Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Open accessIntegrity signals
Registry
Cites
Statistics
Claims the paper makes
5 of 15 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured
- Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Distress tolerance is importantly involved in depression and anxiety.
“Distress tolerance, defined as the ability to withstand aversive emotions, plays a significant role in depression and anxiety [3].”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [3] source
- Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Higher levels of depression and anxiety symptoms are linked to increased risk of recurrent cardiac events and mortality following acute coronary syndrome.
“Elevated depressive and anxiety symptoms increase the risk for recurrent cardiac events and mortality after ACS [2].”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [2] source
The sections on cardiac mortality and composite mortality/nonfatal events report associations between depressive symptoms and adverse outcomes after ACS, including recurrent nonfatal MI. The passages found do not establish the same claim for anxiety symptoms; anxiety appears as a variable in some analyses, not as a supported predictor of these outcomes. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Findingown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Lower distress tolerance had a significant association with more distress about physical symptoms (b = −.34, p<.05) in the adjusted model.
“Lower distress tolerance was significantly associated with greater anxiety symptoms (b = −.60, p<.001), depression symptoms (b = −.50, p<.001), and distress about physical symptoms (b = −.34, p< .05).”
Quote in the paperSubstantial claim - Findingown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Lower distress tolerance was significantly related to greater depression symptoms (b = −.50, p<.001) in the adjusted analysis.
“Lower distress tolerance was significantly associated with greater anxiety symptoms (b = −.60, p<.001), depression symptoms (b = −.50, p<.001), and distress about physical symptoms (b = −.34, p< .05).”
Quote in the paperSubstantial claim - Findingown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Lower distress tolerance showed a significant association with more severe anxiety symptoms (b = −.60, p<.001) in the adjusted model.
“Lower distress tolerance was significantly associated with greater anxiety symptoms (b = −.60, p<.001), depression symptoms (b = −.50, p<.001), and distress about physical symptoms (b = −.34, p< .05).”
Quote in the paperSubstantial claim
- Interpretationown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Among post-ACS patients, distress tolerance is linked to emotional outcomes regardless of age, gender, time since ACS, and medical and psychiatric comorbidities.
“This is the first study to demonstrate that distress tolerance is associated with emotional outcomes among patients after ACS – regardless of age, gender, time since ACS, and comorbidities.”
Quote in the paperSubstantial claim - Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
CBT has only limited effectiveness.
“but it has limited effects [9]”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] source
- Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
Distress tolerance is separate from the severity of emotional symptoms.
“which is indeed separate from the level of emotional symptoms [7]”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] source
- Interpretationown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome
The findings indicate that distress tolerance contributes to emotional outcomes following acute coronary syndrome.
“Overall, the results suggest a role of distress tolerance in emotional outcomes after ACS”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 15
- May combine two claims. 5
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeRoughly 40-50% of individuals who have had an acute coronary syndrome report elevated anxiety or depression symptoms.
“Following acute coronary syndrome (ACS; e.g., a heart attack), 40–50% of patients experience elevated anxiety or depression symptoms, and many have distressing physical symptoms and difficulty with positive health behaviors [1].”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [1] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeA substantial number of acute coronary syndrome patients have distressing physical symptoms and struggle with positive health behaviors.
“Following acute coronary syndrome (ACS; e.g., a heart attack), 40–50% of patients experience elevated anxiety or depression symptoms, and many have distressing physical symptoms and difficulty with positive health behaviors [1].”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [1] source
The Results (Characteristics of the Sample; page unavailable) report that almost one in five patients smoked and one in three was obese, which offers some support for difficulty with positive health behaviors. The paper does not report that many patients had distressing physical symptoms or struggled to change their behaviors. Its sample also included several types of cardiac patients, so these findings are not specific to ACS patients. (LLM, conf=0.78)
Experimental — accuracy not yet measured
May combine two claims.
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeMindfulness-based interventions aim at and enhance distress tolerance.
“Mindfulness-based approaches target and improve distress tolerance”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [10] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeA non-significant trend suggested that lower distress tolerance was related to greater distress about health behaviors (b = −.24, p=.08).
“There was a non-significant trend for lower distress tolerance associated with greater distress about health behaviors (b = −.24, p=.08).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeIndividuals low in distress tolerance are unable to withstand negative emotions.
“Individuals with low distress tolerance are unable to endure negative emotions, experience negative emotions as unacceptable, and use unhealthy emotional coping strategies, which in turn create further exacerbations in symptoms [4].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4] source
Classified as probably not a substantial claim.
Study design and conductown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeThe study used a cross-sectional design.
“cross-sectional design”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeIndividuals with low distress tolerance use maladaptive emotional coping strategies.
“Individuals with low distress tolerance are unable to endure negative emotions, experience negative emotions as unacceptable, and use unhealthy emotional coping strategies, which in turn create further exacerbations in symptoms [4].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4] source
May combine two claims.
Study design and conductown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeThe analysis did not control for symptom count and could not separate patients with many symptoms but no distress from those with no symptoms and no distress.
“We were unable to control for number of symptoms and could not differentiate those who had many symptoms but no distress from those who had no symptoms and therefore no distress.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeDistress tolerance is a personal trait that influences the experience of and reaction to negative emotions.
“Distress tolerance is an individual-level characteristic that impacts the way people experience and respond to negative emotions [4].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeThe sample size was relatively small.
“relatively small sample size”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeSuch maladaptive coping strategies result in additional worsening of symptoms.
“Individuals with low distress tolerance are unable to endure negative emotions, experience negative emotions as unacceptable, and use unhealthy emotional coping strategies, which in turn create further exacerbations in symptoms [4].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4] source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeFrom 297 contacted patients, 92 consented, 11 failed to return surveys, resulting in an analytic sample of 81 and a 27% enrollment rate.
“11 patients did not return their survey, for an analytic sample of N = 81 (81/297 = 27% enrollment rate).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeThose with low distress tolerance perceive negative emotions as unacceptable.
“Individuals with low distress tolerance are unable to endure negative emotions, experience negative emotions as unacceptable, and use unhealthy emotional coping strategies, which in turn create further exacerbations in symptoms [4].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeBehavioral interventions increasingly aim at underlying emotional processes like distress tolerance instead of disorder-specific protocols.
“Behavioral interventions increasingly focus on targeting underlying emotional processes such a distress tolerance, rather than disorder-specific protocols for one type of problem (e.g., Unified Protocol) [8].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] source
May combine two claims.
Study design and conductnone given§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeThe study's demographic variability and generalizability were limited.
“Limitations include limited demographic variability and generaliz-ability”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeDistress about physical symptoms and health behaviors was assessed with a researcher-developed measure.
“researcher-developed measure of distress about physical symptoms and health behaviors”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeCBT is currently the recommended treatment for emotional problems following acute coronary syndrome.
“Currently, cognitive-behavioral therapy is the recommended treatment for emotional problems after ACS, but it has limited effects [9] and does not necessarily aim to target distress tolerance.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndromeBehavioral interventions can enhance distress tolerance.
“Distress tolerance can be improved with behavioral interventions [5]”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] source
The paper relies on this without support.
No previous study has investigated the link between distress tolerance and emotional outcomes among post-ACS patients.
“but no research has explored whether distress tolerance is related to emotional outcomes in patients after ACS.”
The paper relies on this without support.
This study is the first to demonstrate an association between distress tolerance and emotional outcomes in post-ACS patients.
“This is the first study to demonstrate that distress tolerance is associated with emotional outcomes among patients after ACS – regardless of age, gender, time since ACS, and comorbidities.”
The paper relies on this without support.
CBT does not necessarily aim to address distress tolerance.
“and does not necessarily aim to target distress tolerance.”
Cites
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., & Rose, M. (2007) · Medical Care · doi:10.1097/01.mlr.0000258615.42478.55 · Cited by 3,118 · cited 1× · see citing works
“, “I’ll do anything to avoid feeling distressed or upset” and “I can’t handle feeling distressed or upset”, rated from 1 = strongly agree to 5 = strongly disagree) [4]; PROMIS- anxiety and depression [6]; and a researcher-developed checklist of distress due to physical symptoms (tired, weak, low energy, shortness of b…”
BackgroundThe 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
Lichtman, J. H., Froelicher, E. S., Blumenthal, J. A., Carney, R. M., Doering, L. V., Frasure-Smith, N., Freedland, K. E., Jaffe, A. S., Leifheit-Limson, E. C., Sheps, D. S., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000019 · Cited by 1,208 · cited 1× · see citing works
“Elevated depressive and anxiety symptoms increase the risk for recurrent cardiac events and mortality after ACS [2].”
BackgroundLeyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010) · Psychological Bulletin · doi:10.1037/a0019712 · Cited by 868 · see citing works
Barlow, D. H., Farchione, T. J., Bullis, J. R., Gallagher, M. W., Murray-Latin, H., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Conklin, L. R., Boswell, J. F., et al. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.2164 · Cited by 853 · see citing works
Anxiety and depression after a cardiac event: prevalence and predictors
Murphy, B., Le Grande, M., Alvarenga, M., Worcester, M., & Jackson, A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.03010 · Cited by 203 · see citing works
Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis
Whalley, B., Thompson, D. R., & Taylor, R. S. (2014) · International Journal of Behavioral Medicine · doi:10.1007/s12529-012-9282-x · Cited by 149 · cited 1× · see citing works
“Currently, cognitive-behavioral therapy is the recommended treatment for emotional problems after ACS, but it has limited effects [9] and does not necessarily aim to target distress tolerance.”
BackgroundMindfulness and Distress Tolerance: Relations in a Mindfulness Preventive Intervention
Lotan, G., Tanay, G., & Bernstein, A. (2013) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2013.6.4.371 · Cited by 59 · 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 · cited 1× · see citing works
“It may be important for psychological treatments to intervene upon not only the emotional symptom itself, but also the ability to tolerate and cope with distress, which is indeed separate from the level of emotional symptoms [7].”
BackgroundKraemer, K. M., Luberto, C. M., Hall, D. L., Ngo, L. H., & Yeh, G. Y. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103746 · Cited by 21 · see citing works
Self-citation
Flagged first, then by citations
1 of the 11 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Yao, Y.-J., Yan, Z., Xu, D., & Xuan, Y. (2024) · Current Psychology · doi:10.1007/s12144-024-06818-4 · Cited by 11 · see citing works
“…has been found between lower distress tolerance and stronger anxiety symptoms (Keough et al., 2010; Allan et al., 2014; Reitzel et al., 2017; Luberto et al., 2021; Li et al., 2023); moreover, there is a strong negative correlation between distress tolerance and trait anxiety (Kraemer et…”
Tully, P. J., Turnbull, D. A., Horowitz, J. D., Beltrame, J. F., Baune, B. T., Sauer-Zavala, S. E., Baumeister, H., Bean, C., Pinto, R. B., Cosh, S., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.741039 · Cited by 9 · see citing works
Roodmajani, M. B., Nayyeri, M., & Ramezani, J. (2024) · Elderly Health Journal · doi:10.18502/ehj.v10i1.15966 · Cited by 2 · see citing works
徐, 舵. (2023) · Advances in Psychology · doi:10.12677/ap.2023.133155 · Cited by 2 · see citing works
“…(Spielberger, 1966) 。焦虑情绪会对青少年的家庭生活和学校生活造成无法 忽视的影响 (Peleg et al., 2018; Alfonso & Lonigan, 2021) 。因此，寻找减缓焦虑的方法显得尤为重要。以往 研究发现，提升痛苦忍受性和使用情绪调节策略均能有效降低焦虑 (O’Toole et al., 2017; Luberto et al., 2021; Chen & Bonanno, 2021) 。 痛苦忍受性是指个体经历和承受消极心理状态的能力 (Simons & Gaher, 2005) 。研究发现，痛苦忍受…”
Tully, P. J., & Cosh, S. (2023) · doi:10.1093/oso/9780197564295.003.0012 · Cited by 1 · see citing works
Liu, Y., Zeng, L., Zhou, F., Zhang, W., Yang, C., & Liu, H. (2026) · Archives of Dermatological Research · doi:10.1007/s00403-026-04841-y
“Distress tolerance refers to an individual’s ability to experi - ence and withstand negative emotional states [15].”
- Authors
- Luberto, C. M., Crute, S., Wang, A., Yeh, G. Y., Celano, C. M., Huffman, J. C., & Park, E. R.
- Affiliations
- Harvard University (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Luberto, Christina M.
- ORCID
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 70
- Pages
- 143-144
- ISSN
- 0163-8343 (ISSN-L)
- PMC
- PMC8320852
- OpenAlex
- W3127597336
- Cited by
- 6
- References
- 11
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- distress tolerance, anxiety, depression, acute coronary syndrome, cardiac patients, psychological distress, emotion regulation
- MeSH terms
- Anxiety, Anxiety Disorders, Depression, Humans, Stress, Psychological, Acute Coronary Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
