Stability and change in distress tolerance and its prospective relationship with borderline personality features: a short-term longitudinal study
Abstract
Distress tolerance (DT), or the ability to withstand psychological distress, has been proposed as a mechanism underlying multiple forms of psychopathology. However, research on DT is limited in several areas. First, stability and change of DT over time has never been assessed in adults. Second, it is unclear whether alternative conceptualizations of DT yield differences in longitudinal stability and change. Third, gender differences in DT have yet to be examined in nonclinical adult samples. And fourth, longitudinal predictive utility of DT has not been adequately assessed. The purpose of this study was to investigate these 3 questions using data collected at 3 time points over a 6-month period, examining borderline personality disorder (BPD) features as an outcome. Using 3 different measures of DT, results indicated that there is no mean level change in DT. Similarly, there was moderate rank-order stability in DT and no significant individual level change across measures. These findings suggest that DT is similar to other stable, trait-like constructs, as has been previously theorized. Next, a series of cross-lagged panel models revealed that although DT had a cross-sectional relationship with BPD features across all time points, DT did not predict BPD traits longitudinally. These findings have implications for treatments for BPD.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Low DT is associated with wide-ranging psychopathology, including SUDs, eating disorders, BPD, depressive disorders, anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder.
“studies have shown low DT (i.e., distress intolerance) to be associated with wide-ranging psychopathology, including SUDs (McHugh and Kneeland, 2019), eating disorders (Lampard et al., 2011a), BPD (Kiselica et al., 2014)”
From Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis (2022) · cites this paper as Kiselica et al., 2014
Cited by
Sorted by citations
Daros, A. R., & Williams, G. E. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000212 · Cited by 169 · 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
Veilleux, J., Hill, M., Skinner, K. D., Pollert, G. A., Baker, D. E., & Spero, K. D. (2018) · Psychological Assessment · doi:10.1037/pas0000593 · Cited by 49 · see citing works
The Structure of Distress Tolerance and Neighboring Emotion Regulation Abilities
Conway, C. C., Naragon-Gainey, K., & Harris, M. T. (2021) · Assessment · doi:10.1177/1073191120954914 · Cited by 53 · see citing works
“And perhaps its strongest empirical link is with borderline personality disorder (PD), which is characterized in part by frantic, self-destructive behavior in the face of affective disturbance (Anestis et al., 2012; Kiselica et al., 2014).”
BackgroundDistress Tolerance and Pathological Worry: Tests of Incremental and Prospective Relationships
Macatee, R. J., Capron, D. W., Guthrie, W., Schmidt, N. B., & Cougle, J. R. (2015) · Behavior Therapy · doi:10.1016/j.beth.2015.03.003 · Cited by 49 · see citing works
The Nomological Network of Self-Reported Distress Tolerance
Kiselica, A. M., Rojas, E. C., Bornovalova, M. A., & Dubé, C. (2014) · Assessment · doi:10.1177/1073191114559407 · Cited by 45 · see citing works
Self-citationVeilleux, J. C., Pollert, G. A., Zielinski, M. J., Shaver, J. A., & Hill, M. A. (2017) · Assessment · doi:10.1177/1073191116689819 · Cited by 41 · see citing works
“, 2008) or borderline features (Kiselica et al., 2014), due to our college sample, we chose to focus on more common indices of pathology.”
BackgroundBrown, R. J., Burton, A. L., & Abbott, M. J. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23370 · Cited by 39 · see citing works
Distress intolerance during smoking cessation treatment
Farris, S. G., Leyro, T. M., Allan, N. P., Øverup, C. S., Schmidt, N. B., & Zvolensky, M. J. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.08.002 · Cited by 33 · see citing works
Akbari, M., Seydavi, M., & Zamani, E. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2685 · Cited by 31 · see citing works
“Distress (in)tolerance is known as a stable construct (Kiselica et al., 2014).”
BackgroundGratz, K. L., Kiel, E. J., Mann, A. J., & Tull, M. T. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.06.066 · Cited by 27 · see citing works
Perceived willpower self-efficacy fluctuates dynamically with affect and distress intolerance
Veilleux, J. C., Skinner, K. D., Baker, D. E., & Chamberlain, K. D. (2020) · Journal of Research in Personality · doi:10.1016/j.jrp.2020.104058 · Cited by 19 · see citing works
Haehner, P., Sleep, C. E., Miller, J. D., Lynam, D. R., & Hopwood, C. J. (2023) · Clinical Psychological Science · doi:10.1177/21677026231197607 · Cited by 17 · see citing works
“…characteristics (Fassbender et al., 2022; Haehner et al., 2022) but more rank-order stable than different indicators of well-being, such as affective well-being, depressive symptoms, or distress tolerance (Haehner et al., 2022; Kiselica et al., 2014; see Table S10 in the Supplemental Material).”
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
Childhood trauma and distress tolerance in a trauma-exposed acute-care psychiatric inpatient sample.
Berenz, E. C., Vujanovic, A. A., Rappaport, L. M., Kevorkian, S. S., Gonzalez, R., Chowdhury, N., Dutcher, C. D., Dick, D. M., Kendler, K. S., & Amstadter, A. B. (2017) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000300 · Cited by 17 · see citing works
Acute Effects of Cannabis on Breath-Holding Duration
Farris, S. G., & Metrik, J. (2016) · Experimental and clinical psychopharmacology · doi:10.1037/pha0000075 · Cited by 13 · see citing works
“Importantly, while distress intolerance is posited as a stable, trait-like construct (e.g., Kiselica et al., 2014), it is plausible that cannabis-specific contexts (acute intoxication, deprivation) may result in within-person changes in one’s ability to tolerate distress states.”
BackgroundEmotion regulation and borderline personality features in daily life: The role of social context
Dixon–Gordon, K. L., Fitzpatrick, S., & Haliczer, L. A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.12.125 · Cited by 14 · see citing works
Greenberg, L. P., Martindale, S. L., Fils-Aimé, L. R., & Dolan, S. L. (2016) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.30.1.50 · Cited by 14 · see citing works
Tull, M. T., Edmonds, K. A., Forbes, C. N., Richmond, J. R., Rose, J. P., Anestis, M. D., & Gratz, K. L. (2020) · Substance Use & Misuse · doi:10.1080/10826084.2020.1741632 · Cited by 11 · see citing works
“Although DT is a relatively stable individual difference characteristic (Cummings et al., 2013; Kiselica et al., 2014), it has been found to be modifiable through behavioral interventions (Bornovalova et al., 2012).”
BackgroundConway, C., Penrod, M. T., Pugsley, G. M., Larrazabal, M. A., & Snyder, C. E. (2018) · Journal of Personality Disorders · doi:10.1521/pedi_2018_32_359 · Cited by 9 · see citing works
The effect of passive heat stress on distress andself-control in male smokers and non-smokers
Veilleux, J. C., Zielinski, M. J., Moyen, N. E., Tucker, M. A., Dougherty, E. K., & Ganio, M. S. (2018) · The Journal of General Psychology · doi:10.1080/00221309.2018.1494127 · Cited by 9 · see citing works
Distress Tolerance and Craving for Cigarettes Among Heavy Drinking Smokers
Lim, A. C., Roche, D. J. O., & Ray, L. A. (2018) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2018.79.918 · Cited by 8 · see citing works
Reilly, M. E., & Hines, D. A. (2017) · Journal of Interpersonal Violence · doi:10.1177/0886260517712274 · Cited by 8 · see citing works
Distress Tolerance as a Familial Vulnerability for Distress-Misery Disorders
Macatee, R. J., Correa, K. A., Carrillo, V. L., Berenz, E. C., & Shankman, S. (2020) · The Behavior Therapist · doi:10.1016/j.beth.2019.12.008 · Cited by 8 · see citing works
“Indeed, moderate temporal stability has been reported for behavioral and self-report measures of DT (Cummings et al., 2013; Kiselica et al., 2014).”
BackgroundMethodThe self-efficacy in distress tolerance scale (SE-DT): a psychometric evaluation
Alfonsson, S., Mardula, K., Toll, C., Isaksson, M., & Wolf‐Arehult, M. (2022) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-022-00195-9 · Cited by 7 · see citing works
“It has also been suggested that DT is a traitlike construct, not likely to change over time [24].”
BackgroundDistress Intolerance Moderation of Attention to Emotion: An Eye-Tracking Study
Macatee, R. J., McDermott, K. A., Albanese, B. J., Schmidt, N. B., & Cougle, J. R. (2017) · Cognitive Therapy and Research · doi:10.1007/s10608-017-9869-2 · Cited by 6 · see citing works
“, actual ability to persist on a distressing laboratory task) measures of DI have demonstrated temporal stability (Cummings et al. 2013; Kiselica et al. 2014; Macatee et al. 2015) and predictive validity (e.”
BackgroundResultHaehner, P., Sleep, C. E., Miller, J., Lynam, D. R., & Hopwood, C. J. (2023) · doi:10.31234/osf.io/rbyjw · Cited by 6 · see citing works
Crabtree, M. A., Meyer, E. C., Kimbrel, N. A., DeBeer, B. B., Kruse, M. I., Gulliver, S. B., Telch, M. J., & Morissette, S. B. (2019) · Military Psychology · doi:10.1080/08995605.2019.1637210 · Cited by 5 · see citing works
“Given its long-term stability, further use of the measure may improve understanding of the malleability of both emotional and physical distress tolerance ((Kiselica, Webber, & Bornovalova, 2014)), particularly in response to treatment.”
BackgroundSommers, B. (2017) · doi:10.32597/dissertations/1633 · Cited by 5 · see citing works
“Distress tolerance is a concept with importance across multiple diagnostic categories (Bardeen et al., 2013; Kiselica et al., 2014).”
BackgroundMethodInfluentialDefining distress tolerance in a structural model of Big Five personality domains
Lopez, M. M., Naragon‐Gainey, K., & Conway, C. (2024) · Journal of Personality · doi:10.1111/jopy.12952 · Cited by 6 · see citing works
Mattingley, S., Youssef, G. J., Graeme, L. G., Sloan, E., Manning, V., & Hall, K. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23579 · Cited by 3 · see citing works
Perceived and behavioral distress tolerance: links with avoidance and anxiety
Ishimuro, H. S., DePrince, A. P., Kateri Mcrae, A., & Rozenman, M. S. (2025) · Anxiety Stress & Coping · doi:10.1080/10615806.2025.2564330 · Cited by 2 · see citing works
“…DT has consistently been identified as a transdiagnostic feature of most forms of psychopathology (e.g., Akbari et al., 2022; Eichen et al., 2017; Kiselica et al., 2014; Lass & Winer, 2020; Pedrelli et al., 2018; Robinson & Freeston, 2014), and particularly for anxiety (e.g., Bernstein et al.,…”
Xie, Z., Bi, K., & Cui, L. (2025) · Journal of Research on Adolescence · doi:10.1111/jora.70092 · Cited by 4 · see citing works
Byllesby, B. M., Charak, R., Cano-González, I., & Christ, N. M. (2025) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-025-10226-8 · Cited by 2 · see citing works
Elevated integration within the reward network underlies vulnerability to distress
Kozak, S., Dezachyo, O., Stanford, W., Bar‐Haim, Y., Censor, N., & Dayan, E. (2022) · Cerebral Cortex · doi:10.1093/cercor/bhac460 · Cited by 2 · see citing works
Nwosu, K. C., Wahl, W. P., Okeke, N. U., et al. (2023) · Journal of Research in Special Educational Needs · doi:10.1111/1471-3802.12616 · Cited by 2 · see citing works
Defining Distress Tolerance in a Structural Model of Big Five Personality DomainsPreprint
Conway, C., Naragon‐Gainey, K., & Lopez, M. M. (2023) · doi:10.31234/osf.io/gpnwq · Cited by 2 · see citing works
Byllesby, B. M., & Palmieri, P. A. (2024) · Journal of Traumatic Stress · doi:10.1002/jts.23092 · Cited by 1 · see citing works
Halıcı, Ö. Y., & Arıkan, S. (2025) · HUMANITAS - Uluslararası Sosyal Bilimler Dergisi · doi:10.20304/humanitas.1514071 · Cited by 1 · see citing works
McCool, M. W., Carpenter, R. W., & Ellingson, J. M. (2025) · Psychology of Addictive Behaviors · doi:10.1037/adb0001099 · Cited by 1 · see citing works
Keppers, R., Veach, P. M., Schema, L., LeRoy, B. S., & MacFarlane, I. M. (2021) · Journal of Genetic Counseling · doi:10.1002/jgc4.1505 · Cited by 1 · see citing works
Evaluating the construct validity of distress tolerance: A multi-wave study
Evanovich, E. K. (2017) · ThinkTech (Texas Tech University)
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
Bae, N., & Lee, H. (2024) · Korean Journal of Stress Research · doi:10.17547/kjsr.2024.32.4.196
vafazadeh, M., Bakhshani, N., & Ghiasi, Z. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.70046
- Authors
- Kiselica, A. M., Webber, T., & Bornovalova, M. A.
- Venue
- Personality Disorders Theory Research and Treatment
- Published
- 2014-07
- Volume
- 5
- Issue
- 3
- Pages
- 247-256
- ISSN
- 1949-2715 (ISSN-L)
- 1949-2723
- OpenAlex
- W2333609601
- Cited by
- 44
- References
- 0
- Citations by year
- 2025: 6 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 6 · 2016: 3 · 2015: 1 · 2014: 1
- FWCI
- 4.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Personality Disorders Theory Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- distress tolerance, borderline personality disorder, borderline personality traits, trait stability, longitudinal change, gender differences, cross-lagged panel model, non-clinical adults
- MeSH terms
- Adolescent, Adult, Borderline Personality Disorder, Emotions, Female, Frustration, Humans, Longitudinal Studies, Male, Middle Aged, Sex Factors, Stress, Psychological, Young Adult
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.
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
