Distress tolerance and emotional regulation in individuals with alcohol use disorder
Open accessAbstract
Background: Previous research suggests that low distress tolerance may be associated with poor emotion regulation, contribute to drinking to cope motives, and predict alcohol-related problems in non-clinical populations. However, little is known about the ability to tolerate distress among individuals with alcohol use disorder (AUD) and its association with emotional dysregulation. The aim of this study was to examine the link between emotional dysregulation and a behavioral measure of distress tolerance among individuals with AUD. Methods: The sample consisted of 227 individuals with AUD enrolled in an 8-week abstinence-based inpatient treatment program. Behavioral distress tolerance was assessed using a test of ischemic pain tolerance and the Difficulties in Emotion Regulation Scale (DERS) was used to assess emotion dysregulation. Results: Distress tolerance was significantly associated with emotional dysregulation even when accounting for alexithymia, depressive symptomatology, age, and biological sex. Conclusion: The current study provides preliminary support for an association between low distress tolerance and emotion dysregulation in a clinical group of patients with AUD.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Emotion regulation plays a significant role in alcohol addiction, and modifying one's perspective can reduce consumption.
“Emotion regulation plays a significant role in alcohol addiction, 17 and modifying one’s perspective can reduce consumption. 18”
From Enhancing Emotion Regulation and Overcoming Craving in Alcohol Dependence Syndrome Through Mindfulness-based Relapse Prevention (2025) · cites this paper as [17]
Reducing cravings has been recognized as a crucial target in treating ADS.
“Moreover, reducing cravings has been recognized as a crucial target in treating ADS. 17”
From Enhancing Emotion Regulation and Overcoming Craving in Alcohol Dependence Syndrome Through Mindfulness-based Relapse Prevention (2025) · cites this paper as [17]
The Introduction (page unavailable) mentions an association between distress tolerance and substance-use craving, but does not say that reducing cravings is a treatment target for alcohol dependence. The Discussion (page unavailable) instead proposes addressing distress tolerance in AUD treatment. Searches for craving reduction and treatment targets found no passage establishing the attributed claim. (LLM, conf=0.72)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589 · see citing works
Pain and emotion: a biopsychosocial review of recent research
Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., & Keefe, F. J. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20816 · Cited by 836 · see citing works
Alcohol use disorder and depressive disorders
McHugh, R. (2019) · Alcohol Research: Current Reviews · doi:10.35946/arcr.v40.1.01 · Cited by 517 · see citing works
Buckner, J. D., Keough, M. E., & Schmidt, N. B. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2006.12.019 · Cited by 301 · see citing works
Howell, 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
Gorka, S. M., Ali, B., & Daughters, S. B. (2012) · Psychology of Addictive Behaviors · doi:10.1037/a0026386 · Cited by 112 · see citing works
The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies
Jeffries, E. R., McLeish, A. C., Kraemer, K. M., Avallone, K. M., & Fleming, J. B. (2016) · Behavior Modification · doi:10.1177/0145445515619596 · Cited by 105 · cited 1× · see citing works
“, suppression, avoidance, rumination) (30) and are more likely to engage in impulsive, non-planned behaviors (15).”
BackgroundMarshall-Berenz, E. C., Vujanovic, A. A., & MacPherson, L. (2011) · Personality and Individual Differences · doi:10.1016/j.paid.2010.11.033 · Cited by 104 · 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
Distress tolerance and physiological reactivity to stress predict women's problematic alcohol use
Holzhauer, C. G., Wemm, S., & Wulfert, E. (2017) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000116 · Cited by 33 · see citing works
Flagged first, then by citations
Research works printed but not linked: 21
- [1]Simons J Gaher R. The distress tolerance scale: development and validation of a self-report measure. Motiv Emot. (2005) 29: 83– 102. doi: 10.1007/s11031-005-7955-3 · DOI · Paper page
- [2]Leyro TM Zvolensky MJ Bernstein A. Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychol Bull. (2010) 136: 576– 600. doi: 10.1037/a0019712, PMID: 20565169 PMC2891552 · DOI · Paper page
- [3]Pedrelli P MacPherson L Khan AJ Shapero BG Fisher LB Nyer M. Sex differences in the association between heavy drinking and behavioral distress tolerance and emotional reactivity among non-depressed college students. Alcohol Alcohol. (2018) 53: 674– 81. doi: 10.1093/alcalc/agy045, PMID: 29947730 PMC6454502 · DOI
- [4]Pilatti A Michelini Y Bravo AJ Pautassi RM. The association between distress tolerance and alcohol outcomes via internal drinking motives. Subst Use Misuse. (2022) 57: 230– 8. doi: 10.1080/10826084.2021.2002900, PMID: 34789052 · DOI
- [5]Khan AJ Pedrelli P Shapero BG Fisher L Nyer M Farabaugh AI. The association between distress tolerance and alcohol related problems: the pathway of drinking to cope. Subst Use Misuse. (2018) 53: 2199– 209. doi: 10.1080/10826084.2018.1464027, PMID: 29708456 · DOI
- [9]Shorey RC Gawrysiak MJ Elmquist J Brem M Anderson S Stuart GL. Experiential avoidance, distress tolerance, and substance use cravings among adults in residential treatment for substance use disorders. J Addict Dis. (2017) 36: 151– 7. doi: 10.1080/10550887.2017.1302661, PMID: 28358236 PMC6126664 · DOI · Paper page
- [10]Gratz KL Roemer L. Multidimensional assessment of emotion regulation anddysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. (2004) 26: 41– 54. doi: 10.1023/B:JOBA.0000007455.08539.94 · DOI · Paper page
- [11]Petit G Luminet O Maurage F Tecco J Lechantre S Ferauge M. Emotion regulation in alcohol dependence. Alcohol Clin Exp Res. (2015) 39: 2471– 9. doi: 10.1111/acer.12914 26613633 · DOI
- [12]Berking M Margraf M Ebert D Wupperman P Hofmann SG Junghanns K. Deficits in emotion-regulation skills predict alcohol use during and after cognitive-behavioral therapy for alcohol dependence. J Consult Clin Psychol. (2011) 79: 307– 18. doi: 10.1037/a0023421, PMID: 21534653 PMC3109184 · DOI · Paper page
- [13]Khosravani V Sharifi Bastan F Kolubinski DC Amirinezhad A Ghorbani F. Distress tolerance and special alcohol metacognitions behave differently in the association of negative affect with alcohol-related patterns in men with problematic alcohol use in the abstinence phase. Clin Psychol Psychother. (2021) 28: 345– 54. doi: 10.1002/cpp.2514, PMID: 32896028 · DOI
- [18]Sheehan DV Lecrubier Y Sheehan KH Amorim P Janavs J Weiller E. The Mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. (1998) 59: 34– 57. 9881538
- [19]Folstein MF Folstein SE McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. (1975) 12: 189– 98. doi: 10.1016/0022-3956(75)90026-6 1202204 · DOI · Paper page
- [21]Jakubczyk A Ilgen MA Bohnert AS Kopera M Krasowska A Klimkiewicz A. Physical pain in alcohol-dependent patients entering treatment in Poland-prevalence and correlates. J Stud Alcohol Drugs. (2015) 76: 607– 14. doi: 10.15288/jsad.2015.76.607, PMID: 26098037 PMC4495079 · DOI
- [23]Bagby RM Taylor GJ Parker JD. The twenty-item Toronto alexithymia scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res. (1994) 38: 33– 40. doi: 10.1016/0022-3999(94)90006-x 8126688 · DOI
- [24]Cedro A Kokoszka A Popiel A Narkiewicz-Jodko W. Alexithymia in schizophrenia: an exploratory study. Psychol Rep. (2001) 89: 95– 8. doi: 10.2466/pr0.2001.89.1.95 11729558 · DOI
- [26]Thorberg FA Young RM Sullivan KA Lyvers M. Alexithymia and alcohol use disorders: a critical review. Addict Behav. (2009) 34: 237– 45. doi: 10.1016/j.addbeh.2008.10.016, PMID: 19010601 · DOI
- [28]Linn BK Zhao J Bradizza CM Lucke JF Ruszczyk MU Stasiewicz PR. Alexithymia disrupts emotion regulation processes and is associated with greater negative affect and alcohol problems. J Clin Psychol. (2021) 77: 2915– 28. doi: 10.1002/jclp.23279, PMID: 34787929 PMC8800422 · DOI
- [29]Nyklíček I Vingerhoets AJJM. Alexithymia is associated with low tolerance to experimental painful stimulation. Pain. (2000) 85: 471– 5. doi: 10.1016/S0304-3959(99)00295-X, PMID: 10781921 · DOI
- [31]Maleki N Tahaney K Thompson BL Oscar-Berman M. At the intersection of alcohol use disorder and chronic pain. Neuropsychology. (2019) 33: 795– 807. doi: 10.1037/neu0000558, PMID: 31448947 PMC6711399 · DOI
- [32]Vujanovic AA Webber HE McGrew SJ Green CE Lane SD Schmitz JM. Distress tolerance: prospective associations with cognitive-behavioral therapy outcomes in adults with posttraumatic stress and substance use disorders. Cogn Behav Ther. (2022) 51: 326– 42. doi: 10.1080/16506073.2021.2007995, PMID: 34994673 PMC8986561 · DOI
- [33]Amiri M Alavinia M Singh M Kumbhare D. Pressure pain threshold in patients with chronic pain: a systematic review and Meta-analysis. Am J Phys Med Rehabil. (2021) 100: 656– 74. doi: 10.1097/PHM.0000000000001603, PMID: 33002911 · DOI
Cited by
Sorted by citations
Riya, Kumar, N., & Chandel, N. (2025) · Indian Journal of Psychological Medicine · doi:10.1177/02537176241246332 · Cited by 3 · see citing works
“One such study is by Zaorska et al., 17 which investigated the relationship between emotional dysregulation and distress tolerance in AUD patients.”
Influential
- Authors
- Zaorska, J., Rydzewska, M., Kopera, M., Wiśniewski, P., Trucco, E. M., Kobyliński, P., & Jakubczyk, A.
- Affiliations
- Medical University of Warsaw (PL)
- Florida International University (US)
- National Information Processing Institute (PL)
- Corresponding author
- Wiśniewski, Paweł
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2023-05-12
- Volume
- 14
- Pages
- 1175664-1175664
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC10213258
- OpenAlex
- W4378746784
- Cited by
- 17
- References
- 10
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 5 · 2023: 1
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Minority Health and Health Disparities (U54MD012393)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- distress tolerance, emotional dysregulation, alcoholism, Difficulties in Emotion Regulation Scale, alexithymia, depressive symptoms, inpatient alcohol treatment, coping motives
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
