested. Participants were 83 community-recruited individuals (63.8% women;
age = 22.98, SD = 9.24) who endorsed exposure to at least one traumatic life event and past-month alcohol use. Participants were assessed using structured diagnostic interviews and a series of self-report inventories. Results were consistent with hypotheses, because
distress tolerance was significantly and incrementally associated with alcohol use coping motives; and distress tolerance at least partially mediated the association between posttraumatic stress and alcohol use coping motives. Theoretical and clinical implications as well as future directions
regarding the association between distress tolerance and alcohol use motives among trauma-exposed persons are discussed.
Journal of Cognitive Psychotherapy 05/2011; 25(2):130-141. DOI:10.1891/0889-83126.96.36.199
[Show abstract][Hide abstract] ABSTRACT: Emotion dysregulation is likely a core psychological process underlying the heterogeneity of presentations in borderline personality disorder (BPD) and is associated with BPD symptom severity. Emotion dysregulation has also been independently associated with posttraumatic stress disorder (PTSD), a disorder that has been found to co-occur with BPD in 30.2% of cases in a nationally representative sample. However, relatively little is known about the specific relationships between emotion dysregulation and PTSD among those diagnosed with BPD. The purpose of this study was to evaluate relationships between PTSD symptom severity and negative affect intensity and affective lability among individuals with BPD.
Participants were 67 individuals diagnosed with BPD (79% women; M(age) = 38, SD = 10), who reported one or more DSM-IV PTSD Criterion A events.
Hierarchical multiple regression analyses indicated that when examined concurrently with BPD symptom severity, PTSD symptom severity, but not BPD symptom severity, was related to negative affect intensity and affective lability. Re-experiencing symptoms uniquely predicted affective lability, and hyperarousal symptoms uniquely predicted negative affect intensity, lending additional support to emerging literature linking re-experiencing and hyperarousal symptoms with emotion dysregulation.
PTSD symptom severity among individuals with a BPD diagnosis is related to elevations in emotion dysregulation. It is important to evaluate whether early treatment of PTSD symptoms provided concurrently with BPD treatment leads to enhanced improvements in emotion regulation among individuals with co-occurring PTSD and BPD.
Depression and Anxiety 05/2011; 28(5):393-9. DOI:10.1002/da.20798 · 4.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present investigation examined the mediating role of distress tolerance in the association between impulsivity and alcohol use coping motives among trauma-exposed individuals. Participants were 86 adults (64.3% women; M(age) = 23.4, SD = 9.3) who met the DSM-IV-TR posttraumatic stress disorder (PTSD) criterion A for at least one traumatic life event and endorsed alcohol use in the past month. Distress tolerance at least partially mediated the association between impulsivity and alcohol use coping motives, after controlling for the variance explained by PTSD symptom severity and alcohol use problems. Clinical implications and future directions related to this line of inquiry are presented and discussed.
[Show abstract][Hide abstract] ABSTRACT: The present investigation examined the explanatory (i.e,. mediating) role of distress tolerance (DT) in the relation between posttraumatic stress (PTS) symptom severity and marijuana use coping motives. The sample consisted of 142 adults (46.5% women; M(age) = 22.18, SD = 7.22, range = 18-55), who endorsed exposure to at least one Criterion A traumatic life event (DSM-IV-TR, 2000) and reported marijuana use within the past 30 days. As predicted, results demonstrated that DT partially mediated the relation between PTS symptom severity and coping-oriented marijuana use. These preliminary results suggest that DT may be an important cognitive-affective mechanism underlying the PTS-marijuana use coping motives association. Theoretically, trauma-exposed marijuana users with greater PTS symptom severity may use marijuana to cope with negative mood states, at least partially because of a lower perceived capacity to withstand emotional distress.
[Show abstract][Hide abstract] ABSTRACT: The present investigation examined the main and interactive effects of posttraumatic stress symptom severity and 12-hr cigarette deprivation (cf. smoking as usual) in the prediction of anxious responding during a 4-min 10% carbon dioxide (CO₂)-enriched air laboratory challenge. It was hypothesized that 12-hr cigarette deprivation would exacerbate the effects of posttraumatic stress symptom severity with regard to anxious responding during the challenge.
Participants were 63 daily smokers (46.0% women; M(age) = 30.79, SD = 13.12, range = 18-60) who reported experiencing one or more traumatic events. The study consisted of two laboratory sessions. At the first session, participants were administered a structured diagnostic interview and completed self-reported measures. Eligible participants were randomly assigned to one of two conditions for the second session: (a) 12-hr cigarette deprivation or (b) noncigarette deprivation (i.e., smoking as usual). At the second session, participants' smoking status was biochemically verified, and all eligible participants then were administered the 10% CO₂-enriched air laboratory challenge protocol.
The main and interactive effects of posttraumatic stress symptom severity and the smoking-as-usual condition--not the hypothesized 12-hr cigarette deprivation condition--were significantly predictive of peri-challenge anxiety. The interactive effect of posttraumatic stress by smoking as usual was significant at Minutes 3 and 4 of the challenge specifically.
The present investigation provided novel findings related to the roles of cigarette deprivation and smoking with regard to self-reported anxious responding, among trauma-exposed smokers, during a challenge paradigm.
[Show abstract][Hide abstract] ABSTRACT: Despite initial evidence linking distress tolerance to posttraumatic stress disorder (PTSD) symptom severity, there is a need for the investigation of interrelations among multiple measures of distress tolerance and PTSD symptom severity. Therefore, the present study investigated concurrent relations among multiple measures of distress tolerance, as well as the relations between these measures and PTSD symptom severity, within a trauma-exposed community sample. The sample consisted of 81 trauma-exposed adults (63.1% women). Results indicated that Distress Tolerance Scale (Simons & Gaher, 2005) scores, but no other measures of distress tolerance were significantly related to PTSD symptom severity above and beyond the variance accounted for by number of traumas, trait-level neuroticism, and participant sex. Implications and future directions are discussed.
[Show abstract][Hide abstract] ABSTRACT: The current study investigated the main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptoms. The sample consisted of 91 adults (62.6% women; M(age)=23.45, SD=9.56) who met DSM-IV criteria for trauma exposure, 53.8% of whom met criteria for a recent (past 2 years) history of nonclinical panic attacks. Results indicated that distress tolerance, as measured by the Distress Tolerance Scale (Simons & Gaher, 2005), was significantly related to all PTSD symptom clusters, and a nonclinical panic attack history was significantly related to PTSD re-experiencing and hyperarousal symptoms. The interaction of a nonclinical panic attack history and distress tolerance significantly predicted unique variance in only PTSD hyperarousal symptoms. Implications and future directions are discussed for the role of nonclinical panic attacks and distress tolerance in PTSD symptom expression.