Distress tolerance and early adolescent externalizing and internalizing symptoms: the moderating role of gender and ethnicity
Open accessAbstract
A large body of research has examined the development of internalizing and externalizing symptoms in childhood and early adolescence. Notably, there is significant concomitant impairment associated with early adolescent symptomatology, as well as association of these symptoms with future development of psychopathology, poor physical health, self-destructive thoughts and behaviors, criminal behavior, and HIV risk behaviors. Drawing on negative reinforcement theory, the current study sought to examine the potential role of distress tolerance, defined as the ability to persist in goal-directed activity while experiencing emotional distress, as a potential mechanism that may underlie both internalizing and externalizing symptoms among 231 Caucasian and African American youth (M age=10.9 years; 45.5% female; 54.5% Caucasian ethnicity). A series of regressions resulted in significant moderated relationships, such that low distress tolerance conferred increased risk for alcohol use among Caucasians, delinquent behavior among African Americans, and internalizing symptoms among females. Clinical implications, including the potential role of negative reinforcement models in early intervention with young adolescents, are discussed.
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Findings suggest that SIDI may be portable and generalizable, and may have utility for various psychological difficulties and maladaptive behaviors thought to stem from distress intolerance.
“findings that SIDI targets distress tolerance directly (and effectively) suggest the potential portability and generalizability of this treatment, highlighting its potential utility for a variety of psychological difficulties and maladaptive behaviors thought to stem from distress intolerance”
From Initial RCT of a distress tolerance treatment for individuals with substance use disorders (2012) · cites this paper as Daughters et al., 2009
The Introduction (§1.2) links low distress tolerance with several psychological difficulties and maladaptive behaviors. The Discussion (§4) suggests that these links could inform targeted treatments for youth. The paper does not study SIDI or establish that it effectively targets distress tolerance, is portable, or is generalizable. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLower distress tolerance levels are associated with more severe internalizing symptoms.
“Lower distress tolerance levels were found to be associated with more severe internalizing symptoms”
From The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders. (2024) · cites this paper as [29]
Results §3.4.3 and the Discussion report that lower distress tolerance was associated with more internalizing symptoms among female youth. The claim omits this gender qualification: the study found no such association among male youth. Page numbers were not supplied in the passages. (LLM, conf=0.90)
Experimental — accuracy not yet measuredLow distress tolerance is associated with higher levels of externalizing problems, such as alcohol use and delinquent behaviors, among nonclinical samples of Western and Chinese adolescents.
“and that is associated with higher levels of externalizing problems (such as alcohol use and delinquent behaviors) among nonclinical samples of both Western and Chinese adolescents”
From The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders. (2024) · cites this paper as [29]
The Results (§3.4.1–3.4.2; page unavailable) associate low distress tolerance with alcohol use among Caucasian adolescents and delinquent behavior among African American adolescents in a community sample. The paper does not study Chinese adolescents, and the associations differ by subgroup rather than applying generally to all adolescents described in the claim. (LLM, conf=0.90)
Experimental — accuracy not yet measuredA variety of psychological difficulties and maladaptive behaviors are thought to stem from distress intolerance.
“a variety of psychological difficulties and maladaptive behaviors thought to stem from distress intolerance (e.g., Bornovalova et al., 2008; Daughters et al., 2008; Daughters et al., 2009).”
From Initial RCT of a distress tolerance treatment for individuals with substance use disorders (2012) · cites this paper as Daughters et al., 2009
Distress tolerance may be exhibited as the ability to pursue goal-directed activity while experiencing emotional distress and to withstand experiential discomfort.
“The toleration of distress may be exhibited as the ability to move in a goal-directed activity while experiencing emotional distress and the ability to withstand experiential discomfort (e.g., Brown, Lejuez, Kahler, Strong, & Zvolensky, 2005; Daughters et al., 2009).”
From Does change in distress matter? Mechanisms of change in prolonged exposure for PTSD (2014) · cites this paper as Daughters et al., 2009
These results are in line with our hypotheses and with those postulated in previous studies.
“Globally, these results are in line with our hypotheses and with those postulated in previous studies (e.g., [25,28,29]).”
From The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders. (2024) · cites this paper as [29]
The Discussion reports findings about distress tolerance and adolescent symptoms, and the Introduction states this paper’s hypotheses. The citing sentence does not identify what “these results” or its own hypotheses are, so our copy cannot establish whether they align with this study. (LLM, conf=0.72)
Experimental — accuracy not yet measuredThe PASAT-C is a widely employed behavioral measure of distress tolerance.
“The PASAT-C (Lejuez et al., 2003) is a widely employed behavioral measure of distress tolerance (Daughters, Lejuez, Kahler, Strong, & Brown, 2005; Daughters et al., 2009; Lejuez et al., 2003).”
From Investigating the association between parental reflective functioning and distress tolerance in motherhood. (2015) · cites this paper as Daughters et al., 2009
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“…2009) and distress tolerance (Ellis, Fischer, & Beevers, 2010; Huang, Szabó, & Han, 2009; Keough, Riccardi, Timpano, Mitchell, & Schmidt, 2010; Daughters et al., 2009) constructs related to both depression and anxiety, drive their associations with suicidality (Zlotnick, Donaldson, Spirito, &…”
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“For example, among Caucasian adolescents, negative affect and low distress tolerance are associated with increased probability of alcohol use (Daughters et al., 2009).”
BackgroundEmotion Dysregulation and Negative Affect
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“…behavior, and, most notably, drug and alcohol use (Anestis et al., 2007; Bornovalova et al., 2008; Buckner et al., 2007; Daughters and Lejuez, 2005; Daughters et al., 2009; Daughters et al., 2008; Ellis et al., 2010; Howell et al., 2010; Keough et al., 2010; Nock and Mendes, 2008; Zvolensky et…”
BackgroundInfluentialSelf-citationShared variance among self-report and behavioral measures of distress intolerance
McHugh, R. K., Daughters, S. B., Lejuez, C. W., Murray, H. W., Hearon, B. A., Gorka, S. M., & Otto, M. W. (2011) · Cognitive Therapy and Research · doi:10.1007/s10608-010-9295-1 · Cited by 206 · see citing works
“As some authors have recently suggested that the dichotomous evaluation is more ecologically valid for the measurement of DI (e.g., Daughters et al. 2009), because it reflects the behavior of negative reinforcement (i.e., persisting or discontinuing).”
Self-citationPiqueras, J. A., Martín-Vivar, M., Sandín, B., Costas, C. S. L., & Pineda, D. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.04.022 · Cited by 194 · see citing works
Clinical experimental stress studies: methods and assessment
Bali, A., & Jaggi, A. S. (2015) · Reviews in the Neurosciences · doi:10.1515/revneuro-2015-0004 · Cited by 175 · see citing works
Rutherford, H. J. V., Goldberg, B., Luyten, P., Bridgett, D. J., & Mayes, L. C. (2013) · Infant Behavior and Development · doi:10.1016/j.infbeh.2013.06.008 · Cited by 167 · see citing works
Rutherford, H. J. V., Booth, C. R., Luyten, P., Bridgett, D. J., & Mayes, L. C. (2015) · Infant Behavior and Development · doi:10.1016/j.infbeh.2015.04.005 · Cited by 149 · see citing works
“, 2003) is a widely employed behavioral measure of distress tolerance (Daughters, Lejuez, Kahler, Strong, & Brown, 2005; Daughters et al., 2009; Lejuez et al., 2003).”
BackgroundVujanovic, 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
“…stress, are significantly related to an increased risk of anxiety symptoms and panic attacks (Boelen and Reijntjes 2009; Bonn-Miller et al. 2009; Daughters et al. 2009; Marshall et al. 2008), fears about the negative consequences of anxiety symptoms (Timpano et al. 2009), and escape behavior in…”
BackgroundSelf-citationBujarski, S. J., Norberg, M. M., & Copeland, J. (2012) · Addictive Behaviors · doi:10.1016/j.addbeh.2012.05.014 · Cited by 130 · see citing works
Altering Impulsive Decision Making With an Acceptance-Based Procedure
Morrison, K. L., Madden, G. J., Odum, A. L., Friedel, J. E., & Twohig, M. P. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.01.001 · Cited by 129 · see citing works
“Consistent with this interpretation, substance use disorders are correlated with steep delay discounting (MacKillop et al., 2011) and low distress tolerance (e.g., Daughters et al., 2009; Zvolensky et al., 2009).”
BackgroundA reverse translational approach to quantify approach-avoidance conflict in humans
Aupperle, R. L., Sullivan, S., Melrose, A. J., Paulus, M. P., & Stein, M. B. (2011) · Behavioural Brain Research · doi:10.1016/j.bbr.2011.08.003 · Cited by 120 · see citing works
“…approach and avoidance drives is thought to be important for successful navigation of our environment, as avoidance protects from primary and secondary threats such as prey, pain, or reprimand, while approach helps obtain primary and secondary rewards such as food, money, or social support [11,12].”
BackgroundAnxiety sensitivity: Prospective prediction of anxiety among early adolescents
Schmidt, N. B., Keough, M. E., Mitchell, M. A., Reynolds, E. K., MacPherson, L., Zvolensky, M. J., & Lejuez, C. W. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.03.007 · Cited by 118 · see citing works
Self-citationGorka, S. M., Ali, B., & Daughters, S. B. (2012) · Psychology of Addictive Behaviors · doi:10.1037/a0026386 · Cited by 112 · see citing works
“Only one study to date has utilized a behavioral measure to examine the relationship between distress tolerance and alcohol use, and reported that low distress tolerance was associated with an increased frequency of alcohol use among Caucasian early adolescents (Daughters et al., 2009).”
InfluentialSelf-citationCummings, J. R., Bornovalova, M. A., Ojanen, T., Hunt, E., MacPherson, L., & Lejuez, C. (2013) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-012-9704-x · Cited by 111 · see citing works
“As an example, Daughters et al. (2009) documented an inverse cross-sectional relationship of distress tolerance with EXT (indexed by a CD- like composite) in adolescents and INT (indexed via MDD and anxiety symptoms) in adolescent females.”
InfluentialInfluencing Self-rated Health Among Adolescent Girls With Dance Intervention
Duberg, A., Hagberg, L., Sunvisson, H., & Möller, M. (2012) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2013.421 · Cited by 83 · see citing works
Positive and Negative Reinforcement Underlying Risk Behavior in Early Adolescents
MacPherson, L., Reynolds, E., Daughters, S., Wang, F. L., Cassidy, J., Mayes, L., & Lejuez, C. (2010) · Prevention Science · doi:10.1007/s11121-010-0172-7 · Cited by 80 · see citing works
“…more recently has begun to shed light on the critical need to understand the role of avoidance of affective distress as well (Cooper et al. 2003; Daughters et al. 2009), this finding highlights the importance of considering the combined vulnerability of positive and negative reinforcement…”
BackgroundSelf-citationDaughters, S. B., Sargeant, M. N., Bornovalova, M. A., Gratz, K. L., & Lejuez, C. W. (2008) · Journal of Personality Disorders · doi:10.1521/pedi.2008.22.5.509 · Cited by 80 · see citing works
Self-citationChanges in distress intolerance and treatment outcome in a partial hospital setting
McHugh, R. K., Kertz, S. J., Weiss, R. B., Baskin-Sommers, A. R., Hearon, B. A., & Björgvinsson, T. (2014) · Behavior Therapy · doi:10.1016/j.beth.2013.11.002 · Cited by 79 · see citing works
“Although much of the research on DI has focused on substance use disorders, recent research has highlighted the relevance of this risk factor in depression and anxiety (e.g., Cummings et al., 2013; Daughters et al., 2009).”
Leban, L. (2021) · Crime & Delinquency · doi:10.1177/0011128721989059 · Cited by 78 · see citing works
“Consistent with documented gender differences in internalizing and externalizing outcomes (e.g., Daughters et al., 2009; Hankin et al., 2007), girls had higher internalizing scores across assessment periods (with the exception of internalizing behavior at age 12, at which boys and girls had the…”
BackgroundResultInfluentialSuicidal Ideation in Anxiety-Disordered Youth: Identifying Predictors of Risk
Rodriguez, K. A. O., & Kendall, P. C. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.843463 · Cited by 75 · see citing works
“Although distress tolerance has not been frequently studied in anxiety-disordered youth, low distress tolerance was related to internalizing symptoms for females in a sample of children recruited from the community (Daughters et al., 2009).”
BackgroundMethodDistress tolerance and pre-smoking treatment attrition: Examination of moderating relationships
MacPherson, L., Stipelman, B. A., Duplinsky, M., Brown, R. A., & Lejuez, C. W. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2008.07.001 · Cited by 73 · see citing works
Self-citationJentsch, J. D., Woods, J. A., Groman, S. M., & Seu, E. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2010.47 · Cited by 73 · see citing works
“The value of behavioral measures of risk taking in human beings has been their potential as prognostic indicators of real-world high-risk behaviors (Lejuez et al, 2002, 2003), though they measure only one dimension of temperament likely relevant to this vulnerability (Daughters et al, 2009).”
BackgroundDoes 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
“The toleration of distress may be exhibited as the ability to move in a goal-directed activity while experiencing emotional distress and the ability to withstand experiential discomfort (e.g., Brown, Lejuez, Kahler, Strong, & Zvolensky, 2005; Daughters et al., 2009).”
BackgroundPosttraumatic stress and marijuana use coping motives: The mediating role of distress tolerance
Potter, C. M., Vujanovic, A. A., Marshall‐Berenz, E. C., Bernstein, A., & Bonn‐Miller, M. O. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.11.007 · Cited by 70 · see citing works
Allan, N. P., Capron, D. W., Lejuez, C. W., Reynolds, E. K., MacPherson, L., & Schmidt, N. B. (2013) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-013-9806-0 · Cited by 68 · see citing works
Self-citationWinward, J. L., Bekman, N. M., Hanson, K. L., Lejuez, C., & Brown, S. A. (2014) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.12415 · Cited by 61 · see citing works
“, disengaging from stressful activities by quitting the task) to provide relief (Daughters et al. 2009).”
BackgroundInfluentialSelf-citationBeck, K., Daughters, S., & Ali, B. (2013) · Accident Analysis and Prevention · doi:10.1016/j.aap.2012.10.012 · Cited by 69 · see citing works
Self-citationKranzler, A., Fehling, K. B., Anestis, M. D., & Selby, E. A. (2016) · Death Studies · doi:10.1080/07481187.2016.1145156 · Cited by 66 · see citing works
Mattingley, S., Youssef, G. J., Manning, V., Graeme, L., & Hall, K. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.126 · Cited by 65 · see citing works
Kahn, R. E., Frick, P. J., Golmaryami, F. N., & Marsee, M. A. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-016-0179-z · Cited by 62 · see citing works
“This total anxiety score has demonstrated good internal consistency (α = 0.95) in previous studies of children and adolescents (Daughters et al. 2009).”
ResultInfluentialGenetic associations with performance on a behavioral measure of distress intolerance
Amstadter, A. B., Daughters, S. B., MacPherson, L., Reynolds, E. K., Danielson, C. K., Wang, F. M., Potenza, M. N., Gelernter, J. E., & Lejuez, C. W. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.09.017 · Cited by 60 · see citing works
“…with externalizing and internalizing features that contribute to the development of future psychopathology such as anxiety and depressive symptoms, delinquent behavior and substance use (Daughters et al., 2009), risk-taking behaviors (MacPherson et al., 2010), and self-harm (Nock and Mendes, 2008).”
BackgroundSelf-citationFelton, J. W., Banducci, A. N., Shadur, J. M., Stadnik, R., MacPherson, L., & Lejuez, C. W. (2017) · Development and Psychopathology · doi:10.1017/s0954579417000335 · Cited by 60 · see citing works
“…BIRD (Lejuez et al., 2006) was developed based upon the adult computerized DT task the Paced Auditory Serial Addition Test—Children (Lejuez et al., 2003) and has previously been used as an indicator of DT among youth (Danielson et al., 2010; Daughters et al., 2009, 2013; MacPherson et al., 2010).”
BackgroundMethodResultInfluentialSelf-citationChuang, C.-W. I., Chan, C., & Leventhal, A. M. (2016) · Journal of Dual Diagnosis · doi:10.1080/15504263.2016.1146557 · Cited by 56 · see citing works
Gajos, J. M., Miller, C. R., Leban, L., & Cropsey, K. L. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.07.047 · Cited by 54 · see citing works
Frustration Tolerance in Youth With ADHD
Seymour, K. E., Macatee, R. J., & Chronis-Tuscano, A. M. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716653216 · Cited by 54 · see citing works
Banducci, A. N., Lejuez, C. W., Dougherty, L. R., & MacPherson, L. (2016) · Prevention Science · doi:10.1007/s11121-016-0691-y · Cited by 52 · see citing works
“…in the development and persistence of anxiety (Barlow 2002), thereby explaining why low DT youth (e.g., Cummings et al. 2013; Danielson et al. 2010; Daughters et al. 2009; 2013) and adults (Banducci et al. 2016; Keough et al. 2010; Telch et al. 2003) experience particularly elevated anxiety.”
BackgroundMethodResultInfluentialSelf-citationGender Specific Effect of Psychological Stress and Cortisol Reactivity on Adolescent Risk Taking
Daughters, S. B., Gorka, S. M., Matusiewicz, A. K., & Anderson, K. E. (2013) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-013-9713-4 · Cited by 51 · see citing works
“Described in greater detail elsewhere (Danielson et al. 2010; Daughters et al. 2009), participants engage in a task with the goal of selecting correct numbered boxes at an increasingly difficult speed in order to free a bird from its cage.”
BackgroundSelf-citationBerenz, 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-citationThe Impact of Adolescent Binge Drinking and Sustained Abstinence on Affective State
Bekman, N. M., Winward, J. L., Lau, L. L., Wagner, C., & Brown, S. A. (2013) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12096 · Cited by 51 · see citing works
Bai, S., & Repetti, R. L. (2017) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-017-0311-8 · Cited by 50 · see citing works
“Individual differences in constructs related to emotion regulation, such as distress tolerance or rumination, may be linked to internalizing problems among girls but not boys (Daughters et al. 2009; Tompkins et al. 2011).”
BackgroundKao, K., Doan, S. N., John, A. M. S., Meyer, J. S., & Tarullo, A. R. (2017) · Stress · doi:10.1080/10253890.2017.1391210 · Cited by 50 · see citing works
“Children also engaged in the Behavior Indicator of Resiliency to Distress (BIRD; Lejuez, Daughters, Danielson, & Ruggiero, 2006) task, a psychological stress task which has demonstrated effectiveness in increasing stress and negative affect (Daughters et al., 2009).”
BackgroundAli, B., Seitz-Brown, C. J., & Daughters, S. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.11.024 · Cited by 50 · see citing works
“The PASAT-C has been shown to reliably increase participant distress levels and has repeatedly been used as a behavioral measure of distress tolerance (Daughters et al., 2005a, 2009, 2008).”
Self-citationInternalizing and externalizing in adolescence: the roles of academic self‐efficacy and gender
Rocchino, G. H., Dever, B. V., Telesford, A. E., & Fletcher, K. (2017) · Psychology in the Schools · doi:10.1002/pits.22045 · Cited by 45 · see citing works
Cherewick, M., Hipp, E., Njau, P. F., & Dahl, R. E. (2023) · Global Public Health · doi:10.1080/17441692.2023.2213300 · Cited by 42 · see citing works
“…more externalising symptoms than girls, gender di ff erences in internalising and externalising symptoms emerge in mid-to late-adolescence (Bongers et al., 2004; Daughters et al., 2009; Hankin et al., 2007; Leadbeater et al., 1999; Rudolph, 2002; Scaramella et al., 1999; Telzer & Fuligni, 2013).”
BackgroundImpact of Growing Up with a Chronically Ill Sibling on Well Siblings' Late Adolescent Functioning
Fleary, S. A., & Heffer, R. W. (2013) · ISRN Family Medicine · doi:10.5402/2013/737356 · Cited by 42 · see citing works
Magidson, J., Listhaus, A., Seitz-Brown, C. J., Anderson, K. E., Lindberg, B., Wilson, A., & Daughters, S. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9488-x · Cited by 44 · see citing works
“Low distress tolerance has been associated with higher rates of alcohol use in early adolescence (Daughters et al. 2009; MacPherson et al. 2010), and among adults, has been associated with problematic substance use (O’Cleirigh et al. 2007; Simons and Gaher 2005), poor substance abuse treatment…”
BackgroundInfluentialSelf-citationTaylor, J. J., Grant, K. E., Zulauf-McCurdy, C. A., Fowler, P. J., Meyerson, D. A., & Irsheid, S. B. (2016) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2016.1152553 · Cited by 42 · see citing works
“Hoeksema, 2002), while boys tend to maintain a more stable rate over time (Cole et al., 2002; Costello et al., 2008; Daughters et al., 2009; Twenge & Nolen-Hoeksema, 2002).”
BackgroundGautam, N., Rahman, M. M., & Khanam, R. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.07.064 · Cited by 42 · see citing works
Stress coping and mental health among adolescents: applying a multi-dimensional stress coping model
Yoo, C. (2019) · Children and Youth Services Review · doi:10.1016/j.childyouth.2019.01.030 · Cited by 41 · see citing works
Yoon, D., Yoon, S., Pei, F., & Ploss, A. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104921 · Cited by 42 · see citing works
Maternal and adolescent distress tolerance: the moderating role of gender
Daughters, S. B., Gorka, S. M., Rutherford, H. J. V., & Mayes, L. C. (2014) · Emotion · doi:10.1037/a0034991 · Cited by 40 · see citing works
Self-citationvan Lier, H. G., Pieterse, M. E., Schraagen, J. M., Postel, M. G., Vollenbroek-Hutten, M. M. R., de Haan, H. A., & Noordzij, M. L. (2017) · Addiction Research & Theory · doi:10.1080/16066359.2017.1309525 · Cited by 39 · see citing works
“Fifteen articles found that negative affect is an important predictor of drinking or relapse (Hussong 2007; Daughters et al. 2009; Spada & Wells 2009; Witkiewitz & Villarroel 2009; Simons et al. 2010; Witkiewitz & Bowen 2010; Cranford et al. 2011; Ostafin & Brooks 2011; Witkiewitz et al. 2011;…”
BackgroundKozak, A. T., Davis, J., Brown, R., & Grabowski, M. (2017) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2016.09.010 · Cited by 37 · see citing works
Problematic drinking and physiological responses among female college students
Wemm, S., Fanean, A. P., Baker, A., Blough, E. R., Mewaldt, S. P., & Bardi, M. (2013) · Alcohol · doi:10.1016/j.alcohol.2012.12.006 · Cited by 37 · see citing works
“Distress tolerance has been found to correlate negatively with substance use and positively with abstinence duration among individuals using alcohol (Daughters et al., 2009).”
BackgroundVeilleux, J. C. (2022) · Clinical Psychological Science · doi:10.1177/21677026221118327 · Cited by 40 · see citing works
Thomas, A. L., & Brausch, A. M. (2020) · Journal of American College Health · doi:10.1080/07448481.2020.1786096 · Cited by 35 · see citing works
“oppositional defiant and conduct problems) than their Black counterparts.(46) Another study found that depression, distress tolerance, and discounting delayed outcomes were predictive of alcohol-related problems for Black American college students but only depression was a significant predictor of alcohol problems for…”
BackgroundDaughters, S., Gorka, S., Magidson, J., MacPherson, L., & Seitz-Brown, C. J. (2013) · Journal des adolescens · doi:10.1016/j.adolescence.2013.08.008 · Cited by 39 · see citing works
“…most commonly applied to understanding substance use behaviors (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004), recent evidence suggests that negative reinforcement may play a critical role in multiple forms of psychopathology (Eissenberg, 2004; Daughters et al., 2009; MacPherson et al., 2010a).”
BackgroundMethodResultInfluentialSelf-citationWalker, K. A., & Jiang, X. (2022) · Journal of Adolescence · doi:10.1002/jad.12006 · Cited by 34 · see citing works
Cohen, J. R., Danielson, C., Adams, Z. W., & Ruggiero, K. (2016) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-016-9545-y · Cited by 33 · see citing works
“2010), low DT relates to emotional distress in both community (Daughters et al. 2009) and clinical adolescent samples (Nock and Mendes 2008).”
BackgroundSelf-citationDistress tolerance and physiological reactivity to stress predict women's problematic alcohol use
Holzhauer, C. G., Wemm, S., & Wulfert, E. (2017) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000116 · Cited by 33 · see citing works
Confirming the Factor Structure and Validity of the Distress Tolerance Scale (DTS) in Youth
Tonarely, N. A., & Ehrenreich-May, J. (2020) · Child Psychiatry & Human Development · doi:10.1007/s10578-019-00935-z · Cited by 33 · see citing works
Ali, B., Ryan, J., Beck, K., & Daughters, S. (2013) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.12198 · Cited by 36 · see citing works
“, 2010), with previous research establishing a relation between low distress tolerance and substance use initiation, frequency, and relapse (Brown et al., 2009; Daughters et al., 2009; Howell et al., 2010; Simons and Gaher, 2005).”
BackgroundSelf-citationClinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents
Danielson, C. K., Cohen, J. R., Adams, Z. W., Youngstrom, E. A., Soltis, K. E., Amstadter, A. B., & Ruggiero, K. J. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-016-0159-3 · Cited by 33 · see citing works
Self-citationCho, J., Bello, M. S., Christie, N. C., Monterosso, J., & Leventhal, A. M. (2021) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.1882552 · Cited by 28 · see citing works
“Additionally, low distress tolerance in adolescence has been reported to increase risk of alcohol use, delinquent behaviors, and internalizing symptoms among youths (Daughters et al., 2009) and was associated with the later belief that smoking cigarettes will be effective in reducing negative affect; a belief that can…”
BackgroundFelton, J. W., Collado, A., Havewala, M., Shadur, J. M., MacPherson, L., & Lejuez, C. W. (2018) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2017.1405354 · Cited by 29 · see citing works
“…symptoms in both adult and adolescent clinical (Anestis, Gratz, Bagge, & Tull, 2012; Ellis, Fischer, & Beevers, 2010; Gorka, Ali, & Daughters, 2012; Nock & Mendes, 2008; Williams, Thompson, & Andrews, 2013) and nonclinical samples (Daughters et al., 2009; Peterson, DavisBecker, & Fischer, 2014).”
BackgroundResultInfluentialSelf-citationDistress Tolerance as a Predictor of Risky and Aggressive Driving
Beck, K. H., Ali, B., & Daughters, S. B. (2013) · Traffic Injury Prevention · doi:10.1080/15389588.2013.829569 · Cited by 29 · see citing works
“These findings are consistent with research that has documented a relationship between distress tolerance and other forms of high-risk behavior such as initiation, frequency, and relapse to substance abuse (e.g., Buckner et al. 2007; Daughters et al. 2009; Gorka et al. 2012; O’Cleirigh et al. 2007).”
ResultSelf-citationMcIntosh, R., Ironson, G., & Krause, N. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110403 · Cited by 28 · see citing works
“Another report cited low DT was associated with greater alcohol abuse problems and delinquent behavior in Black, but not NHW young adults [25][23].”
BackgroundFry, C. M., Telzer, E. H., & Rogers, C. R. (2021) · Journal of Family Psychology · doi:10.1037/fam0000876 · Cited by 28 · see citing works
“T hi s ar tic le is in te nd ed so le ly fo r th e pe rs on al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. problems or interpersonal distress through problematic or antisocial behaviors, including substance use and delinquency (Daughters et al., 2009).”
BackgroundInfluentialDistress tolerance in social versus solitary college student drinkers
Williams, C. L., Vik, P. W., & Wong, M. M.-H. (2015) · Addictive Behaviors · doi:10.1016/j.addbeh.2015.06.025 · Cited by 27 · see citing works
You, J., & Leung, F. (2012) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-011-9256-3 · Cited by 26 · see citing works
“, alcohol use, delinquent behaviors) among both western and Chinese adolescents (Chen 2000; Daughters et al. 2009; Galaif et al. 2003; Huang 1997).”
BackgroundClifford, M. E., Nguyen, A. J., & Bradshaw, C. P. (2020) · Journal of Applied School Psychology · doi:10.1080/15377903.2020.1714859 · Cited by 26 · see citing works
“…gender norms contribute to greater acceptability of problem behaviors among boys and internalizing symptoms such as fear and sadness among girls (Daughters et al., 2009; Lee & Bukowski, 2012), yet evidence suggests that these gender-based differences in manifestation are representative of the…”
BackgroundFelton, J. W., Schwartz, K. T. G., Oddo, L. E., Lejuez, C. W., & Chronis-Tuscano, A. M. (2021) · Depression and Anxiety · doi:10.1002/da.23225 · Cited by 25 · see citing works
“Moreover, the BIRD demonstrates both concurrent and prospective validity (Danielson et al., 2010; Daughters et al., 2009).”
BackgroundSelf-citationLeban, L., & Delacruz, D. J. (2023) · Journal of Interpersonal Violence · doi:10.1177/08862605231162664 · Cited by 25 · see citing works
“This is an important inquiry given that the broader literature on stress and trauma has long demonstrated that boys and girls tend to cope with and respond differently to traumatic experiences (Daughters et al., 2009; Rudolph, 2002).”
BackgroundResultRegulación emocional y habilidades académicas: relación en niños de 9 a 11 años de edad
Andrés, M. L., Stelzer, F., Vernucci, S., Juric, L. C., Galli, J. I., & Guzmán, J. I. N. (2017) · Suma Psicológica · doi:10.1016/j.sumpsi.2017.07.001 · Cited by 25 · see citing works
Vujanovic, A. A., & Zegel, M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816022-0.00012-0 · Cited by 25 · see citing works
Duranceau, S., Fetzner, M. G., & Carleton, R. N. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9591-7 · Cited by 24 · see citing works
“A relationship was established previously between hyperarousal and re-experiencing PTSD symptoms and alcohol use (Dixon et al. 2009; McFall et al. 1992); however, in the current study, only hyperarousal PTSD symptoms exerted an effect on the relationship between distress tolerance and alcohol use.”
BackgroundLabella, M. H., Klein, N. D., Yeboah, G., Bailey, C., Doane, A. N., Kaminer, D., Bravo, A. J., & Cross‐Cultural Addictions Study Team (2023) · Aggressive Behavior · doi:10.1002/ab.22111 · Cited by 32 · see citing works
“…States, race/ethnicity has been shown to moderate associations between distress tolerance and psychiatric symptoms in early and late adolescence (Daughters et al., 2009, 2013), and a recent systematic review highlighted stronger links between distress tolerance and smoking dependence in Iranian…”
Lahav‐Kadmiel, Z., & Klomek, A. B. (2018) · Journal of Adolescence · doi:10.1016/j.adolescence.2018.07.014 · Cited by 22 · see citing works
Underwood, J. J., Barry, C. T., & Charles, N. E. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110901 · Cited by 21 · see citing works
“…have been linked to higher rates of borderline personality disorder, depression, and anxiety sensitivity, as well as increased substance use and higher rates of antisocial personality disorder (Anestis, Selby, Fink, & Joiner, 2007; Buckner, Keough, & Schmidt, 2007; Daughters et al., 2009).”
BackgroundBrandt, C. P., Johnson, K. A., Schmidt, N. B., & Zvolensky, M. J. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.10.007 · Cited by 21 · see citing works
Self-citationManczak, E. M., Donenberg, G. R., & Emerson, E. M. (2018) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2018.1443458 · Cited by 20 · see citing works
“symptoms, African American adolescents consume alcohol at lower rates than their White peers but are rated as having more aggression-related problems and higher delinquency (Cameron & Guterman, 2007; Daughters et al., 2009; Eaton et al., 2012).”
BackgroundInfluentialNeuroticism as an underlying construct in youth emotional disorders
Tonarely, N. A., Sherman, J. A., Grossman, R. A., Shaw, A. M., & Ehrenreich, J. T. (2020) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2020.84.3.214 · Cited by 19 · see citing works
Ehrlich, K. B., Cassidy, J. A., Gorka, S. M., Lejuez, C. W., & Daughters, S. B. (2013) · Emotion · doi:10.1037/a0032587 · Cited by 18 · see citing works
“The second distress tolerance task, the computerized Paced Auditory Serial Addition Task (PASAT-C; Diehr, Heaton, Miller, & Grant, 1998; Lejuez, Kahler, & Brown, 2003), measures persistence on a challenging number-addition task that has reliably been shown to increase distress levels (Daughters, Lejuez, Kahler, et al.…”
Self-citationPedrelli, P., MacPherson, L., Khan, A. J., Shapero, B. G., Fisher, L. B., Nyer, M., Cassano, P., Parnarouskis, L., Farabaugh, A. H., D, M. F. M., et al. (2018) · Alcohol and Alcoholism · doi:10.1093/alcalc/agy045 · Cited by 20 · see citing works
“Another study found an association between low behavioral DT and greater risk of having consumed alcohol more than once in the past year among Caucasian, but not African-American, adolescents (Daughters et al., 2009).”
BackgroundSelf-citationGu, M. (2022) · Journal of Adolescence · doi:10.1002/jad.12032 · Cited by 17 · see citing works
Lee, Y., Harris, M. N., & Kim, J. (2022) · Crime & Delinquency · doi:10.1177/00111287221081025 · Cited by 17 · see citing works
“Additionally, because girls tend to rely on internalization strategies to cope with stress (Daughters et al., 2009; Hankin et al., 2007), higher levels of resilience can make a substantial difference among girls by reducing the stress of exposure to cyberbullying and expediting recovery from…”
BackgroundLongitudinal Association of Sleep Problems and Distress Tolerance During Adolescence
Kechter, A., & Leventhal, A. M. (2018) · Behavioral Medicine · doi:10.1080/08964289.2018.1514362 · Cited by 17 · see citing works
Heleniak, C., Bolden, C. R., McCabe, C. J., Lambert, H. K., Rosen, M. L., King, K. M., Monahan, K. C., & McLaughlin, K. A. (2021) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-021-00805-0 · Cited by 16 · see citing works
More of a Good Thing Is Not Always Better: Validation of a Distress Overtolerance Measure
Gorey, C. M., Rojas, E. C., & Bornovalova, M. A. (2016) · Assessment · doi:10.1177/1073191116654218 · Cited by 16 · see citing works
“Past research has found age and gender to be significant correlates for both DT and externalizing/internalizing symptoms (Daughters et al., 2009).”
BackgroundDoan, S. N., Son, H., & Kim, L. N. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.06.008 · Cited by 16 · 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:10.1007/978-3-319-08613-2_66-1 · Cited by 15 · see citing works
Working on the Inside: Mindfulness for Adolescents
Broderick, P. C., & Metz, S. M. (2016) · Mindfulness in behavioral health · doi:10.1007/978-1-4939-3506-2_22 · Cited by 14 · see citing works
Moschak, T. M., Terry, D., Daughters, S. B., & Carelli, R. (2017) · Addiction Biology · doi:10.1111/adb.12488 · Cited by 15 · see citing works
“For example, although studies on drug naïve adolescents provide evidence suggesting a link between low DT and risk behavior, including alcohol use (Daughters et al. 2009; Cummings et al. 2013), it is unknown whether drug naïve DT influences subsequent substance use or, conversely, if substance use lowers DT.”
Self-citationBanks, D. E., Winningham, R. D., Wu, W., & Zapolski, T. C. B. (2019) · American Journal of Orthopsychiatry · doi:10.1037/ort0000390 · Cited by 15 · see citing works
“…traditional individual and environmental factors posited as important risk factors for engagement in substance use, such as distress tolerance and alcohol exposure, have been inadequate at explaining variance in risk for minority youth (Daughters et al., 2009; Rinehart, Bridges, & Sigelman, 2006).”
BackgroundShaw, A. M., Halliday, E. R., Tonarely, N. A., & Ehrenreich-May, J. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.048 · Cited by 14 · see citing works
Naya, C. H., Yi, L., Chu, D., Dunton, G. F., & Mason, T. B. (2021) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.15809 · Cited by 14 · see citing works
Zapolski, T. C. B., Rowe, A. T., Banks, D. E., & Faidley, M. T. (2018) · Substance Use & Misuse · doi:10.1080/10826084.2018.1512625 · Cited by 16 · see citing works
“Daughters et al. (2009) conducted a study examining racial differences in the relationship between distress tolerance and substance use, finding that high distress intolerance was significantly associated with greater odds of past year alcohol use for White youth.”
Background
- Authors
- Daughters, S. B., Reynolds, E. K., MacPherson, L., Kahler, C. W., Danielson, C. K., Zvolensky, M., & Lejuez, C. W.
- Affiliations
- University of Maryland, College Park (US)
- Brown University (US)
- Medical University of South Carolina (US)
- University of Vermont (US)
- Corresponding author
- Daughters, Stacey B.
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 47
- Issue
- 3
- Pages
- 198-205
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC2653593
- OpenAlex
- W2029992258
- Cited by
- 203
- References
- 74
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 10 · 2023: 9 · 2022: 15 · 2021: 15 · 2020: 13 · 2019: 6 · 2018: 14 · 2017: 14 · 2016: 19 · 2015: 10 · 2014: 9 · 2013: 20 · 2012: 8
- FWCI
- 7.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA18647, R01DA018647, R21DA022741)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- distress tolerance, early adolescence, externalizing problems, internalizing problems, gender differences, ethnicity, African American youth, alcohol consumption, delinquency, moderating effect
- MeSH terms
- Adaptation, Psychological, Adolescent, Adolescent Behavior, Alcohol Drinking, Black or African American, Child, Cross-Sectional Studies, Female, Humans, Internal-External Control, Juvenile Delinquency, Male, Socioeconomic Factors, Stress, Psychological
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