Measurement invariance of the distress tolerance scale among university students with and without a history of non-suicidal self-injury.

Ashley Slabbert,Penelope Hasking,Mark Boyes,Danyelle Greene

doi:10.7717/peerj.10915

Abstract

Non-suicidal self-injury (NSSI) is the intentional damage to one’s body tissue in the absence of suicidal intent. NSSI primarily serves an emotion regulation function, with individuals engaging in self-injury to escape intense or unwanted emotion. Low distress tolerance has been identified as a mechanism that underlies self-injury, and is commonly assessed using the self-report Distress Tolerance Scale. There are mixed findings regarding the factor structure of the Distress Tolerance Scale, with some researchers utilising a higher-order distress tolerance score (derived from the scores on the four lower-order subscales) and other researchers using the four subscales as unique predictors of psychological outcomes. Neither of these factor structures have been assessed among individuals with a history of self-injury. Of note, an inability to tolerate distress (thought to underlie NSSI) may limit an individual’s capacity to accurately observe and report specific thoughts and emotions experienced in a state of heightened distress, which may impact the validity of scores on the Distress Tolerance Scale. Therefore, measurement invariance should be established before attributing NSSI-related differences on the scale to true differences in distress tolerance. We compared the Distress Tolerance Scale higher-order model with the lower-order four factor model among university students with and without a history of NSSI. Our results indicated that the lower-order four factor model was a significantly better fit to the data than the higher-order model. We then tested the measurement invariance of this lower-order factor model among individuals with and without a history of NSSI, and established configural and full metric invariance, followed by partial scalar and full residual error invariance. These results suggest the four subscales of the Distress Tolerance Scale can be used to confidently discern NSSI-related differences in distress tolerance.

Highlights

Non-suicidal self-injury (NSSI) is the intentional damage to one’s body tissue in the absence of suicidal intent, for reasons not socially or culturally sanctioned (International Society for the Study of Self-Injury, 2018)
Data analysis To determine the best fitting model, we examined the model fit of the original higher-order factor structure and the lower-order four factor structure of the Distress Tolerance Scale using a sequence of Confirmatory Factor Analyses with a Maximum Likelihood Estimation with robust standard errors and a mean- and variance adjusted test statistic (MLMV)
To ensure confidence in these findings it is important that we confirm the psychometric properties, including measurement invariance, of the Distress Tolerance Scale among individuals with and without a history of self-injury

Summary

Introduction

Non-suicidal self-injury (NSSI) is the intentional damage to one’s body tissue in the absence of suicidal intent, for reasons not socially or culturally sanctioned (International Society for the Study of Self-Injury, 2018). Several key theoretical models of NSSI, including the Emotional Cascade Model (Selby, Anestis & Joiner, 2008), the Experiential Avoidance Model (Chapman, Gratz & Brown, 2006) and the Cognitive-Emotional Model (Hasking et al, 2017), specify a central role for emotion regulation in the onset and maintenance of self-injury According to these models and previous empirical research, heightened negative affect (Armey, Crowther & Miller, 2011; Boyes, Wilmot & Hasking, 2019; Najmi, Wegner & Nock, 2007; Slabbert et al, 2020), low positive affect (Bresin, 2014; Slabbert et al, 2020; Victor & Klonsky, 2014), greater repetitive negative thinking (Gong et al, 2019; Slabbert, Hasking & Boyes, 2018), as well as greater difficulties in emotion regulation (Gratz, Breetz & Tull, 2010; Jenkins & Schmitz, 2012) are all associated with increased likelihood of engaging in NSSI. Common to these models is one’s ability to tolerate distress arising from emotional experiences

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