Symposia
Treatment - CBT
Kiran Kaur, M.S.
Student
University of Utah
Salt Lake City, Utah
Anu Asnaani, Ph.D.
Principal Investigator
University of Utah
Salt Lake City, UT
Background: Distress tolerance (DT) is associated with the etiology or maintenance of several psychological disorders, including depression and anxiety. Although mindfulness has been shown to increase DT, other therapeutic techniques (e.g., interoceptive exposure; IE) remain unexamined. Further, the association between DT and emotion regulation (ER) is unclear, despite ER also being a transdiagnostic construct. The present study explored whether three therapeutic techniques (IE, mindfulness, and positive induction of self-efficacy; SE) would (1) improve DT; (2) decrease state anxiety; and (3) whether lower baseline ER would weaken improvements in DT.
Method: Undergraduate students (N=137) completed the State-Trait Anxiety Inventory and Difficulties in Emotion Regulation Scale (DERS) online. Participants then completed two behavioral tasks designed to evoke distress via a live Zoom session with a trained experimenter (administered in a randomized order): a breath-holding (BH) task and watching a distressing film of fatal car accidents. Participants were then randomly assigned to one of three brief interventions (IE (n=46), mindfulness (n=47), and SE (n=44)), and repeated the behavioral assessment tasks (with a novel film) in a counterbalanced fashion after the intervention phase. Participants reported their subjective units of distress (SUDS) and state anxiety before and after each task.
Results: Dependent samples t-tests (Aims 1 & 2) and linear regressions (Aim 3) were conducted. In terms of improvements in DT (Aim 1), while BH did not significantly differ pre- and post-intervention for any of the conditions, film SUDS were significantly higher pre-IE techniques than after, t(43)=2.3, p=.02, but not for mindfulness or SE. State anxiety after IE-techniques was significantly lower than before, t(45)=2.0, p=.04, but not for the other conditions (Aim 2). Aim 3 revealed no differences among conditions with total DERS scores. However, lower scores on the emotional clarity subscale predicted worsening of film SUDS for the mindfulness condition (p=.02), and greater impulse control difficulties predicted an increase in film SUDS for the SE condition (p=.04).
Conclusions: These results suggest that IE techniques (taught remotely in a single setting) can increase DT to distressing stimuli and, importantly, reduce overall anxiety. Further, specific facets of ER seem to play a differential negative influence on improvements in DT in mindfulness and SE interventions, possibly conferring less benefit from these interventions on DT.