Technology
Daily variation in distress intolerance and emotion regulation strategies in a high-risk community sample
Grace N. Anderson, M.A.
PhD Student
Fordham University
New York, New York
Maria Martin Lopez, M.A.
Graduate student
Fordham University
Bronx, New York
Ana Rabasco, M.A.
PhD Student
Fordham University
New York, New York
Gabrielle S. Ilagan, B.A.
Graduate Student
Fordham University
New York, New York
Isabella A. Manuel, B.S.
Graduate Student
Fordham University
Bronx, New York
Melanie R. Silverman, M.A.
PhD Student
Fordham University
Bronx, New York
Christopher C. Conway, Ph.D.
Assistant Professor of Psychology
Fordham University
Bronx, New York
Difficulties with distress tolerance (DT), or one’s ability to withstand negative psychological states, has been linked to various negative outcomes, including addiction, disordered eating, depression, and suicidality (Richards et al., 2011; Simons & Gaher, 2005; Vujanovic et al., 2017). A leading hypothesis is that DT confers its protective effects by predisposing people to adaptive emotion regulation (ER) decisions (e.g., Iverson et al., 2012). This prediction has only been tested at the between-person level using cross-sectional data. Thus, the ecological validity and temporal resolution of existing data are limited. The current study addressed this gap by applying ecological momentary assessment (EMA) to investigate the association between DT and ER response style on a day-to-day basis.
Participants included 60 adults (56% female, 85% people of color, Mage=36.2 years) recruited from the Bronx, NY, who had engaged in past-month self-injurious thoughts and behaviors. Participants completed a 10-day EMA study that involved 4 daily DT assessments and 1 daily measurement of ER strategy engagement in response to the worst negative emotional experience of the day. We hypothesized that higher levels of DT during the day would predict using more adaptive responses (i.e., social support, cognitive reappraisal, acceptance, distraction) to negative emotion and less engagement with maladaptive responses (i.e., substance use, self-harm, rumination, suicidal ideation, suppression).
We used multilevel modeling to compute within-person correlations between DT and the various ER strategies. There were statistically significant correlations with 4 out of 9 strategies, and all were negative, indicating that more DT was associated with less engagement. This was true for both adaptive (r = -.237 for social support) and maladaptive (rs = -.124 and -.203 for suppression and suicidal ideation) strategies, except for cognitive reappraisal (r = .280) which indicated more DT was associated with more engagement. The within-person results reveal that on days when DT is higher, individuals engaged in less suppression, suicidal ideation, and reaching out to social supports and in more cognitive reappraisal.
In contrast, at the between-person level, cognitive reappraisal, rumination, suppression, and self-harm were significantly correlated with daily DT (r = -.392 -.555, p < .05). Of these significant correlations, cognitive reappraisal was once again the only response style positively correlated with DT. These results suggest that individual differences in average DT over the 10-day period are related to the tendencies to engage in rumination, suppression, self-harm, and cognitive reappraisal over the 10-day period.
Our results imply that daily fluctuations in DT have a significant effect on ER response style and that these associations are slightly different that those found at the between-person level, highlighting the utility of EMA studies to parse out nuanced associations. Based on our findings, we hypothesize that incorporating DT into cognitive and behavioral therapies will improve clients’ use of cognitive reappraisal to cope with negative emotions rather than resort to maladaptive behaviors like suppression or self-harm.