An Evaluation of the Relation Between Distress Tolerance and Posttraumatic Stress within a Trauma-Exposed Sample

Abstract

The present investigation examined the incremental associations between distress tolerance, or the perceived capacity to tolerate emotional distress, and global posttraumatic stress symptom severity as well as symptom cluster severity, beyond the variance accounted for by number of trauma exposure types and negative affectivity. The sample consisted of 140 adults (72 women; Mage=25.9, SD=11.1) who endorsed exposure to traumatic life events, as defined by posttraumatic stress disorder diagnostic criterion A (American Psychiatric Association 2000). Participants did not meet diagnostic criteria for current axis I psychopathology. Distress tolerance demonstrated significant incremental associations with global posttraumatic stress symptom severity (p<.01) as well as re-experiencing (p<.05), avoidance (p=.05), and hyperarousal (p<.001) symptom cluster severity. Given the cross-sectional study design, causation cannot be inferred. Theoretical implications and future directions for better understanding associations between distress tolerance and posttraumatic stress are discussed.

Influence of Multiple Traumatic Event Types on Mental Health Outcomes: Does Count Matter?

“…Distress tolerance is one's perceived ability to handle physical and emotional distress (Simons and Gaher 2005;Leyro et al 2010). With the experience of a PTE, an individual may find it difficult to cope emotionally, develop maladaptive coping skills, and thus experience distress tolerance difficulties (Vujanovic et al 2011a). With each additional PTE, distress tolerance may be lowered which further decreases an individual's capacity to cope effectively (Fetzner et al 2014), and in turn may increase the risk of experiencing additional PTEs (Finkelhor et al 2009).…”

Perceived control and avoidance in posttraumatic stress

“…Individual differences in perceived control and mastery are vulnerability factors in anxiety and stress-related disorders, with diminished perceived control being associated with conditions such as posttraumatic stress disorder (PTSD; Chorpita & Barlow, 1998; Grills-Taquechel, Littleton, & Axsom, 2011; Vujanovic, Bonn-Miller, Potter, Marshall, & Zvolensky, 2011). Individuals with PTSD who report negative beliefs about personal control, including appraising symptoms as uncontrollable or having a sense of diminished self-agency, display poorer outcomes following trauma exposure and treatment (Ayers, 2007; Dunmore, Clark, & Ehlers, 2001; Kleim, Ehlers, & Glucksman, 2007; Livanou et al, 2002).…”

“…While suggestive, the existing correlational studies do not examine the function of discrete experiences of perceived control after PTSD onset, or examine putative mechanisms such as distress tolerance or avoidance. Distress tolerance is significantly associated with PTSD severity (Marshall-Berenz, Vujanovic, & Zvolensky, 2011) and avoidance of trauma reminders (Vujanovic et al, 2011), and links PTSD with a range of comorbid problems (e.g. Anestis & Joiner, 2012; Bonn-Miller, Vujanovic, Boden, & Gross, 2011; Gaher, Hofman, Simons, & Hunsaker, 2013).…”

Loneliness Corresponds with Politically Conservative Thought

“…Distress tolerance indexes "the perceived or actual ability to withstand negative affect or other aversive psychological and/or physical states" [47]. Distress tolerance is inversely related to anxiety and the tendency to worry [48], as well as to subclinical post-traumatic stress [49]. Research shows that low tolerance for distress is associated with a range of maladaptive coping behaviors, including disordered eating [50], alcohol and cannabis abuse [51], tobacco dependence [52], and even a tendency to drop out prematurely from substance abuse treatment [53].…”