Main and interactive effects of distress tolerance and negative affect intensity in relation to PTSD symptoms among trauma-exposed adults

Vujanovic, Anka A.; Hart, Ashley S.; Potter, Carrie M.; Berenz, Erin C.; Niles, Barbara; Bernstein, Amit

doi:10.1007/s10862-012-9325-2

Cited by 88Posttraumatic Stress Disorder ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesResilience and Mental Health

Main and interactive effects of distress tolerance and negative affect intensity in relation to PTSD symptoms among trauma-exposed adults

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Vujanovic, Anka A., Hart, Ashley S., Potter, Carrie M., Berenz, Erin C., Niles, Barbara, Bernstein, Amit·2013·Journal of Psychopathology and Behavioral Assessment

DOI 10.1007/s10862-012-9325-2PMC PMC3889149

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Abstract

The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; Mage=25.3 years, SD=11.4) recruited from the community. Distress tolerance (i.e., perceived ability to withstand distressing emotional states) demonstrated significant incremental associations with global PTSD symptom severity as well as Re-Experiencing, Emotional Numbing, and Hyperarousal symptom cluster severity. Negative affect intensity (i.e., perceived intensity of negative emotional responses) demonstrated significant incremental associations with each of the PTSD symptom outcomes. Moreover, the incremental interactive effect of distress tolerance and negative affect intensity was significantly associated with PTSD symptom severity as well as PTSD-Emotional Numbing symptom cluster severity. These incremental effects were evident after accounting for the variance explained by anxiety sensitivity (i.e., fear of anxiety-related sensations). Post hoc probing analyses supported the moderating role of negative affect intensity in the association between distress tolerance and PTSD symptom severity, such that low levels of distress tolerance, in the context of elevated levels of negative affect intensity, were associated with the greatest levels of PTSD symptoms.

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Lower distress tolerance is associated with higher PTSD symptom severity.
“recent studies have shown that lower distress tolerance is associated with higher PTSD symptom severity (Marshall-Berenz, Vujanovic & Zvolensky, 2011; Vujanovic, Bonn-Miller, Potter, Marshall, & Zvolensky, 2011; Vujanovic, Hart, Potter, Berenz, Niles, & Bernstein, 2013).”
From Does change in distress matter? Mechanisms of change in prolonged exposure for PTSD (2014) · cites this paper as Vujanovic, Hart, Potter, Berenz, Niles, & Bernstein, 2013
The Distress Tolerance Scale (DTS) has been shown to be associated with PTSD.
“The DTS has been shown to be associated with PTSD [60]”
From A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery (2021) · cites this paper as [60]
Inability to tolerate distress may be a maintaining factor in Post-Traumatic Stress Disorder (PTSD).
“Similarly, inability to tolerate distress may be a maintaining factor in Post-Traumatic Stress Disorder (PTSD), as distress intolerance has been found to be associated with global PTSD symptom severity (Vujanovic et al. 2013).”
From Brief psychological intervention for distress tolerance in an adult secondary care community mental health service: an evaluation (2020) · cites this paper as Vujanovic et al. 2013
Distress tolerance scores in the present firefighter sample were significantly higher than those reported for trauma-exposed adults in the community.
“DTS distress tolerance scores in the present sample were significantly higher compared to prior reports of trauma-exposed adults in the community (Vujanovic et al., 2013)”
From Occupational stress and suicidality among firefighters: Examining the buffering role of distress tolerance (2018) · cites this paper as Vujanovic et al., 2013

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Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,769 · see citing works
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences.
Henry, N. W., Cohen, J., & Cohen, P. R. (1977) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2064799 · Cited by 7,231 · see citing works
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences.
Tufte, E. R., Cohen, J., & Cohen, P. (1979) · Journal of the American Statistical Association · doi:10.2307/2286442 · Cited by 5,214 · see citing works
Anxiety, sensitivity, anxiety frequency, and the prediction of fearfulness
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986) · Behaviour Research and Therapy · doi:10.1016/0005-7967(86)90143-9 · Cited by 3,169 · see citing works
The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale
Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997) · Psychological Assessment · doi:10.1037/1040-3590.9.4.445 · Cited by 2,709 · see citing works
Reliability and validity of a brief instrument for assessing post-traumatic stress disorder
Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993) · Journal of Traumatic Stress · doi:10.1002/jts.2490060405 · Cited by 2,537 · see citing works
Post-hoc Probing of Significant Moderational and Mediational Effects in Studies of Pediatric Populations
Holmbeck, G. N. (2002) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/27.1.87 · Cited by 1,819 · see citing works
The Distress Tolerance Scale: Development and Validation of a Self-Report Measure
Simons, J. S., & Gaher, R. M. (2005) · Motivation and Emotion · doi:10.1007/s11031-005-7955-3 · Cited by 1,730 · see citing works
Affect intensity as an individual difference characteristic: A review
Larsen, R. J., & Diener, E. (1987) · Journal of Research in Personality · doi:10.1016/0092-6566(87)90023-7 · Cited by 1,172 · see citing works
Anxiety and It's Disorders
Prakash, R. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n0318d · Cited by 1,031 · see citing works
Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults.
Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010) · Psychological Bulletin · doi:10.1037/a0019712 · Cited by 868 · see citing works
Self-citation
Confirmatory factor analysis of the clinician-administered PTSD Scale: Evidence for the dimensionality of posttraumatic stress disorder.
King, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998) · Psychological Assessment · doi:10.1037/1040-3590.10.2.90 · Cited by 784 · see citing works
The Collaborative Longitudinal Personality Disorders Study: Reliability of Axis I and II Diagnoses
Zanarini, M. C., Skodol, A. E., Bender, D., Dolan, R., Sanislow, C., Schaefer, E., Morey, L. C., Grilo, C. M., Shea, M. T., McGlashan, T. H., et al. (2000) · Journal of Personality Disorders · doi:10.1521/pedi.2000.14.4.291 · Cited by 771 · see citing works
Anxiety sensitivity and panic disorder
McNally, R. J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01475-0 · Cited by 717 · see citing works
Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis.
Olatunji, B. O., & Wolitzky-Taylor, K. B. (2009) · Psychological Bulletin · doi:10.1037/a0017428 · Cited by 609 · see citing works
Methods to Improve Diagnostic Accuracy in a Community Mental Health Setting
Basco, M. R., Bostic, J. Q., Davies, D., Rush, A. J., Witte, B. P., Hendrickse, W. A., & Barnett, V. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.10.1599 · Cited by 388 · see citing works
Distress Tolerance: Theory, Measurement, and Relations to Psychopathology
Zvolensky, M. J., Vujanovic, A. A., Bernstein, A., & Leyro, T. (2010) · Current Directions in Psychological Science · doi:10.1177/0963721410388642 · Cited by 357 · cited 1× · see citing works
“Distress tolerance is generally conceptualized as the perceived or actual capacity to withstand aversive experiential states (Simons and Gaher 2005), such as negative emotion, uncertainty, and physical discomfort (Zvolensky et al. 2010).”
Self-citation
Information processing in anxiety disorders: Application to the understanding of post-traumatic stress disorder
Litz, B. T. (1989) · Clinical Psychology Review · doi:10.1016/0272-7358(89)90030-5 · Cited by 196 · see citing works
COGNITIVE FACTORS IN TRAUMATIC STRESS REACTIONS: PREDICTING PTSD SYMPTOMS FROM ANXIETY SENSITIVITY AND BELIEFS ABOUT HARMFUL EVENTS
Fedroff, I. C., Taylor, S. J., Asmundson, G. J. G., & Koch, W. J. (2000) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465800000023 · Cited by 172 · see citing works
Multimethod study of distress tolerance and PTSD symptom severity in a trauma-exposed community sample
Marshall‐Berenz, E. C., Vujanovic, A. A., Bonn‐Miller, M. O., Bernstein, A., & Zvolensky, M. J. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20568 · Cited by 158 · cited 2× · see citing works
“Indeed, several empirical studies to date have documented significant inverse relations between distress tolerance and PTSD symptoms (Marshall-Berenz et al. 2010; Vujanovic, Bonn-Miller et al. 2011), such that higher levels of tolerance for negative emotional states were related to lower levels of PTSD symptoms (and v…”
Self-citation
Distress Tolerance: Theory, Research, and Clinical Applications
Buckner, J. D. (2011) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2011.600616 · Cited by 148 · see citing works
Posttraumatic stress disorder symptoms and functional impairment among OEF and OIF National Guard and Reserve veterans
Shea, M. T., Vujanovic, A. A., Mansfield, A. K., Sevin, E., & Liu, F. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20497 · Cited by 139 · see citing works
Self-citation
An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample
Vujanovic, A. A., Bonn-Miller, M. O., Potter, C. M., Marshall, E. C., & Zvolensky, M. J. (2011) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-010-9209-2 · Cited by 134 · see citing works
Self-citation
A mediational model relating affect intensity, emotion inhibition, and psychological distress
Lynch, T. R., Robins, C. J., Morse, J. Q., & Krause, E. D. (2001) · Behavior Therapy · doi:10.1016/s0005-7894(01)80034-4 · Cited by 128 · see citing works
Breath-holding endurance as a predictor of success in smoking cessation
Hajek, P., Belcher, M., & Stapleton, J. (1987) · Addictive Behaviors · doi:10.1016/0306-4603(87)90041-4 · Cited by 119 · see citing works
The Role of Negative Affect Intensity and the Fear of Emotions in Posttraumatic Stress Symptom Severity Among Victims of Childhood Interpersonal Violence
Tull, M. T., Jakupcak, M., McFadden, M. E., & Roemer, L. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318093ed5f · Cited by 76 · see citing works
Profiling Posttraumatic Functional Impairment
Norman, S. B., Stein, M. B., & Davidson, J. R. T. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000252135.25114.02 · Cited by 76 · see citing works
Predictors of emotional numbing, revisited: A replication and extension
Flack, W. F., Litz, B. T., Hsieh, F. Y., Kaloupek, D. G., & Keane, T. M. (2000) · Journal of Traumatic Stress · doi:10.1023/a:1007806132319 · Cited by 69 · see citing works
Distress tolerance: Theory, research, and clinical applications.
Zvolensky, M. J., Bernstein, A., & Vujanovic, A. A. (2011) · Cited by 57 · see citing works
Self-citation
Untitled work
(1995) · Cited by 52 · see citing works
Anxiety sensitivity and breath-holding duration in relation to PTSD symptom severity among trauma exposed adults
Berenz, E. C., Vujanovic, A. A., Coffey, S. F., & Zvolensky, M. J. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.10.004 · Cited by 51 · see citing works
Self-citation
Affect intensity and the appraisal of emotion
Flett, G. L., Boase, P. H., McAndrews, M. P., Pliner, P. P., & Blankstein, K. R. (1986) · Journal of Research in Personality · doi:10.1016/0092-6566(86)90125-x · Cited by 37 · see citing works
Main and interactive effects of a nonclinical panic attack history and distress tolerance in relation to PTSD symptom severity
Marshall-Berenz, E. C., Vujanovic, A. A., & Zvolensky, M. J. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.09.001 · Cited by 31 · see citing works
Self-citation
Affect intensity: association with anxious and fearful responding to bodily sensations
Vujanovic, A. A., Zvolensky, M. J., Gibson, L. E., Lynch, T. R., Leen‐Feldner, E. W., Feldner, M. T., & Bernstein, A. (2005) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.12.002 · Cited by 27 · see citing works
Self-citation

Flagged first, then by citations

3 of the 38 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

First M Spitzer R Williams J Gibbon M Structured clinical interview for DSM-IV-Non-patient edition (SCID-NP, version 1.0) 1995 American Psychiatric Press Washington, DC

Sorted by citations

Overrepresentation of unaccompanied refugee minors in inpatient psychiatric care
Ramel, B., Täljemark, J., Lindgren, A., & Johansson, B. A. (2015) · SpringerPlus · doi:10.1186/s40064-015-0902-1 · Cited by 98 · see citing works
The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders
Banducci, A. N., Bujarski, S. J., Bonn‐Miller, M. O., Patel, A. B., & Connolly, K. M. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.03.003 · Cited by 88 · see citing works
A systematic review of randomized trials of mind-body interventions for PTSD
Niles, B. L., Mori, D. L., Polizzi, C., Pless Kaiser, A., Weinstein, E. S., Gershkovich, M., & Wang, C. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22634 · Cited by 72 · see citing works
Self-citation
Does change in distress matter? Mechanisms of change in prolonged exposure for PTSD
Bluett, E. J., Zoellner, L. A., & Feeny, N. C. (2014) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2013.09.003 · Cited by 71 · see citing works
“…role of toleration of distress in exposure therapy for PTSD, recent studies have shown that lower distress tolerance is associated with higher PTSD symptom severity (Marshall-Berenz, Vujanovic, & Zvolensky, 2011; Vujanovic, Bonn-Miller, Potter, Marshall, & Zvolensky, 2011; Vujanovic et al., 2013).”
Result
Posttraumatic Stress and Suicidality Among Firefighters: The Moderating Role of Distress Tolerance
Bartlett, B. A., Jardin, C., Martin, C. E., Tran, J. K., Buser, S. J., Anestis, M. D., & Vujanovic, A. A. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-018-9892-y · Cited by 69 · see citing works
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Stanley, I. H., Boffa, J. W., Smith, L. J., Tran, J. K., Schmidt, N. B., Joiner, T. E., & Vujanovic, A. A. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.05.058 · Cited by 67 · see citing works
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Distress tolerance and posttraumatic stress disorder: a systematic review and meta-analysis
Akbari, M., Hosseini, Z. S., Seydavi, M., Zegel, M., Zvolensky, M. J., & Vujanovic, A. A. (2021) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.1942541 · Cited by 65 · see citing works
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Influence of Multiple Traumatic Event Types on Mental Health Outcomes: Does Count Matter?
Gerber, M. M., Frankfurt, S. B., Contractor, A. A., Oudshoorn, K., Dranger, P., & Brown, L. A. (2018) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-018-9682-6 · Cited by 62 · see citing works
The impact of changes in distress tolerance on PTSD symptom severity post-treatment among veterans in residential trauma treatment
Banducci, A. N., Connolly, K. M., Vujanovic, A. A., Alvarez, J., & Bonn-Miller, M. O. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2017.01.004 · Cited by 52 · see citing works
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Self-citation
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Baker, D. E., Hill, M. A., Chamberlain, K. D., Hurd, L. E., Karlsson, M. E., Zielinski, M. J., Calvert, M. L., & Bridges, A. J. (2020) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2020.1760172 · Cited by 44 · see citing works
Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms
Bardeen, J. R., & Fergus, T. A. (2015) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-015-9522-x · Cited by 43 · see citing works
Tolerating Distress After Trauma: Differential Associations Between Distress Tolerance and Posttraumatic Stress Symptoms
Fetzner, M. G., Peluso, D. L., & Asmundson, G. J. G. (2014) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-014-9413-6 · Cited by 43 · see citing works
Relationship between anxiety sensitivity and post-traumatic stress symptoms in trauma-exposed adults: A meta-analysis
Chiu, H. T. S., Low, D. C. W., Chan, A. H. T., & Meiser‐Stedman, R. (2024) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2024.102857 · Cited by 39 · see citing works
Distress tolerance as a mechanism of PTSD symptom change: Evidence for mediation in a treatment-seeking sample
Boffa, J. W., Short, N. A., Gibby, B. A., Stentz, L. A., & Schmidt, N. B. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.03.085 · Cited by 39 · see citing works
Multimodal examination of distress tolerance and posttraumatic stress disorder symptoms in acute-care psychiatric inpatients
Vujanovic, A. A., Dutcher, C. D., & Berenz, E. C. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.08.005 · Cited by 37 · see citing works
Self-citation
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Insomnia symptoms predict the development of post‐traumatic stress symptoms following an experimental trauma
Short, N. A., Boffa, J. W., Wissemann, K., & Schmidt, N. B. (2019) · Journal of Sleep Research · doi:10.1111/jsr.12909 · Cited by 33 · see citing works
Psychological and behavioral moderators of the relationship between trauma severity and HIV transmission risk behavior among MSM with a history of childhood sexual abuse
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Affective dynamics among veterans: Associations with distress tolerance and posttraumatic stress symptoms.
Simons, J. S., Simons, R. M., Grimm, K. J., Keith, J. A., & Stoltenberg, S. F. (2020) · Emotion · doi:10.1037/emo0000745 · Cited by 31 · see citing works
Examining Transdiagnostic Factors among Firefighters in Relation to Trauma Exposure, Probable PTSD, and Probable Alcohol Use Disorder.
Lebeaut, A., Zegel, M., Leonard, S. J., Bartlett, B. A., & Vujanovic, A. A. (2021) · Journal of Dual Diagnosis · doi:10.1080/15504263.2020.1854411 · Cited by 30 · see citing works
Self-citation
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Hernandez, D. C., Daundasekara, S. S., Zvolensky, M. J., Reitzel, L. R., Maria, D. S., Alexander, A. C., Kendzor, D. E., & Businelle, M. S. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17155301 · Cited by 29 · see citing works
Distress tolerance: Associations with trauma and substance cue reactivity in low-income, inner-city adults with substance use disorders and posttraumatic stress.
Vujanovic, A. A., Wardle, M. C., Bakhshaie, J., Smith, L. J., Green, C. E., Lane, S. D., & Schmitz, J. M. (2018) · Psychology of Addictive Behaviors · doi:10.1037/adb0000362 · Cited by 29 · see citing works
Self-citation
Emotion Dysregulation Prospectively Predicts Posttraumatic Stress Disorder Symptom Severity 3 Months After Trauma Exposure
Forbes, C. N., Tull, M. T., RAPPORT, D. J., Xie, H., Kaminski, B., & Wang, X. (2020) · Journal of Traumatic Stress · doi:10.1002/jts.22551 · Cited by 28 · see citing works
Distraction/Suppression and Distress Endurance diminish the extent to which generalized conditioned fear is associated with maladaptive behavioral avoidance
Hunt, C., Cooper, S. E., Hartnell, M. P., & Lissek, S. M. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.04.013 · Cited by 28 · see citing works
The relationship between distress tolerance regulation, counterfactual rumination, and PTSD symptom clusters
Erwin, M. C., Mitchell, M. A., Contractor, A. A., Dranger, P., Charak, R., & Elhai, J. D. (2018) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2018.01.012 · Cited by 27 · see citing works
Sleep disturbance among firefighters: Understanding associations with alcohol use and distress tolerance
Smith, L. J., Bartlett, B. A., Tran, J. K., Gallagher, M. W., Alfano, C., & Vujanovic, A. A. (2019) · Cognitive Therapy and Research · doi:10.1007/s10608-018-9955-0 · Cited by 25 · see citing works
Self-citation
Posttraumatic Stress and Distress Tolerance
Vujanovic, A. A., Bakhshaie, J., Martin, C. E., Reddy, M. K., & Anestis, M. D. (2017) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000690 · Cited by 25 · see citing works
Self-citation
A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood
Berenz, E. C., Vujanovic, A. A., Rappaport, L. M., Kevorkian, S. S., Gonzalez, R., Chowdhury, N., Dutcher, C. D., Dick, D. M., Kendler, K. S., & Amstadter, A. B. (2017) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2017.1382636 · Cited by 25 · see citing works
Self-citation
The role of distress intolerance for panic and nicotine withdrawal symptoms during a biological challenge
Farris, S. G., Zvolensky, M. J., Otto, M. W., & Leyro, T. M. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115575536 · Cited by 25 · see citing works
Distress tolerance in PTSD
Vujanovic, A. A., & Zegel, M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816022-0.00012-0 · Cited by 25 · see citing works
Self-citation
Trait Mindfulness: A Multifaceted Evaluation.
Polizzi, C., Gautam, A., & Lynn, S. J. (2018) · Imagination Cognition and Personality · doi:10.1177/0276236618774321 · Cited by 23 · see citing works
Main and Interactive Effects of Mental Contamination and Tolerance of Negative Emotions in Relation to Posttraumatic Stress Symptoms Following Sexual Trauma
Fergus, T. A., & Bardeen, J. R. (2015) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-015-9511-0 · Cited by 23 · see citing works
Network analysis of posttraumatic stress disorder in a treatment-seeking sample of US firefighters and emergency medical technicians
Beattie, E. H., Thomas, K. L., Ponder, W. N., Meyer, E. C., Kimbrel, N. A., Cammarata, C. M., Coe, E., Pennington, M. L., Sacco, A., Nee, B., et al. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.08.068 · Cited by 19 · see citing works
Fruit and vegetable consumption and emotional distress tolerance as potential links between food insecurity and poor physical and mental health among homeless adults
Hernandez, D. C., Daundasekara, S. S., Arlinghaus, K. R., Sharma, A. P., Reitzel, L. R., Kendzor, D. E., & Businelle, M. S. (2019) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2019.100824 · Cited by 19 · see citing works
The relationship between peer victimization and social anxiety among adolescents: a moderated mediation model with cognitive flexibility and affect intensity
Liu, X., Qian, W., Liang, P., Xie, T., & Wang, J. (2021) · Psychology Health & Medicine · doi:10.1080/13548506.2021.1971729 · Cited by 18 · see citing works
Distress tolerance: prospective associations with cognitive-behavioral therapy outcomes in adults with posttraumatic stress and substance use disorders
Vujanovic, A. A., Webber, H. E., McGrew, S. J., Green, C. E., Lane, S. D., & Schmitz, J. M. (2022) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.2007995 · Cited by 18 · see citing works
Self-citation
Personality traits and trauma exposure: The relationship between personality traits, PTSD symptoms, stress, and negative affect following exposure to traumatic cues
Weinberg, M., Gil, S., Avi Besser, A., & Bass, J. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110802 · Cited by 17 · see citing works
Distress Tolerance as Risk and Maintenance Factor for PTSD: Empirical and Clinical Implications
Vujanovic, A. A., Litz, B. T., & Farris, S. G. (2015) · Springer eBooks · doi:10.1007/978-3-319-08359-9_66 · Cited by 17 · see citing works
Self-citation
Brief psychological intervention for distress tolerance in an adult secondary care community mental health service: an evaluation
Wright, I., Travers-Hill, E., Gracey, F., Troup, J., Parkin, K., Casey, S., & Kim, Y. (2020) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x20000513 · Cited by 16 · see citing works
Association between spatial working memory and Re-experiencing symptoms in PTSD
Mathew, A. S., Lotfi, S., Bennett, K. P., Larsen, S. E., Dean, C., Larson, C. L., & Lee, H. (2021) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2021.101714 · Cited by 15 · see citing works
Longitudinal Investigation of Bidirectional Relations Between Childhood Trauma and Emotion-Driven Impulsivity in the Adolescent Brain Cognitive Development Study
Weiss, N. H., Goncharenko, S., Forkus, S. R., Ferguson, J. J., & Yang, M. (2023) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2023.05.027 · Cited by 15 · see citing works
Emotional distress and positive and negative memories from military deployment: the influence of PTSD symptoms and time
Niziurski, J. A., Johannessen, K. B., & Berntsen, D. (2017) · Memory · doi:10.1080/09658211.2017.1418380 · Cited by 15 · see citing works
Conceptualization and Measurement of Traumatic Events among Refugees and Other War-Affected Populations
Rasmussen, A., Miller, K. E., & Verkuilen, J. (2018) · Springer eBooks · doi:10.1007/978-3-319-97046-2_16 · Cited by 14 · see citing works
Disentangling Distress Tolerance, Emotion Regulation, and Quality of Life in Childhood Trauma and Adult Anxiety
Rosencrans, P. L., Bui, E., Rogers, A. H., Simon, N. M., & Baker, A. W. (2017) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2017.10.4.283 · Cited by 12 · see citing works
Multimodal Examination of Distress Tolerance and Suicidality in Acute-Care Psychiatric Inpatients
Vujanovic, A. A., Berenz, E. C., & Bakhshaie, J. (2017) · Journal of Experimental Psychopathology · doi:10.5127/jep.059416 · Cited by 12 · see citing works
Self-citation
Efficacy and mechanisms of imagery rescripting and imaginal exposure for nightmares: study protocol for a randomized controlled trial
Kunze, A. E., Lancee, J., Nexhmedin Morina, B., Kindt, M., & Arntz, A. R. (2016) · Trials · doi:10.1186/s13063-016-1570-3 · Cited by 10 · see citing works
The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders.
Caiado, B., Santos, D., Pereira, B., Góis, A. C., Canavarro, M. C., & Moreira, H. (2024) · Children · doi:10.3390/children11010115 · Cited by 8 · see citing works
“Additionally, some studies have highlighted the potential that distress tolerance is a moderating variable in the relationship between negative affect and the development of maladaptive symptoms and behaviors [21–23].”
Background
Distress overtolerance among firefighters: Associations with posttraumatic stress.
Zegel, M., Kabel, K. E., Lebeaut, A., & Vujanovic, A. A. (2022) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0001393 · Cited by 8 · see citing works
Self-citation
Distress tolerance but not impulsivity predicts outcome in concurrent treatment for posttraumatic stress disorder and substance use disorder
Levy, H. C., Wanklyn, S. G., Voluse, A. C., & Connolly, K. M. (2018) · Military Psychology · doi:10.1080/08995605.2018.1478548 · Cited by 7 · see citing works
Fear of pain as a predictor of concurrent and downstream PTSD symptoms
Barbano, A. C., Tull, M. T., Christ, N. M., Xie, H., Kaminski, B., & Wang, X. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102441 · Cited by 7 · see citing works
The Role of Emotion Regulation in the Relationship Between Trauma and Health-Related Outcomes
Hofman, N. L., Simons, R. M., Simons, J. S., & Hahn, A. M. (2019) · Journal of Loss and Trauma · doi:10.1080/15325024.2018.1460528 · Cited by 7 · see citing works
Escala de Tolerancia al Distrés: Propiedades Psicométricas en Estudiantes Universitarios Argentinos
del Valle, M. V., Andrés, M. L., & Urquijo, S. (2020) · Acta de Investigación Psicológica · doi:10.22201/fpsi.20074719e.2020.3.359 · Cited by 6 · see citing works
An initial investigation of the association between distress intolerance and posttraumatic stress within military sexual trauma survivors.
McGrew, S. J., Ennis, C. R., Vujanovic, A. A., Franklin, C. L., & Raines, A. M. (2019) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000516 · Cited by 6 · see citing works
Self-citation
A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery
Lang, A. J., Malaktaris, A., Maluf, K. S., Kangas, J., Sindel, S., Herbert, M., Bomyea, J., Simmons, A. N., Weaver, J., Velez, D., et al. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100719 · Cited by 5 · see citing works
“The DTS has been shown to be associated with PTSD [60], prospectively predict problematic alcohol use [61] and improved by Hatha yoga [23].”
Background
Trauma symptoms and deliberate self-harm among sexual violence survivors: Examining state emotion regulation and reactivity as dual mechanisms.
Brockdorf, A. N., Gratz, K. L., Messman, T. L., & DiLillo, D. (2022) · Psychology of Violence · doi:10.1037/vio0000432 · Cited by 5 · see citing works
A comparison of DSM-5 and ICD-11 models of PTSD: Measurement invariance and psychometric validation in Filipino trauma samples
Garabiles, M. R., Mordeno, I. G., & Nalipay, M. J. N. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.05.006 · Cited by 5 · see citing works
Moderating Effect of Distress Tolerance on the Relationship Between Negative Affect Intensity and Adaptive and Maladaptive Emotion Regulation Strategies
이지영, & 정지현 (2016) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2016.21.4.003 · Cited by 5 · see citing works
Assessment of emotion and emotion-related processes in PTSD
McDevitt‐Murphy, M. E., Zakarian, R. J., & Olin, C. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816022-0.00001-6 · Cited by 3 · see citing works
Association of positive psychobehavioral factors and structural disadvantage with condomless sex in men who have sex men with childhood sexual abuse histories
Fitch, C., Shepard, C., Foley, J. D., Ironson, G. H., Safren, S. A., Carrico, A. W., Rodriguez, A. E., & O’Cleirigh, C. M. (2021) · Journal of Behavioral Medicine · doi:10.1007/s10865-021-00251-9 · Cited by 3 · see citing works
The moderating role of sexual minority status in the associations of the experience and tolerance of shame‐related emotions to suicide risk
Mann, A. J., Kurtz, A., Tull, M. T., & Gratz, K. L. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23367 · Cited by 3 · see citing works
Unique and interactive relations among posttraumatic stress, distress tolerance, and anger responding to traumatic event cues
Morabito, D. M., Babson, K. A., Badour, C. L., & Feldner, M. T. (2019) · Journal of Experimental Psychopathology · doi:10.1177/2043808719831472 · Cited by 3 · see citing works
Role of distress tolerance, meaning in life and social support in the relationship between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among Nigerian cancer patients
Aliche, C. J., & Idemudia, E. S. (2024) · Journal of Psychology in Africa · doi:10.1080/14330237.2024.2371718 · Cited by 2 · see citing works
Compassion Meditation for Veterans with PTSD: Home Practice Matters
Herbert, M. S., Liu, L., Malaktaris, A. L., Kamura, K., Casmar, P. V., & Lang, A. J. (2022) · Mindfulness · doi:10.1007/s12671-022-01959-8 · Cited by 2 · see citing works
Distress tolerance interacts with peritraumatic emotions to predict posttraumatic stress symptoms following sexual victimization.
Hood, C. O., Jones, A. C., Flores, J., Badour, C. L., & Feldner, M. T. (2020) · Traumatology An International Journal · doi:10.1037/trm0000279 · Cited by 2 · see citing works
Distress Tolerance
Rappaport, L. M., Berenz, E. C., Lejuez, C. W., & Roberson‐Nay, R. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108140416.009 · Cited by 2 · see citing works
Self-citation
A Psychometric Investigation of the Distress Tolerance Scale Short Form (DTS-SF): Reliability, Validity, and Factor Structure in a Trauma-Exposed Sample
Byllesby, B. M., Charak, R., Cano-González, I., & Christ, N. M. (2025) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-025-10226-8 · Cited by 2 · see citing works
Two aspects of distress tolerance: The relationship between subjective cognition and behavioral response
정지현, & Kwon, S. (2015) · The Korean Journal of Clinical Psychology · doi:10.15842/kjcp.2015.34.1.011 · Cited by 2 · see citing works
Associations of Interpersonal Trauma, Distress Intolerance, and Posttraumatic Stress Symptoms With Recent Problem Opioid Use in a Non-Clinical Sample of Women
Cole, J., & Logan, T. (2024) · Journal of Drug Issues · doi:10.1177/00220426241252336 · Cited by 1 · see citing works
The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment
Byllesby, B. M., & Palmieri, P. A. (2024) · Journal of Traumatic Stress · doi:10.1002/jts.23092 · Cited by 1 · see citing works
Covert Narcissism and Negative Emotions of Female High School Students: the Mediating Effects of Emotional Distress Tolerance and Self-report of Soothing Receptivity
김혜원, & Lee, J. (2016) · The Korea Journal of Youth Counseling · doi:10.35151/kyci.2016.24.1.009 · Cited by 1 · see citing works
Differences between Positive Affect Intensity and Negative Affect Intensity : Focused on the Personality Traits and Emotion Regulation Strategies
Lee, J., & Kim, E. (2018) · 한국심리학회지: 일반 · doi:10.22257/kjp.2018.09.37.3.411 · Cited by 1 · see citing works
An Examination of the Interpersonal-Psychological Theory of Suicide among Urban Firefighters: Associations with Posttraumatic Stress and Distress Tolerance
Bartlett, B. A. (2021) · Cited by 1 · see citing works
Distress
Vijay, A., Paquette, C., & Douglas, J. (2020) · Springer eBooks · doi:10.1007/978-3-319-24612-3_504 · Cited by 1 · see citing works
LONGITUDINAL INVESTIGATION OF CHILDHOOD TRAUMA AND EMOTIONDRIVEN IMPULSIVITY
Goncharenko, S. (2022) · doi:10.23860/diss-goncharenko-svetlana-2022 · Cited by 1 · see citing works
The Development of Behavioral Measurement Task for Distress Tolerance: Preliminary Study
정지현 (2017) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2017.22.2.004
THE ROLE OF CHILDHOOD TRAUMA IN THE ASSOCIATIONS AMONG POSTTRAUMATIC STRESS DISORDER, EMOTIONAL REACTIVITY, AND EMOTION DYSREGULATION: A MODERATED MEDIATION MODEL
Goncharenko, S. (2019) · doi:10.23860/thesis-goncharenko-svetlana-2019
Acceptance-based behavioral therapy for PTSD
Coe, E., Batten, S. V., & Meyer, E. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816022-0.00019-3
Exposure Therapy: Stimulus Intensity as a Factor in Treatment Preference
Arias, M. C. (2020) · doi:10.33915/etd.7749
Relation of distress tolerance and dental care-related fear and anxiety
Hayes, S. E. (2014) · doi:10.33915/etd.5782
Distress
Louras, P., & Fairchild, J. K. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_420
Distress
Louras, P., & Fairchild, J. K. (2019) · Springer eBooks · doi:10.1007/978-3-319-69892-2_420-1
Distress
Vijay, A., Paquette, C., & Douglas, J. (2017) · Springer eBooks · doi:10.1007/978-3-319-28099-8_504-1
Resilience and distress tolerance among firefighters: Associations with anxiety and depression symptoms
Zegel, M., Lebeaut, A., McGrew, S. J., Anderson-Fletcher, E. A., Zvolensky, M. J., & Vujanovic, A. A. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120696
Self-citation
Main and Interactive effects of self-disgust and affect intensity in predicting the severity of mental contamination, contact contamination, and PTSD symptoms
Tipsword, J. M., Seymour, G. M., & Badour, C. L. (2025) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2025.100624
Dialectics of Humanism: Thematic Readings of the Literature of the Vietnam and Iraq Wars
Alzahrani, S. A. (2020) · Figshare · doi:10.25392/leicester.data.11800215
Structural Equation Modeling of the Mediating Role of Experiential Avoidance and Distress Tolerance in the Relationship Between Health Anxiety and Rumination in Patients With Hypertension
Rafiepoor, A., Moghimi, S., Raveshi, F. K., & Nikoozadeh, E. K. (2025) · Ikhtilāl/hā-yi ̒aṣabī taḥavvulī. · doi:10.61838/kman.jndd.4.1.17
Emotion Regulation is Associated with Symptoms of Racial Trauma Among Minoritized People
Canovas, C. A., & Benuto, L. T. (2026) · Journal of Interpersonal Violence · doi:10.1177/08862605261473542

An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample
Vujanovic, A. A., Bonn-Miller, M. O., Potter, C. M., Marshall, E. C., & Zvolensky, M. J. (2011) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-010-9209-2 · Cited by 134 · see citing works
Self-citation
Tolerating Distress After Trauma: Differential Associations Between Distress Tolerance and Posttraumatic Stress Symptoms
Fetzner, M. G., Peluso, D. L., & Asmundson, G. J. G. (2014) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-014-9413-6 · Cited by 43 · see citing works
Multimethod study of distress tolerance and PTSD symptom severity in a trauma-exposed community sample
Marshall‐Berenz, E. C., Vujanovic, A. A., Bonn‐Miller, M. O., Bernstein, A., & Zvolensky, M. J. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20568 · Cited by 158 · see citing works
Self-citation
The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment
Byllesby, B. M., & Palmieri, P. A. (2024) · Journal of Traumatic Stress · doi:10.1002/jts.23092 · Cited by 1 · see citing works
Distress tolerance and posttraumatic stress disorder: a systematic review and meta-analysis
Akbari, M., Hosseini, Z. S., Seydavi, M., Zegel, M., Zvolensky, M. J., & Vujanovic, A. A. (2021) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.1942541 · Cited by 65 · see citing works
Self-citation

Authors: Vujanovic, A. A., Hart, A. S., Potter, C. M., Berenz, E. C., Niles, B., & Bernstein, A.
Affiliations: The University of Texas Health Science Center at Houston (US)
Brown University (US)
Temple University (US)
Virginia Commonwealth University (US)
Boston University (US)
University of Haifa (IL)
Corresponding author: Vujanovic, Anka A.
ORCID: Vujanovic, Anka A.
Berenz, Erin C.
Niles, Barbara
Bernstein, Amit
Venue: Journal of Psychopathology and Behavioral Assessment
Publisher: Springer Science and Business Media LLC
Published: 2012-10-13
Volume: 35
Issue: 2
Pages: 235-243
ISSN: 0164-0305 (ISSN-L)
0882-2689
1573-3505
DOI: 10.1007/s10862-012-9325-2
PMC: PMC3889149
OpenAlex: W2024606333
Cited by: 88
References: 38
Citations by year: 2026: 1 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 9 · 2020: 15 · 2019: 8 · 2018: 13 · 2017: 10 · 2016: 6 · 2015: 6 · 2014: 2 · 2013: 1
FWCI: 3.24
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Psychopathology and Behavioral Assessment (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: U.S. Department of Veterans Affairs
Psychology Beyond Borders
European Commission
Rothschild Caesarea Foundation
Council for Higher Education
University of Haifa
Yükseköğretim Kurulu
National Institutes of Health (5f31mh073205-02)
National Institute of Mental Health (F31 MH073205, F31MH080453)
National Institute on Drug Abuse (F31DA021006)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
Keywords: distress tolerance, post-traumatic stress disorder, PTSD symptom severity, symptom clusters, re-experiencing, emotional numbing, hyperarousal, anxiety sensitivity, trauma exposure, moderating effect, emotion regulation

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Main and interactive effects of distress tolerance and negative affect intensity in relation to PTSD symptoms among trauma-exposed adults

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