Cited by 105Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentMindfulness and Compassion Interventions

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The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies

Jeffries, Emily R., McLeish, Alison C., Kraemer, Kristen M., Avallone, Kimberly M., Fleming, John B.·2016·Behavior Modification

DOI 10.1177/0145445515619596

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Abstract

The present study evaluated the role of distress tolerance (DT), defined as the ability to tolerate negative emotional states, in the use of four specific emotion regulation strategies (suppression, avoidance, rumination, and reappraisal). Undergraduate psychology students (N = 431, 71.7% female; Mage = 19.80 years, SD= 3.71) completed self-report measures online for course credit. It was hypothesized that, after controlling for the effects of anxiety sensitivity and negative affectivity, DT would be negatively associated with suppression, avoidance, and rumination, and positively associated with reappraisal. Consistent with prediction, low DT significantly predicted greater use of suppression, avoidance, and rumination. However, contrary to prediction, DT did not significantly predict reappraisal. These results suggest that individuals who are unable to withstand negative emotions are more likely to use maladaptive regulation strategies.

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“The positive brooding-positive cognition link may reflect cognitive dissonance, wherein adolescents display superficial optimism while remaining trapped in maladaptive cognitive loops (Burwell & Shirk, 2007; Jeffries et al., 2016).”
The mediating role of distress tolerance on the relationship between childhood trauma and suicide risk in patients with major depressive disorder
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
Distress Intolerance Is Associated With Emotion Regulation Effort and Difficulty, But Not Success in Daily Life
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Impacts of Distress Intolerance and Anxiety Sensitivity on the Maintenance and Treatment of Youth Misophonia
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The Impact of Emotion Coaching on Changes in Caregiver Burden and Distress Tolerance During Family‐Based Treatment
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Development and preliminary validation of a scale to assess physicians’ emotional distress intolerance in end-of-life care communication
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“Contrastingly, individuals with low IU use other adaptive emotion regulation strategies, which in turn reduces the likelihood of suicidal ideation (Jeffries et al., 2016).”
The Relationship between Distress Tolerance and Anxiety in Adolescents: The Mediating Role of Emotion Regulation Strategies
徐, 舵. (2023) · Advances in Psychology · doi:10.12677/ap.2023.133155 · Cited by 2
Distress Tolerance in Patients with Metastatic and Non-metastatic Breast Cancer: A Single-center Experience
Erdal, G. Ş., Balcioglu, S. S. K., & Namlı, M. N. (2023) · Acibadem Universitesi Saglik Bilimleri Dergisi · doi:10.31067/acusaglik.1266533 · Cited by 2
“In addition, low distress tolerance has been associated with both poorer quality of life and reduced life satisfaction (12,13).”
Background
I know why the caged bird sings: Distress tolerant individuals show greater resting state connectivity between ventromedial prefrontal cortex and right amygdala as a function of higher vagal tone
McIntosh, R. C., Hoshi, R. A., Nomi, J. S., Goodman, Z., Kornfeld, S., & Vidot, D. C. (2023) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2023.112274 · Cited by 2
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“…ratings are also assumed to be consciously accepted appraisals of subjective reality rather than unconscious defenses, and thus, were not expected to correlate with responses to emotions such as suppression, avoidance, or rumination (Responses to Emotions Questionnaire; Jeffries et al., 2016).”
Influential
Sexual Self-Objectification and Sex-Related Drinking Motives Among College Women: Do Emotion Regulation and Distress Tolerance Matter?
Ndungu, R. W., Hammett, J. F., Peddle, A. K., Jaffe, A. E., Duckworth, J. C., & Stappenbeck, C. A. (2025) · Archives of Sexual Behavior · doi:10.1007/s10508-025-03138-x · Cited by 3
“Distress tolerance, referring to one’s ability to manage actual or perceived stressors (Conway et al., 2021), is closely tied to emotion regulation abilities (Jeffries et al., 2016).”
A Psychometric Investigation of the Distress Tolerance Scale Short Form (DTS-SF): Reliability, Validity, and Factor Structure in a Trauma-Exposed Sample
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
“In addition to associations with distress disorder symptom severity, distress tolerance has been found to be negatively associated with neuroticism (Kaiser et al., 2012 ), negative affect intensity (Vujanovic et al., 2013), and negative affect (Jeffries et al., 2016).”
Loss of Control Eating Predicted by the Interaction Between Emotion Regulation Difficulties, Distress Tolerance, and the Expectancy that Eating Reduces Negative Affect
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“Further, individuals with low DT may demonstrate more “ maladaptive ” ER strategies (e.g., rumination, avoidance, emotion suppression) than individuals with high DT (Jeffries et al., 2016; Naragon-Gainey et al., 2017).”
“I thought that crying was weakness”: a thematic analysis of emotional experience in an online self-harm forum
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“…dysregulation more generally, where distress (in)tolerance, (non)acceptance of emotions, and a (perceived) lack of ability to access effective emotion regulation strategies are linked to, or key facets of, difficulties with emotion regulation (e.g. Gratz & Roemer, 2004; Jeffries et al., 2016).”
The relationship between irritability and suicidal ideation: the chain mediating effects of rumination and distress tolerance
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“Previous studies have found a significant association between more serious rumination and lower distress tolerance [39, 40, 48, 49].”
Distress Intolerance, Social Anxiety, and Depressive Symptoms in Adolescents: Evidence from Random-Intercept Cross-Lagged Panel and Cross-Lagged Panel Network Analyses
Tian, X., Chen, J., Wang, B., Wan, X., & Wang, S. (2026) · Journal of Youth and Adolescence · doi:10.1007/s10964-026-02391-0 · Cited by 1
“…distress as unbearable may possess diminished confidence in their capacity to endure aversive emotional states, making them more likely to rely on maladaptive regulation strategies such as avoidance, withdrawal, rumination, or suppression (Jeffries et al., 2016; Naragon-Gainey et al., 2017).”
The Relationship between Distress Tolerance, Parenting, and Substance Use Among Adolescent Mothers
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Evaluating the Model of Direct and Indirect Effects of Origin Family Function and Perception of Parents' Marriage on Depression and Marital Quality in Women: The Mediating Role of Emotional Maturity
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Bailey, C. A. (2016)
A Randomized Controlled Trial of a Hatha Yoga Intervention for Smokers
Jeffries, E. R. (2018) · Louisiana State University · doi:10.31390/gradschool_dissertations.4692
Self-citation
Emotion regulation in young people with complex mental health and substance use issues
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Authors: Jeffries, E. R., McLeish, A. C., Kraemer, K. M., Avallone, K. M., & Fleming, J. B.
Affiliations: University of Cincinnati (US)
Corresponding author: McLeish, Alison C.
ORCID: Jeffries, Emily R.
McLeish, Alison C.
Kraemer, Kristen M.
Fleming, John B.
Venue: Behavior Modification
Publisher: SAGE Publications
Published: 2015-12-08
Volume: 40
Issue: 3
Pages: 439-451
ISSN: 0145-4455 (ISSN-L)
1552-4167
DOI: 10.1177/0145445515619596
OpenAlex: W2216480565
Cited by: 105
References: 31
Citations by year: 2026: 10 · 2025: 17 · 2024: 15 · 2023: 15 · 2022: 12 · 2021: 10 · 2020: 7 · 2019: 6 · 2018: 7 · 2017: 3 · 2016: 3
FWCI: 6.53
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Behavior Modification (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5ul1rr026314-03)
National Center for Research Resources (UL1-RR026314)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords: distress tolerance, emotion regulation strategies, emotional suppression, avoidance, rumination, cognitive reappraisal, anxiety sensitivity, negative affectivity, maladaptive emotion regulation, negative emotions
MeSH terms: Emotional Adjustment, Adaptation, Psychological, Adolescent, Anxiety, Anxiety Disorders, Avoidance Learning, Emotions, Female, Humans, Male, Psychiatric Status Rating Scales, Surveys and Questionnaires, Stress, Psychological, Young Adult, Self Report

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The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies

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