Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity

“…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, &…”

“For example, among Caucasian adolescents, negative affect and low distress tolerance are associated with increased probability of alcohol use (Daughters et al., 2009).”

“…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…”

“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).”

“, 2003) is a widely employed behavioral measure of distress tolerance (Daughters, Lejuez, Kahler, Strong, & Brown, 2005; Daughters et al., 2009; Lejuez et al., 2003).”

“…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…”

“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).”

“…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].”

“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).”

“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.”

“…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…”

“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).”

“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…”

“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).”

“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).”

“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).”

“, disengaging from stressful activities by quitting the task) to provide relief (Daughters et al. 2009).”

“This total anxiety score has demonstrated good internal consistency (α = 0.95) in previous studies of children and adolescents (Daughters et al. 2009).”

“…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).”

“…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).”

“…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.”

“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.”

“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).”

“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).”

“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).”

“…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).”

“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…”

“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).”

“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;…”

“Distress tolerance has been found to correlate negatively with substance use and positively with abstinence duration among individuals using alcohol (Daughters et al., 2009).”

“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…”

“…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).”

“2010), low DT relates to emotional distress in both community (Daughters et al. 2009) and clinical adolescent samples (Nock and Mendes 2008).”

“, 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).”

“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…”

“…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).”

“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).”

“Another report cited low DT was associated with greater alcohol abuse problems and delinquent behavior in Black, but not NHW young adults [25][23].”

“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).”

“, alcohol use, delinquent behaviors) among both western and Chinese adolescents (Chen 2000; Daughters et al. 2009; Galaif et al. 2003; Huang 1997).”

“…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…”

“Moreover, the BIRD demonstrates both concurrent and prospective validity (Danielson et al., 2010; Daughters et al., 2009).”

“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).”

“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.”

“…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…”

“…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).”

“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).”

“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.…”

“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).”

“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…”

“Past research has found age and gender to be significant correlates for both DT and externalizing/internalizing symptoms (Daughters et al., 2009).”

“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.”

“…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).”

“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.”