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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 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
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
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“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
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“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
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“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]
Experimental — accuracy not yet measuredIn the citing paper
“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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“For example, among Caucasian adolescents, negative affect and low distress tolerance are associated with increased probability of alcohol use (Daughters et al., 2009).”
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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-citation
Metadata
- 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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