Low distress tolerance as an indirect risk factor for suicidal behavior: Considering the explanatory role of non-suicidal self-injury
Abstract
Although some theorists conceptualize the relationship between emotion dysregulation and suicidal behavior as direct, recent research suggests that this relationship may be indirect and mediated by repeated experiences with certain behaviors (e.g., non-suicidal self-injury; NSSI) common among individuals with heightened emotion dysregulation. To date, however, this research has been limited in both scope (e.g., examining few components of emotion dysregulation) and generalizability (e.g., over-emphasis on undergraduate samples). This study sought to extend the research in this area by examining the mediating role of NSSI in the association between one relevant aspect of emotion dysregulation (i.e., low distress tolerance [DT]) and suicidal behavior with a clear intent to die among an at-risk sample of substance use disorder (SUD) patients in residential treatment. SUD patients (N=93) completed a structured interview assessing past suicidal behavior and questionnaires assessing DT and NSSI. Consistent with hypotheses, results revealed a significant indirect association between low DT and lifetime suicide attempts through NSSI frequency. These results suggest that exposure to painful and provocative events through experience with NSSI may be one pathway through which certain facets of emotion dysregulation increase the risk for suicidal behaviors (consistent with theories that individuals low in DT may be unable and/or unwilling to engage in suicidal behavior unless they have experienced sufficient levels of painful and/or provocative events capable of changing their relationship with and experience of pain and fear of death).
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Emotionally dysregulated individuals may exhibit impulsive and dysregulated behaviors that increase their capability for suicide and increase their likelihood of attempting suicide in the presence of ideation.
“emotionally dysregulated individuals may also exhibit impulsive and dysregulated behaviors that increase their capability for suicide and increase their likelihood of attempting suicide in the presence of ideation [10,11].”
From The Role of Emotion Dysregulation in Understanding Suicide Risk: A Systematic Review of the Literature (2024) · cites this paper as [10]
Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
(1998) · Cited by 36,049 · see citing works
Preacher, K. J., & Hayes, A. F. (2008) · Behavior Research Methods · doi:10.3758/brm.40.3.879 · Cited by 34,117 · see citing works
Gratz, K. L., & Roemer, L. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000007455.08539.94 · Cited by 8,942 · cited 1× · see citing works
“, Gratz and Roemer [4]).”
Self-citation(1993) · Cited by 7,136 · see citing works
(1995) · Cited by 6,909 · see citing works
Cognitive-Behavioral Treatment of Borderline Personality Disorder
Cary, G. L. (1994) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1994.48.1.155 · Cited by 6,300 · see citing works
The interpersonal theory of suicide.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010) · Psychological Review · doi:10.1037/a0018697 · Cited by 5,292 · cited 1× · see citing works
“, negative urgency and low distress tolerance) with two facets of the Interpersonal Psychological Theory of Suicidal Behavior (IPTS; [9]): suicidal desire (comprised of thwarted belongingness and perceived burdensomeness) and the acquired capacity for suicide (comprised of heightened pain tolerance and a diminished fe…”
BackgroundWhiteside, S. P., & Lynam, D. R. (2001) · Personality and Individual Differences · doi:10.1016/s0191-8869(00)00064-7 · Cited by 4,123 · see citing works
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1152 · Cited by 3,595 · see citing works
Joiner, T. E. (2007) · Harvard University Press eBooks · doi:10.2307/j.ctvjghv2f · Cited by 2,891 · 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
Solving the puzzle of deliberate self-harm: The experiential avoidance model
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.03.005 · Cited by 1,475 · see citing works
Self-citationMeasurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory
Gratz, K. L. (2001) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1012779403943 · Cited by 1,166 · cited 2× · see citing works
“Deliberate Self-Harm Inventory (DSHI) [32].”
BackgroundSelf-citationVan Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.1.72 · Cited by 1,126 · see citing works
The borderline diagnosis I: psychopathology, comorbidity, and personaltity structure
Skodol, A. E., Gunderson, J. G., Pfohl, B., Widiger, T. A., Livesley, W. J., & Siever, L. J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01324-0 · Cited by 769 · cited 1× · see citing works
“[18–20], Frances et al.”
Contextual Features and Behavioral Functions of Self-Mutilation Among Adolescents.
Nock, M. K., & Prinstein, M. J. (2005) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.114.1.140 · Cited by 724 · see citing works
Nock, M. K., & Mendes, W. B. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.1.28 · Cited by 572 · see citing works
Risk Factors for and Functions of Deliberate Self-Harm: An Empirical and Conceptual Review
Gratz, K. L. (2003) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.bpg022 · Cited by 541 · see citing works
Self-citationLinehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., & Wagner, A. (2006) · Psychological Assessment · doi:10.1037/1040-3590.18.3.303 · Cited by 486 · see citing works
The multifaceted role of distress tolerance in dysregulated eating behaviors
Anestis, M. D., Selby, E. A., Fink, E. L., & Joiner, T. E. (2007) · International Journal of Eating Disorders · doi:10.1002/eat.20471 · Cited by 278 · see citing works
Self-citationAnestis, M. D., Bagge, C. L., Tull, M. T., & Joiner, T. E. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.10.013 · Cited by 271 · see citing works
Self-citationThe role of urgency in maladaptive behaviors
Anestis, M. D., Selby, E. A., & Joiner, T. E. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.08.012 · Cited by 232 · see citing works
Self-citationDialectical behavior therapy (DBT) applied to college students: A randomized clinical trial.
Pistorello, J., Fruzzetti, A. E., MacLane, C., Gallop, R., & Iverson, K. M. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029096 · Cited by 227 · see citing works
Affect Regulation and Suicide Attempts in Adolescent Inpatients
Zlotnick, C., Donaldson, D. L., Spirito, A., & Pearlstein, T. B. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199706000-00016 · Cited by 213 · see citing works
Fliege, H., Kocalevent, R.-D., Walter, O., Beck, S., Gratz, K. L., Gutierrez, P. M., & Klapp, B. F. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2005.10.006 · Cited by 205 · see citing works
Self-citationGratz, K. L., & Tull, M. T. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-009-9268-4 · Cited by 197 · see citing works
Self-citationRisk Factors for and Functions of Deliberate Self-Harm: An Empirical and Conceptual Review
Gratz, K. L. (2003) · Clinical Psychology Science and Practice · doi:10.1093/clipsy/bpg022 · Cited by 164 · see citing works
Self-citationHowell, A. N., Leyro, T. M., Hogan, J., Buckner, J. D., & Zvolensky, M. J. (2010) · Addictive Behaviors · doi:10.1016/j.addbeh.2010.07.003 · Cited by 163 · see citing works
Zvolensky, M. J., Marshall, E. C., Johnson, K., Hogan, J., Bernstein, A., & Bonn‐Miller, M. O. (2009) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0014961 · Cited by 156 · see citing works
Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Nick, B., Delany-Brumsey, A., Lynch, T. R., Kosson, D., & Lejuez, C. W. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.07.014 · Cited by 152 · see citing works
Self-citationFRANCES, A. J., Fyer, M. R., & Clarkin, J. F. (1986) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1986.tb27907.x · Cited by 145 · see citing works
Tamás, Z., Kovács, M., Gentzler, A. L., Tepper, P. G., Gádoros, J., Kiss, E., Kapornai, K., & Vetró, Á. (2007) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-007-9119-2 · Cited by 127 · see citing works
Joiner, T. E. (2011) · Harvard University Press eBooks · doi:10.2307/j.ctv1p6hp7n · Cited by 122 · see citing works
E.Briggs, N. (2006) · OhioLink ETD Center (Ohio Library and Information Network) · Cited by 102 · see citing works
Gratz, K. L., Hepworth, C., Tull, M. T., Paulson, A., Clarke, S., Remington, B., & Lejuez, C. W. (2010) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2010.04.009 · Cited by 101 · see citing works
Self-citationThe Pernicious Blend of Rumination and Fearlessness in Non-Suicidal Self-Injury
Selby, E. A., Connell, L. D., & Joiner, T. E. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-009-9260-z · Cited by 88 · see citing works
Anestis, M. D., Tull, M. T., Bagge, C. L., & Gratz, K. L. (2012) · Archives of Suicide Research · doi:10.1080/13811118.2012.695269 · Cited by 76 · see citing works
Self-citationBehaviorally-indexed distress tolerance and suicidality
Anestis, M. D., & Joiner, T. E. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.02.015 · Cited by 60 · see citing works
Self-citationAnestis, M. D., Gratz, K. L., Bagge, C. L., & Tull, M. T. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2012.04.004 · Cited by 55 · see citing works
Self-citationBornovalova, M. A., Tull, M. T., Gratz, K. L., Levy, R., & Lejuez, C. W. (2011) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0021579 · Cited by 51 · see citing works
Self-citationRe‐considering the association between negative urgency and suicidality
Anestis, M. D., Fink, E. L., Bender, T. W., Selby, E. A., Smith, A. R., Witte, T. K., & Joiner, T. E. (2011) · Personality and Mental Health · doi:10.1002/pmh.178 · Cited by 30 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Psychological pain, depression, and suicide: Recent evidences and future directions
Conejero, I., Olié, E., Calati, R., Ducasse, D., & Courtet, P. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0893-z · Cited by 206 · see citing works
Ford, J. D., & Gómez, J. M. (2015) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2015.989563 · Cited by 199 · see citing works
The role of emotion dysregulation in suicide as considered through the ideation to action framework
Law, K. C., Khazem, L. R., & Anestis, M. D. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.01.014 · Cited by 151 · see citing works
Self-citationKuehn, K. S., Dora, J., Harned, M. S., Foster, K. T., Song, F., Smith, M. R., & King, K. M. (2022) · Nature Human Behaviour · doi:10.1038/s41562-022-01340-8 · Cited by 90 · see citing works
Nonsuicidal self-injury disorder: The path to diagnostic validity and final obstacles
Selby, E. A., Kranzler, A., Fehling, K. B., & Panza, E. A. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.03.003 · Cited by 89 · see citing works
Rogers, M. L., & Joiner, T. E. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.12.017 · Cited by 86 · see citing works
Brausch, A. M., & Woods, S. E. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12478 · Cited by 87 · see citing works
Brausch, A. M., Clapham, R. B., & Littlefield, A. K. (2021) · Journal of Youth and Adolescence · doi:10.1007/s10964-021-01525-w · Cited by 85 · see citing works
Angelakis, I., & Gooding, P. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12784 · Cited by 79 · see citing works
Millner, A. J., den Ouden, H. E. M., Gershman, S. J., Glenn, C. R., Kearns, J. C., Bornstein, A. M., Marx, B. P., Keane, T. M., & Nock, M. K. (2018) · Journal of Abnormal Psychology · doi:10.1037/abn0000395 · Cited by 75 · see citing works
Heffer, T., & Willoughby, T. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.11.075 · Cited by 74 · see citing works
Kira, I. A., Lewandowski, L., Chiodo, L. M., & Ibrahim, A. (2014) · Psychology · doi:10.4236/psych.2014.55050 · Cited by 71 · see citing works
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
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
Self-citationAnestis, M. D., Kleiman, E. M., Lavender, J. M., Tull, M. T., & Gratz, K. L. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.07.007 · Cited by 64 · see citing works
Self-citationKang, N., Jiang, Y., Ren, Y., Gong, T., Liu, X., Leung, F. Y. K., & You, J. (2018) · Journal of Youth and Adolescence · doi:10.1007/s10964-018-0877-7 · Cited by 63 · see citing works
Distress tolerance and symptoms of depression: A review and integration of literatures
Lass, A. N. S., & Winer, E. S. (2020) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12336 · Cited by 62 · see citing works
Lin, M.-P., You, J.-N., Wu, Y.-W., & Jiang, Y.-Q. (2018) · Suicide and Life-Threatening Behaviour · doi:10.1111/sltb.12382 · Cited by 49 · see citing works
Interactive role of depression, distress tolerance and negative urgency on non‐suicidal self‐injury
Peterson, C. M., Becker, K. R., & Fischer, S. F. (2014) · Personality and Mental Health · doi:10.1002/pmh.1256 · Cited by 47 · see citing works
Riding the emotional roller coaster: The role of distress tolerance in non-suicidal self-injury
Slabbert, A., Hasking, P. A., & Boyes, M. E. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.061 · Cited by 45 · see citing works
What are measures of distress tolerance really capturing? A mixed methods analysis.
Ameral, V., Palm Reed, K. M., Cameron, A., & Armstrong, J. L. (2014) · Psychology of Consciousness: Theory, Research, and Practice · doi:10.1037/cns0000024 · Cited by 45 · see citing works
Khazem, L. R., & Anestis, M. D. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.08.038 · Cited by 44 · see citing works
Self-citationRogante, E., Cifrodelli, M., Sarubbi, S., Costanza, A., Erbuto, D., Berardelli, I., & Pompili, M. (2024) · Healthcare · doi:10.3390/healthcare12020169 · Cited by 39 · see citing works
“Moreover, emotionally dysregulated individuals may also exhibit impulsive and dysregulated behaviors that increase their capability for suicide and increase their likelihood of attempting suicide in the presence of ideation [10,11].”
BackgroundAmmerman, B. A., Olino, T. M., Coccaro, E. F., & McCloskey, M. S. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_278 · Cited by 39 · see citing works
The Relationship Between Nonsuicidal Self‐Injury and Suicidal Ideation
Wester, K. L., Ivers, N., Villalba, J. A., Trepal, H. C., & Henson, R. (2016) · Journal of Counseling & Development · doi:10.1002/jcad.12057 · Cited by 36 · see citing works
Nonsuicidal self‐injury and rumination: A meta‐analysis
Nagy, L. M., Shanahan, M. L., & Seaford, S. P. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23394 · Cited by 36 · see citing works
Distress intolerance in substance dependent patients
Özdel, K., & Ekinci, S. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.12.012 · Cited by 34 · see citing works
Joo, Y. Y., Moon, S., Wang, H., Kim, H., Lee, E., Kim, J. H., Posner, J. E., Ahn, W., Choi, I., Kim, J.-W., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.48585 · Cited by 35 · see citing works
Eaddy, M., Zullo, L., Horton, S. E., Hughes, J. L., Kennard, B., Diederich, A., Emslie, G. J., Schuster, L., & Stewart, S. M. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12472 · Cited by 32 · see citing works
Nagy, L. M., Shanahan, M. L., & Baer, R. A. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103819 · Cited by 35 · see citing works
Rogers, M. L., Hom, M. A., Dougherty, S. P., Gallyer, A. J., & Joiner, T. E. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2018.1522283 · Cited by 31 · see citing works
Non-suicidal self-injury and bulimia: the role of emotion dysregulation and body dissatisfaction
Hovrud, L., Simons, R. M., Simons, J. S., & Korkow, J. (2019) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-019-00741-5 · Cited by 31 · see citing works
Hashoul-Andary, R., Nitzan-Assayag, Y., Yuval, K., Aderka, I. M., Litz, B. T., & Bernstein, A. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9730-4 · Cited by 30 · see citing works
Rugo, K. F., Tabares, J. V., Crowell, S. E., Baucom, B. R. W., Rudd, M., & Bryan, C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.095 · Cited by 20 · see citing works
Emotion regulation deficits across the spectrum of self-harm
Clapham, R., & Brausch, A. (2022) · Death Studies · doi:10.1080/07481187.2021.1972366 · Cited by 26 · see citing works
Perceived emotion regulation and emotional distress tolerance in patients with hoarding disorder
Worden, B. L., Levy, H. C., Das, A., Katz, B. W., Stevens, M. C. G., & Tolin, D. F. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100441 · Cited by 27 · see citing works
Lass, A. N. S., Winer, E. S., Collins, A. C., & Rokke, P. D. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10131-2 · Cited by 26 · 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
Tuna, E., & Gençöz, T. (2020) · Current Psychology · doi:10.1007/s12144-020-00634-2 · Cited by 23 · see citing works
Speed, K. J., Drapeau, C. W., & Nadorff, M. R. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7116 · Cited by 22 · see citing works
Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature
Stanley, E. A., & Larsen, K. L. (2018) · Political Psychology · doi:10.1111/pops.12493 · Cited by 24 · see citing works
Skinner, K. D., Rojas, S. M., & Veilleux, J. C. (2016) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12249 · Cited by 22 · see citing works
A suicidal mind tends to maintain less negative information in visual working memory
Xie, W., Li, H., Zou, Y.-M., Sun, X., & Shi, C. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.043 · Cited by 22 · see citing works
Martin, R. L., Bauer, B. W., Ramsey, K. L., Green, B. A., Capron, D. W., & Anestis, M. D. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12523 · Cited by 22 · see citing works
Self-citationPsychopathy and suicide: The mediating effects of emotional and behavioral dysregulation
Fadoir, N. A., Lutz-Zois, C. J., & Goodnight, J. A. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.01.021 · Cited by 21 · see citing works
Akbari, M., Seydavi, M., Firoozabadi, M. A., & Babaeifard, M. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2957 · Cited by 21 · see citing works
Prediction and network modelling of self-harm through daily self-report and history of self-injury
Kyron, M. J., Hooke, G. R., & Page, A. C. (2020) · Psychological Medicine · doi:10.1017/s0033291720000744 · Cited by 20 · see citing works
Practical capability: The impact of handgun ownership among suicide attempt survivors
Houtsma, C., & Anestis, M. D. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.064 · Cited by 20 · see citing works
Self-citationBaer, M. M., LaCroix, J. M., Browne, J. C., Hassen, H. O., Perera, K. U., Soumoff, A., Weaver, J., & Ghahramanlou-Holloway, M. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.082 · Cited by 18 · see citing works
Doorley, J. D., Kashdan, T. B., Alexander, L. A., Blalock, D. V., & McKnight, P. E. (2019) · Motivation and Emotion · doi:10.1007/s11031-019-09751-3 · Cited by 17 · see citing works
Coping with Suicidal Urges: An Important Factor for Suicide Risk Assessment and Intervention
Interian, A., Chesin, M. S., Kline, A., Hill, L. S., King, A. R., Miller, R. B., Latorre, M., Gara, M. A., & Stanley, B. (2019) · Archives of Suicide Research · doi:10.1080/13811118.2019.1678538 · Cited by 17 · see citing works
Raines, J. C., & Ochocki, S. (2019) · doi:10.1093/oso/9780190886578.003.0014 · Cited by 15 · see citing works
Zhong, J., Huang, X., Wang, X.-M., & Xu, M.-Z. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04600-7 · Cited by 13 · see citing works
Reductions in Distress Intolerance via Intervention: A Review
Heiland, A. M., & Veilleux, J. C. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10425-1 · Cited by 14 · see citing works
Zobel, S. B., Bruno, S., Torru, P., Rogier, G., & Velotti, P. (2023) · Psychiatry Investigation · doi:10.30773/pi.2022.0338 · Cited by 13 · see citing works
Hsu, T., Thomas, E. B. K., Welch, E., O’Hara, M. W., & McCabe, J. E. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.02.001 · Cited by 15 · see citing works
Lewin, C. D. C., Leamy, M. C., & Palmer, L. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23588 · Cited by 13 · 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
O’Connor, S. S., Comtois, K. A., Atkins, D. C., & Kerbrat, A. H. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.05.004 · Cited by 11 · see citing works
Steele, S. J., Hearon, B. A., Batejan, K. L., Gironde, S., & Björgvinsson, Þ. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22342 · Cited by 11 · see citing works
Courtney‐Seidler, E. A., Burns, K. E. A., Zilber, I., & Miller, A. L. (2014) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0101638 · Cited by 9 · see citing works
Differences between suicide and non-suicidal self-harm behaviours: a literary review.
Halicka, J. (2015) · Archives of Psychiatry and Psychotherapy · doi:10.12740/app/58953 · Cited by 9 · see citing works
Identifying Suicide Typologies Among Trauma-Exposed Veterans
Bounoua, N., Hayes, J. P., & Sadeh, N. (2019) · Crisis · doi:10.1027/0227-5910/a000637 · Cited by 9 · see citing works
Raudales, A. M., Darosh, A. G., Contractor, A. A., Schatten, H. T., Dixon–Gordon, K. L., & Weiss, N. H. (2021) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001316 · Cited by 8 · see citing works
Naifeh, J. A., Nock, M. K., Dempsey, C. L., Georg, M. W., Aliaga, P. A., Dinh, H. M., Fullerton, C. S., Mash, H. B. H., Kao, T., Sampson, N. A., et al. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12821 · Cited by 7 · see citing works
Fortaner-Uyà, L., Monopoli, C., Cavicchioli, M., Calesella, F., Colombo, F., Carretta, I., Talè, C., Benedetti, F., Visintini, R., Maffei, C., et al. (2025) · Journal of Clinical Psychology · doi:10.1002/jclp.23763 · Cited by 7 · see citing works
Kokaliari, E. D., Roy, A. W., Panagiotopoulos, C., & Al-Makhamreh, S. (2015) · International Social Work · doi:10.1177/0020872815594225 · Cited by 7 · see citing works
Ellis, É. M., & Gutierrez, D. (2024) · Sexual and Gender Diversity in Social Services · doi:10.1080/29933021.2024.2323503 · Cited by 6 · see citing works
Applying Research to Advance Suicide Prevention in Women Veterans.
Strauss, J., Miller, L. J., & Strickland, S. (2021) · Medical Care · doi:10.1097/mlr.0000000000001434 · Cited by 4 · see citing works
Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation
Barrios, L., Stamatovich, S. N., Simons, R. M., & Simons, J. S. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01275-5 · Cited by 4 · see citing works
Conway, C., Ilagan, G. S., Rabasco, A., Lopez, M. M., Goodrich, M., Kuehn, K. S., & King, K. M. (2025) · Journal of Research in Personality · doi:10.1016/j.jrp.2025.104623 · Cited by 3 · see citing works
Real-time affective predictors of suicidal thinking: A dynamic structural equation modeling study
Kleiman, E. M., Hawes, M. T., Edershile, E. E., Krall, H. R., Flics, M. J., Yoon, E., & Bentley, K. H. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120329 · Cited by 4 · see citing works
Self-Compassion and Non-suicidal Self-Injury
Hasking, P. A. (2023) · Mindfulness in behavioral health · doi:10.1007/978-3-031-22348-8_21 · Cited by 3 · see citing works
Vatandoost, S., Heel, M. V., Azadfar, Z., den Bossche, S. V., Baetens, I., & Meybodi, F. A. (2025) · Social Development · doi:10.1111/sode.70000 · Cited by 3 · see citing works
Lekkas, D., Oh, J. Y., Matsumura, R., Perrier, A. D., & Jacobson, N. C. (2023) · doi:10.31234/osf.io/79mwn · Cited by 3 · see citing works
Yao, K., Zhong, J., Huang, X., Kuang, J., & Xu, M. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.09.003 · Cited by 2 · see citing works
Li, Z., Qiao, X., Ya, Z., & Shi, X. (2023) · Current Psychology · doi:10.1007/s12144-023-05325-2 · Cited by 2 · see citing works
An Integrated Cognitive-Emotional Perspective of NSSI
Tonta, K. E., Greene, D., Hasking, P. A., & Boyes, M. E. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197611272.013.35 · Cited by 1 · see citing works
AghaMohammadi, S., Tehrani, M. A. M., Fata, L., & Mootabi, F. (2024) · Current Psychiatry Research and Reviews · doi:10.2174/0126660822289247240305044908 · Cited by 1 · see citing works
Khan, S., Rehna, T., & Butt, T. A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1449110 · Cited by 1 · see citing works
Ma, Y., Wang, Y., Wang, Y., & Yang, X. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-07821-8 · Cited by 1 · see citing works
Nagy, L. M. (2017) · UKnowledge (University of Kentucky) · doi:10.13023/etd.2017.418 · Cited by 1 · see citing works
Clarifying the Association Between the Subtypes of Narcissism and Suicide Risk
Pennings, S. M. (2015) · Aquila Digital Community (University of Southern Mississippi)
Self-citationUnderstanding the Motivation for Suicide
Brown, J. D. (2019) · UWA Profiles and Research Repository (University of Western Australia) · doi:10.26182/5e8ebaa4c9c8c
Distress Tolerance in the Context of Emotional Reactivity and Learned Helplessness
Khan, F., Khan, A., Jan, S. U., & Khan, H. (2022) · International Journal of Cyber Behavior Psychology and Learning · doi:10.4018/ijcbpl.298687
Schenkel, S., Emmerich, L., Arzapalo, H. D. C., Danböck, S. K., Dietiker, L., El‐Haj‐Mohamad, R., Meyer, C., Sperl, M. F. J., von Wendorff, C., Wallimann, M. S., et al. (2023) · Trauma und Gewalt · doi:10.21706/tg-17-4-296
Cadircioglu, M. K., & Aladağ, M. (2024) · Türk Psikoloji Dergisi · doi:10.31828/turkpsikoloji.1365371
학교모래놀이 집단상담이 초기자해행동 초등학생의 애착에 미치는 효과:예비연구
Park, E., & Ahn, U.-K. (2024) · School Counselling and Sandplay · doi:10.54084/scs.2024.6.2.18
vafazadeh, M., Bakhshani, N., & Ghiasi, Z. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.70046
Stetsiv, K., Wilks, C. R., & Carpenter, R. W. (2026) · Archives of Suicide Research · doi:10.1080/13811118.2026.2620799 · Cited by 1 · see citing works
Conejero, I. (2020) · theses.fr (ABES) · doi:10.70675/e0cb59ecz80a8z4338za3ddz2ea8e8d0334d
Wang, Y., Liang, Q., Zhou, W., Wang, Y., Tian, S., Hu, X., Tian, J., Liu, Y., Fang, H., & Wang, W. (2026) · Behavioral and Brain Functions · doi:10.1186/s12993-026-00332-2
Liu, Y., Zeng, J. Z., & Gong, J. (2026) · Mindfulness · doi:10.1007/s12671-026-02833-7
Shi, X., Wang, H., Chen, X., & Zhu, Y. (2026) · Personality and Individual Differences · doi:10.1016/j.paid.2026.113878
Cotton, A. C., Ramzah, H., & Scalora, M. J. (2026) · Journal of College Student Mental Health · doi:10.1080/28367138.2026.2679668
Hernandez, B. E., Batejan, K. L., Tung, E. S., Worden, P. M., Nadai, A. S. D., & Dickstein, D. P. (2026) · Journal of Child and Adolescent Psychopharmacology · doi:10.1177/10445463261466535
- Authors
- Anestis, M. D., Pennings, S. M., Lavender, J. M., Tull, M. T., & Gratz, K. L.
- Affiliations
- University of Southern Mississippi (US)
- University of North Dakota (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Anestis, Michael D.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 54
- Issue
- 7
- Pages
- 996-1002
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2081382184
- Cited by
- 100
- References
- 42
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 8 · 2023: 11 · 2022: 4 · 2021: 9 · 2020: 7 · 2019: 7 · 2018: 12 · 2017: 9 · 2016: 6 · 2015: 7 · 2014: 5 · 2013: 1
- FWCI
- 7.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Rutgers University Community Repository (Rutgers University) (submittedVersion)
- Aquila Digital Community (University of Southern Mississippi) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- distress tolerance, non-suicidal self-injury, suicidal behavior, suicide attempts, emotional dysregulation, mediation, substance use disorders, residential treatment, fear of death, pain
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Residential Treatment, Risk Factors, Stress, Psychological, Suicide, Attempted, Self-Injurious Behavior, Intention, Suicidal Ideation
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