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Cited by 16Child Abuse and TraumaChild and Adolescent Psychosocial and Emotional DevelopmentResilience and Mental Health

Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence

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Heleniak, Charlotte, Bolden, China R., McCabe, Connor J., Lambert, Hilary K., Rosen, Maya L., King, Kevin M., Monahan, Kathryn C., McLaughlin, Katie A.·2021·Research on Child and Adolescent Psychopathology
DOI 10.1007/s10802-021-00805-0PMC PMC8324573
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Abstract

Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance—the ability to persist in the face of distress—and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16–17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial Addition Task. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling for socio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.

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  • Low functional flexibility and distress tolerance in adolescents lead to susceptibility to addiction.

    “Heleniak et al. [14], stated that low functional flexibility and distress tolerance in adolescents leads to their susceptibility to addiction.”

    From Effectiveness of Mindfulness-based Stress Reduction Intervention in Distress Tolerance and Sensation-seeking in Adolescents With a Drug-addicted Parent (2022) · cites this paper as Heleniak et al. [14]

    The Discussion (page unavailable) reports that low distress tolerance in adolescents was prospectively associated with a small increase in problematic alcohol use. It does not establish that low functional flexibility causes addiction, and its observed outcome is alcohol-use problems rather than addiction generally. (LLM, conf=0.89)

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  1. Beck, A. T., Epstein, N., & Harrison, R. (1983). Cognitions, attitudes and personality dimensions in depression. British Journal of Cognitive Psychotherapy, 1(1), 1–16.
  2. Lejuez, C. W., Kahler, Christopher W., & Brown, R.A. (2003). A modified computer version of the Paced Auditory Serial Addition Task (PASAT) as a laboratory-based stressor. The Behavior Therapist, 26(4), 290–293.
  3. Muthén, L. K., & Muthén, B. O. (1998-2017). Mplus User's Guide. Eighth Edition. Los Angeles, CA: Muthén & Muthén.

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Authors
Heleniak, C., Bolden, C. R., McCabe, C. J., Lambert, H. K., Rosen, M. L., King, K. M., Monahan, K. C., & McLaughlin, K. A.
Affiliations
  • Columbia University (US)
  • Seattle Pacific University (US)
  • University of Washington (US)
  • University of Pittsburgh (US)
  • Harvard University (US)
Corresponding author
Heleniak, Charlotte
ORCID
Venue
Research on Child and Adolescent Psychopathology
Publisher
Springer Science and Business Media LLC
Published
2021-03-30
Volume
49
Issue
9
Pages
1211-1225
ISSN
  • 0091-0627 (ISSN-L)
  • 2730-7166
  • 2730-7174
DOI
10.1007/s10802-021-00805-0
PMC
PMC8324573
OpenAlex
W3143216900
Semantic Scholar
773d43c54468ffc69271987c767cf7a04114931e
Cited by
16
References
119
Citations by year
2026: 4 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 1
FWCI
2.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Research on Child and Adolescent Psychopathology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Smith ScholarWorks (Smith College) (submittedVersion)
Funders
  • National Institutes of Health (5r37mh119194-05)
  • National Institute of Mental Health (R37-MH119194, F31MH116559, R01MH103291, R01MH106482, F31MH108245)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (F32HD089514)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
Keywords
distress tolerance, violence exposure, adolescent alcohol abuse, alcohol abuse, depression, anxiety, internalizing problems, emotion regulation, Paced Auditory Serial Addition Test, mediation, socioeconomic status
MeSH terms
Exposure to Violence, Adolescent, Anxiety, Anxiety Disorders, Female, Humans, Male, Psychopathology, Violence

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