Posttraumatic stress and substance use among military veterans: Associations with distress intolerance and anxiety sensitivity

Posttraumatic stress and alcohol use among Hispanic/Latina survivors of interpersonal trauma: Associations with anxiety sensitivity and distress tolerance.

“…Contrary to hypotheses, PTSD symptom severity was associated with alcohol use severity via AS only. This finding is consistent with recent research demonstrating AS but not the perceived incapacity to tolerate stress (as indexed by the Distress Intolerance Index; McHugh & Otto, 2012) mediates the link between PTSD symptom severity and alcohol use severity among military veterans (Vujanovic et al, 2022). For example, while DT encompasses beliefs about one's ability to tolerate or withstand a broad range of negative emotional states (e.g., "I can't handle feeling distressed or upset"; "I'll do anything to stop feeling distressed or upset"; "I am ashamed of myself when I feel distressed or upset"), AS is focused on beliefs about the experience of anxiety.…”

“…Theoretically, as Hispanic/Latina college students with interpersonal trauma histories may experience heightened PTSD symptoms and greater alcohol use (APA, 2013; Sanchez et al, 2021), understanding mechanisms (i.e., AS, DT) that may account for those associations is clinically relevant. Although AS and DT have been examined individually with regard to PTSD and Alcohol Use Disorder (AUD) symptomatology in various populations, little research has examined these constructs in tandem in the association between PTSD symptoms and alcohol use severity (Vujanovic et al, 2022). Clinically, among Hispanic/Latina survivors of interpersonal trauma, heightened PTSD symptomatology may increase fear of anxiety-related bodily sensations and lower capacity to withstand emotional states due to increased trauma-related avoidance, thus leading potentially to greater alcohol use as a means of self-medication of negative emotional states (i.e., coping motives; Khantzian, 1990).…”

Posttraumatic stress and distress tolerance in relation to opioid misuse and dependence among trauma-exposed adults with chronic pain.

“…Specifically, it may be clinically important for providers to assess perceived distress tolerance prior to beginning treatment for pain, especially among those with trauma exposure, and to employ specific therapeutic tactics for addressing difficulties with distress tolerance. Indeed, distress tolerance may predict treatment outcomes for individuals with posttraumatic stress and substance use disorders (Vujanovic et al, 2022). For example, individuals with low levels of distress tolerance (i.e., distress intolerance) may benefit from interventions to increase their distress tolerance skills.…”

“…Such heterogeneity in substance use behavior underscores the need to advance understanding of malleable individual difference factors, particularly at the psychological level of analysis, that may influence posttraumatic stress-opioid misuse among persons with chronic pain. This line of inquiry has the potential to inform specialized, person-centered approaches to treatment because subgroups can be identified and thereafter targeted for intervention programming (Vujanovic et al, 2022).…”

Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans

“…Deficits in DT may, therefore in part account for the relationship between PTSD/CPTSD and alcohol use (Boffa et al, 2018; Brooks Holliday et al, 2016; Duranceau et al, 2014; Vujanovic et al, 2015; Zegel et al, 2019). Recently, Vujanovic et al (2022) reported that scores on the Distress Intolerance Index (DII; McHugh & Otto, 2012) mediated the relationship between the severity of PTSD symptoms and substance use, but not alcohol use, in US military veterans. It remains to be seen, however, whether DT mediates the relationship between CPTSD and alcohol use among UK veterans.…”