Measures Of Distress Tolerance Research Articles

Assessing shared psychological constructs as risk factors in comorbid PTSD-AUD combat-exposed male veterans

ABSTRACT PTSD and AUD are frequently comorbid post-trauma outcomes. Much remains unknown about shared risk factors as PTSD and AUD work tends to be conducted in isolation. We examined how self-report measures of distress tolerance (DT), experiential avoidance (EA), and drinking motives (DM) differed across diagnostic groups in white, male combat-exposed veterans (n = 77). A MANOVA indicated a significant difference in constructs by group, F (5, 210) = 4.7, p = <.001. Follow-up ANOVAs indicated DM subscales (Coping: F (3,82) = 21.3; Social: F (3,82) = 13.1; Enhancement: F (3,82) = 10.4; ps = <.001) and EA (F (3,73) = 7.8, p < .001) differed by groups but not DT. Post hoc comparisons indicated that mean scores of the comorbid and AUD-only groups were significantly higher than controls for all DM subscales (all ps < .01). EA scores were significantly higher for the comorbid as compared to control (p < .001) and PTS-only (p = .007) groups. Findings support shared psychological factors in a comorbid PTSD-AUD population.

Distress tolerance, coping motives, and alcohol craving and consumption: Two experiments testing momentary responses to a mood induction

BackgroundThe current studies examined the relationship between state and trait distress tolerance (DT), drinking-related variables (alcohol craving and consumption), and the moderating role of drinking to cope with negative affect (i.e., coping motives). MethodsStudy 1 was a laboratory-based experiment. Participants (n=71) completed measures of trait DT, craving, coping motives, and affect valence prior to a negative mood induction task. Post-mood induction, participants completed measures of affect valence, alcohol craving, and state DT. Next, participants completed an alcohol taste task, measuring alcohol consumption. Study 2 was completed online. Participants (n=592) completed the same pre- and post-mood induction measures as study 1, but were randomized to a mood condition (neutral, negative, or positive). Study 2 did not include alcohol consumption. ResultsNegative mood induction lowered reported affect in both studies. In study 1, higher coping motives predicted increased craving in response to negative mood induction but state and trait DT did not predict craving change alone. Contrary to our hypothesis, individuals with higher coping motives showed a positive relationship between trait DT and craving. Analyses predicting alcohol consumption were not significant. In study 2, lower trait DT predicted post-mood induction craving prior to inclusion of interactions in the model. Higher coping motives were the strongest and most consistent predictor of craving. Other predictors (state DT, mood condition) and interaction terms were not significant. ConclusionsFindings broadly align with previous research suggesting that coping motives are predictive of craving and indicate that trait DT may also impact craving.

Distressed drinking: The moderating impact of distress tolerance on the relation between anxiety sensitivity, panic symptoms, and alcohol use and problems.

Undergraduate students are at particular risk for greater alcohol use, which is linked to anxiety disorders among a variety of other negative consequences. Understanding transdiagnostic factors underlying alcohol use problems and other disorders, such as anxiety and mood disorders, can help identify potential targets for intervention. The present study (N = 208 undergraduates; 76.9% female) tested relations between self-reported anxiety sensitivity, panic symptoms, alcohol use and problems, and two different measures of distress tolerance (DT). Specifically, the DT measures assessed 1) perceived ability to handle negative emotion states (emotional DT), measured via self-report, and 2) behavioral ability to tolerate discomforting physical sensations (physical DT), measured via a breath-holding duration task. Consistent with expectations, anxiety sensitivity was associated with greater panic symptoms, which in turn was associated with greater alcohol use problems, for individuals with low but not high levels of physical DT. Contrary to expectations, there was no evidence that panic symptoms explained the relation between anxiety sensitivity and alcohol use and problems at either low or high levels of emotional DT. Taken together, these results suggest that a possible target to decrease alcohol use problems is to increase capacity to withstand or engage with discomforting physiological and panic sensations (i.e., to cultivate greater physical DT).

Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people.

Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.

Distress tolerance and emotional regulation in individuals with alcohol use disorder.

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. 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. Distress tolerance was significantly associated with emotional dysregulation even when accounting for alexithymia, depressive symptomatology, age, and biological sex. The current study provides preliminary support for an association between low distress tolerance and emotion dysregulation in a clinical group of patients with AUD.

What is distress tolerance? Presenting a need for conceptual clarification based on qualitative findings

Distress tolerance is often defined as one's ability to withstand negative and/or uncomfortable emotional states. However, after two decades of research, there is still no consensus on how to best conceptualize and measure distress tolerance. Previous attempts to conceptualize distress tolerance have relied on researchers' understandings of distress tolerance; however, our goal was to gain further insight into distress tolerance through examining how participants may define distress tolerance and related constructs. Thus, in a sample of university students (N = 1013), we conducted a qualitative investigation into how individuals define key terms used in self-report measures of distress tolerance and whether they view their ability to tolerate distress as stable versus variable. Thematic analysis showed that participants' understandings of distress tolerance and related constructs varied dramatically across individuals, and the vast majority of participants reported differences in their ability to tolerate distress across time and settings.

Examining the structure of distress tolerance: Are behavioral and self-report indicators assessing the same construct?

Distress tolerance, or the ability to tolerate physically and emotionally aversive experiences, is a target of psychological intervention in contextual behavioral science. It has been conceptualized as a self-reported ability, as well as a behavioral tendency, and operationalized with a wide variety of questionnaires and behavioral tasks. The current study aimed to investigate whether behavioral tasks and self-report assessments of distress tolerance measure the same underlying dimension, two correlated dimensions, or whether method factors accounted for covariation above and beyond a general content dimension. A university student sample (N = 288) completed behavioral tasks associated with distress tolerance and self-report distress tolerance measures. Confirmatory factor analysis indicated that behavioral and self-report assessments of distress tolerance do not comprise a single dimension of distress tolerance, or two correlated dimensions of self-report or behavioral distress tolerance. Results also failed to support a bifactor conceptualization with a general distress tolerance dimension and domain-specific method dimensions for behavioral and self-report assessments. Findings suggest that more precision and attention to contextual factors are required in the operationalization and conceptualization of distress tolerance.

Anxiety sensitivity and panic symptoms: the moderating influence of distress tolerance

ABSTRACT Background and Objectives Anxiety sensitivity (AS) is the fear of consequences of anxiety-related sensations, and has been linked to the development of panic symptoms. Distress tolerance (DT) encompasses one’s behavioral or self-perceived ability to handle aversive states. We examined whether higher DT buffers the relationship between AS and changes in panic symptoms across two timepoints, spaced ∼three weeks apart. Design and Methods At Time 1, 208 participants completed questionnaires and a physical DT task (breath-holding duration), a cognitive DT task (anagram persistence), and a self-report measure of DT (perceived DT). Panic symptoms were assessed at both timepoints. Structural equation modeling was used to evaluate two models in which AS and DT predicted changes in panic. Results Contrary to hypotheses, for those with longer breath-holding duration (higher physical DT), higher fears of physical anxiety-related sensations (higher physical AS) were associated with worse panic outcomes over time. Conclusions Findings suggest that those with lower physical DT may have been less willing to engage with difficult tasks in the short-term. Although disengagement in the short-term may provide temporary relief, it is possible that averse psychopathological consequences stemming from rigid or habitual avoidance of distressing states may develop over longer periods of time.

Significance of family history in understanding and subtyping trichotillomania

Background and aimsThe existence of subtypes of trichotillomania (TTM) have long been hypothesized, and recent studies have further elucidated characteristic subtypes of TTM and possible ramifications of subtyping for treatment. In clinical applications of subtyping for treatment of TTM, family history (FH) of psychiatric disorders in patients may serve as a tool to differentiate disorder presentations and inform care. We compared prevalence of psychiatric illnesses in first-degree relatives of participants with TTM and healthy controls, respectively, in a large sample, and examined associations between those psychiatric disorders that were significantly different in the FH between groups and measures of disability, severity, and neuropsychological constructs. MethodsWe compared FHs of 152 participants (mean age = 29.9) with TTM and 71 healthy controls (mean age = 29.6), utilizing chi-squared tests to determine which psychiatric illnesses were more prevalent in FHs of participants with TTM. We then used two-tailed t-tests to compare TTM participants with those more prevalent FHs to participants without those FHs on measures of disorder severity, disability, and neuropsychological constructs. FindingsObsessive-compulsive disorder (OCD), TTM, skin picking disorder (SPD), and major depressive disorder (MDD) were significantly more frequent in first-degree relatives (p < 0.0033) of TTM participants than those of healthy controls. TTM participants with a FH of OCD scored significantly higher on measures of impulsivity and lower on measures of distress tolerance. Those with FH of TTM, SPD, and MDD did not differ significantly across measured variables. ConclusionOCD, TTM, SPD, and MDD are more prevalent in the FHs of people with TTM, as compared to healthy controls. TTM participants with a family history of OCD may be more likely to demonstrate decreased distress tolerance and increased impulsivity. In all, as understanding of TTM subtypes develops, the FH may prove a useful tool in delineating subtypes and informing care.

The relationship between distress tolerance and symptoms of depression: Validation of the Distress Tolerance Scale (DTS) and short-form (DTS-SF).

Distress tolerance (DT) has been found to be implicated in the development and maintenance of depressive symptomatology and various other significant psychological conditions. As such, it is critical to have measures of DT that are effective and easy to administer. This study aimed to examine the factor structure, psychometric properties, and clinical utility of the Distress Tolerance Scale (DTS) and the short-form version, the Distress Tolerance Scale Short-form (DTS-SF), in a large population of individuals with varying levels of self-reported depressive symptoms. A total of 959 participants completed an online battery of questionnaires which included an assessment of depressive symptoms as well as the DTS and related measures.Results: Confirmatory factor analyses validated the four-factor structure of the DTS and the one-factor structure of the DTS-SF. Good construct validity and good internal consistency were observed across both the DTS and DTS-SF. Overall, this paper provides new evidence for the validity, reliability and discriminative ability of the DTS and the brief version of the questionnaire, the DTS-SF.

Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence.

Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance-the ability to persist in the face of distress-and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16-17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial AdditionTask. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling forsocio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.

The Efficacy of Skills for Improving Distress Intolerance in Substance Users: A Randomized Clinical Trial

Background: Following inpatient treatment for substance use disorders, abstinence remains elusive. Distress tolerance (DT), persistence in goal directed activity despite psychological distress, is implicated in addictions treatment outcomes. A novel, targeted treatment, Skills for Improving Distress Intolerance (SIDI), integrates skills training with emotional exposure and shows short-term efficacy and specificity to improve distress tolerance. We aimed to compare SIDI to supportive counseling (SC) in DT post-treatment as well as DT and percentage of days using (drugs or alcohol) over 6-month follow-up in the community. Methods: Individuals who attended an inpatient addictions treatment were randomized to 10 weekly group sessions of SIDI or SC, assessed post-treatment, and monitored for six months following community reintegration. Primary outcomes included DT and proportion days using substances (PDU). Variables were assessed at baseline, immediately after SIDI or SC protocol completion, and at 1-, 3-, and 6-months post-discharge. Instruments included three self-reported measures of distress tolerance and the timeline follow-back of substance-using days. Findings: Compared to SC, participants assigned to SIDI reported significantly greater improvement during treatment and post-discharge on several DT measures. Court-mandate status moderated the effects of intervention on drug use outcomes: among those voluntarily admitted to the inpatient treatment, SIDI reduced PDU relative to SC. Among court-mandated individuals, the effects of SIDI and SC on PDU did not differ. Change in DT during treatment predicted frequency of drug use during community reintegration. Interpretation: For individuals who receive inpatient treatment for substance use disorders, SIDI, compared to SC, produced significantly greater improvement in DT. SIDI also reduced relapse risk, but only among voluntary admissions. Change in DT predicted level of PDU in during community reintegration. Results suggest that SIDI leads to a targeted change in DT and substance use, which is sustained. Results also support DT as a key mechanism in substance use disorders. Trial Registration: clinicaltrials.gov Identifier: NCT01741415. Funding Statement: The work was supported by grants DA032582 (NIDA) and MH20030 (NIMH). Declaration of Interests: We declare no competing interests. Ethics Approval Statement: Data for this project were collected at the University of South Florida, with approval from the university’s IRB (Pro00009634). Eligible individuals provided written informed consent.

Relationship of affect intolerance with anxiety, depressive, and obsessive-compulsive symptoms in youth

BackgroundStructural research on the construct of affect intolerance (an overarching latent construct indicated by distress tolerance and anxiety sensitivity) has only been conducted in adults. Given that a self-report measure of distress tolerance was recently validated for youth and affect intolerance may be a core mechanism of transdiagnostic interventions for internalizing disorders, we examined how affect intolerance relates to internalizing symptoms in youth. We predicted that a latent affect intolerance factor (indicated by distress tolerance and anxiety sensitivity) would be associated with self and parent-reports of youth anxiety, depressive, and obsessive-compulsive symptoms, controlling for age and gender. MethodsAt a pre-treatment evaluation, youth with a primary depressive, anxiety, or obsessive-compulsive spectrum disorder (N=277) aged 8-17, and their parent, completed questionnaires. ResultsGreater levels of the affect intolerance factor predicted greater youth- and parent-reported youth anxiety, depression, and obsessive-compulsive symptoms, controlling for age. LimitationsFuture research should replicate findings in a sample with a greater proportion of depressed youth and utilize experimental or longitudinal methods. ConclusionsImportantly, distress tolerance and anxiety sensitivity are core transdiagnostic processes that can be targeted in cognitive-behavioral interventions. Future research should examine how transdiagnostic interventions for youth with internalizing disorders can target these cross-cutting emotional vulnerabilities.

Behavioral strategies to reduce stress reactivity in opioid use disorder: Study design.

More than 2 million people in the United States had an opioid use disorder in 2017. Treatment for opioid use disorder-particularly medication combined with psychosocial support-is effective for reducing opioid use and decreasing overdose risk. However, approximately 50% of people who receive treatment will relapse or drop out. Stress reactivity, defined as the subjective and physiological response to stress, is heightened in people with opioid use disorder and higher stress reactivity is associated with poorer outcomes. Preliminary studies suggest that stress reactivity may be a key mechanistic target for improving outcomes. This article describes the design of an ongoing study examining behavioral strategies for reducing stress reactivity in adults with opioid use disorder. Our objective is to test the efficacy of two behavioral strategies for reducing stress reactivity and enhancing behavioral persistence in the context of stress (distress tolerance). We will recruit 120 adults with opioid use disorder and randomly assign them to brief training in (a) cognitive reappraisal, (b) affect labeling, or (c) a psychoeducational control. Participants will receive the training intervention followed by a laboratory stressor during which they will be instructed to apply the trained skill. Subjective and physiological responses to stress will be measured as indices of stress reactivity and the stressor task will include a behavioral persistence component as a measure of distress tolerance. The ultimate goal of this study is to inform the development of behavioral interventions that can be used as an adjunct to medication-based treatment for opioid use disorder. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Role of Distress Tolerance as a Potential Mechanism Between Anxiety Sensitivity and Gut-Specific Anxiety.

The link between anxiety/fear and gut dysfunction has been robustly documented in both physical and mental health literatures. The current study explored distress tolerance as a potential mechanism in the relation between anxiety sensitivity and gut-specific anxiety. A cross-sectional sample of 828 adults completed measures of distress tolerance, gut-specific anxiety, and anxiety sensitivity. Multiple linear regression analyses were conducted to determine variable associations, including potential mediating factors. The results demonstrated a bidirectional relation between anxiety sensitivity and gut-specific anxiety (ß = 0.23, p < 0.001; ß = 0.22, p < 0.001). Findings suggest distress tolerance is a significant mediator that may partially explain the relation between gut-specific anxiety and anxiety sensitivity more broadly (ß = 0.11, CI [0.07-0.14]). Mediation results were consistent when individual subscales of distress tolerance or anxiety sensitivity were incorporated. The outcome of the present study merits additional examination of the psychosomatic nature of distress tolerance as a potential clinical target for individuals with both anxiety and gut-related disorders.

A multimethod investigation of distress tolerance and problematic alcohol use.

Negative reinforcement has been cited in many prominent theories as a process by which problematic alcohol use develops. According to negative reinforcement theories, alcohol is used to alleviate aversive physical and psychological states. Distress tolerance (DT) has been suggested as a construct that may represent individual differences in ability to tolerate aversive physical and psychological states and therefore may be valuable in identifying individuals at heightened risk for developing alcohol problems via negative reinforcement. However, research on DT is limited by heterogeneity in measurement, which has resulted in equivocal findings comparing measures of DT to each other and also in their relationships to psychopathology. The aim of the current study was to clarify relationships among measures of DT in a sample of alcohol users and to evaluate their relationships to alcohol consumption and problems. Participants were 89 undergraduate alcohol users who completed measures of perceived and behavioral tolerance to physically and psychologically aversive stimuli. Results provided some support for hypotheses, because measures of perceived tolerance were correlated with each other, but, contrary to hypotheses, measures of behavioral tolerance were not correlated with each other. Pain tolerance was the only measure of DT to significantly predict alcohol consumption and problems, although the effect was in the opposite direction from the one hypothesized. Pain tolerance was also indirectly associated with alcohol problems via alcohol consumption. Results support previous assertions of the importance of domain specificity in the measurement of DT and highlight the importance of population-specific processes to the development of alcohol problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Examining Relationships between Gender, Opioid Dependence, and Distress Tolerance among Patients in Substance Use Disorder Treatment

Background: Opioid abuse/dependence is associated with multiple negative outcomes relative to other forms of substance abuse/dependence, including relapse. Research identifying modifiable characteristics associated with opioid dependence and associated negative outcomes may inform the development of targeted interventions for this high-risk population. One factor warranting investigation is low distress tolerance (DT). Purpose/Objectives: In a sample of patients in substance use disorder (SUD) treatment, the present study examined DT levels among patients with current opioid dependence versus no history of opioid dependence, as well as the moderating role of gender. We predicted that patients with opioid dependence would exhibit lower DT than those without a history of opioid dependence, and that women with opioid dependence would exhibit lower levels of DT than men with opioid dependence. Methods: A sample of 203 patients in residential SUD treatment were administered a series of diagnostic interviews and a behavioral measure of DT. Results: DT did not differ significantly as a function of opioid dependence. However, there was a significant opioid dependence by gender interaction, such that men with current opioid dependence exhibited significantly lower levels of DT than women with opioid dependence and men without a history of opioid dependence. Conclusions/Importance: Findings highlight a modifiable characteristic associated with opioid dependence among men that may be targeted in interventions.

Factor structure and initial validation of a brief measure of perceived emotional and physical distress tolerance in post-9/11 US Veterans

ABSTRACTDistress tolerance (i.e., perceived or actual capacity to tolerate aversive internal states) has received considerable research attention as a transdiagnostic risk-factor underlying the development and maintenance of psychopathology. Lower levels of emotional distress tolerance have been linked to psychopathology (e.g. Posttraumatic Stress Disorder) within Military populations; however, the association of physical distress tolerance to psychopathology in this population has been under-researched. This research gap may be due in part to a paucity of comprehensive, temporally stable and brief measures of distress tolerance that have been validated within Military populations, which may hinder further examination and refinement of the construct. Addressing this problem, the current study evaluates the psychometric properties of a novel and brief measure of emotional and physical distress tolerance in a sample of United States post-9/11 Veterans. Participants were 307 Veterans (Mage = 38.9, 67.7% male) who completed the 10-item Distress Tolerance Inventory at baseline and annual follow-up. Exploratory structural equation modeling was used to examine the optimal latent factor structure and longitudinal invariance of the DTI measurement model, along with correlational analyses to examine the convergent properties of the DTI subscales. The DTI reflected a longitudinally invariant two-factor structure (emotional and physical distress tolerance), with excellent internal consistency and preliminary evidence of convergent validity. Thus, the DTI represents a brief, reliable and temporally stable measure of physical and emotional distress tolerance.

A network conceptualization of the multiple facets of distress tolerance

ABSTRACTBackground and Objectives: Using a network analysis (NA) approach, the current study examined the relations among different facets of Distress Tolerance (DT). The NA approach quantifies and displays relations among variables in a visual network consisting of nodes (symptoms) and edges (partial correlations between symptoms). Design: An exploratory NA approach evaluated how manifestations of DT uniquely and systematically relate to one another. Methods: Undergraduate students (N = 288) completed 10 commonly used measures of DT including cognitive, behavioral, and self-report measures. Results: Results indicated all relations in the network were positive apart from social sensitivity and suppression. Further, individual DT facets did not form distinct community structures (nodes that cluster together and thus have stronger relations with each other than other nodes in the network). Conclusions: The lack of community structures suggests that DT is a general ability to tolerate distress that is comprised of many different facets rather than the idea that DT is hierarchical and comprised of distinct domains; a current debate within the literature. The self-reported ability to tolerate life demands and tasks was the most influential facet in the overall network suggesting the Frustration Discomfort Scale may be the best global measure of DT.

Distress tolerance trajectories following substance use treatment.

Distress tolerance (DT), the ability to withstand aversive internal states, represents an important risk factor for substance use relapse and a potential treatment target. Neurobiological research in substance using populations suggests that continued substance use could erode DT, whereas abstinence could bolster it. The current study characterized trajectories of behavioral and self-reported indices of DT and examined the prospective effect of substance use on DT trajectories among those seeking treatment for substance use. Individuals (N = 263, Mage = 42.68, SD = 11.8, 70.7% male, 94.7% African American) in residential substance use treatment completed subjective (Distress Tolerance Scale) and behavioral (Mirror Tracing Persistence Task-computerized version) DT measures, as well as report of daily substance use (timeline follow-back) over 5 assessment time-points from pretreatment to 12 months posttreatment. Latent curve modeling estimated DT trajectories and their associations with substance use behavior, including abstinence duration (days until first use) and substance use frequency (percentage of substance use days between assessments). Self-reported and behavioral DT indicators both exhibited positive, nonlinear change over time (standardized slope parameter estimates: Distress Tolerance Scale β = 0.61, p < .01; Mirror Tracing Persistence Task β = 0.34, p < .01). Abstinence duration was associated with greater improvement in behavioral (β = .20, p = .03) DT specifically. Frequency of use was statistically significantly associated with attenuated behavioral DT at 6-month (β = -.12, p = .03) and 12-month follow-ups (β = -.08, p = .045). DT appears to improve appreciably posttreatment, and return to substance use may shape the degree of this improvement. Collectively, these findings support the conceptualization of DT as a malleable treatment target and emphasize the benefit of abstinence on improvement in DT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).