The authors declare that they have no conflict of interest. Clipboard, Search History, and several other advanced features are temporarily unavailable. The aim of the present study was to evaluate the psychometric properties of the SE-DT, assessing a persons perceived ability to handle distress caused by emotional crises. Become a volunteer, make a tax-deductible donation, or participate in a fundraising event to help us save lives. Therefore, the present study investigated concurrent relations among multiple measures of distress tolerance, as well as the relations between these measures and PTSD symptom severity, within a trauma-exposed community sample. A model demonstrated acceptable fit if it met the following criteria: Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) values between 0.90 (adequate) and 0.95 (good) or higher, and a Standardized Root Mean Square Residual (SRMR) and Root Mean Square Error of Approximation (RMSEA) values close to or below 0.08 (Brown, 2015). It may be the case that physical distress tolerance is related to PTSD symptom severity in a clinically significant way, such that individuals experiencing heightened physiological arousal, who evidence lower perceived or actual physical distress tolerance, experience or perceive such arousal as more intense and disabling. 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. Participants in the NC sample were asked to complete a set of 19 self-report instruments, including the SE-DT, and 45 participants repeated the assessment after 2 weeks. Method: One hundred and sixty seven university students (male=66, female=101) participated in . The Borderline Symptom List short version (BSL-23) is a self-report questionnaire targeting experiences and emotions that are typical of BPD patients [10]. The interactive role of distress tolerance and borderline personality disorder in suicide attempts among substance users in residential treatment. The dialectical behavior therapy ways of coping checklist: development and psychometric properties. The following information was supplied relating to ethical approvals (i.e., approving body and any reference numbers): The Curtin University Human Research Ethics Committee granted ethical approval for the study (HRE2018-0536). 1977;35(3):125. Erin C. Marshall-Berenz, Department of Psychology, University of Vermont. A total of 30 patients at the general psychiatric outpatient clinic, of whom 26 (87%) were female and 4 (13%) were male, chose to participate, signed an informed consent form, and completed the instruments in a baseline assessment. . Items are rated on a 5-point Likert scale (1: strongly agree; 5: strongly disagree), with higher scores reflecting higher levels of distress tolerance. Eligible participants completed a battery of self-report measures, as well as the Mirror Tracing and Breath-Holding Tasks. CAS Bartlett MS. Tests of significance in factor analysis. The low levels of PTSD symptom severity observed in the current sample may have been influenced partly by the exclusion of individuals with panic disorder as well as the exclusion of individuals taking psychotropic medications. In the current study, the alpha value of the HSCL-25 was .95. 2009;42(1):32-39. Extrapolating from such research, it is possible that perceived and actual distress tolerance may similarily maintain unique relations with one another and to the expression of PTSD symptom severity among traumatized persons. Validity. Tax ID Number: 13-1788491. J Personal Disord. If it appeared to assess something more abstract or obscure in comparison to the other items this may explain differences in interpretation however this does not appear to be the case. 2012;53(8):120816. Non-suicidal self-injury (NSSI) is the intentional damage to ones body tissue in the absence of suicidal intent, for reasons not socially or culturally sanctioned (International Society for the Study of Self-Injury, 2018). However, these questionnaires assess self-perceived problems, rather than the use of effective DBT skills. The ePub format is best viewed in the iBooks reader. There were no missing data in the current study. 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. The study was approved by the Regional Ethics Committee in Uppsala (Ref. Assessment of mindfulness: review on state of the art. The current study data were collected as part of a larger laboratory investigation examining cognitive risk factors among individuals with and without a recent history of nonclinical panic attacks. The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature. The pain scale works like this: You might be asked, How is your pain right now on a scale from 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine? This is a helpful way to measure pain. Weve invested more than $5 billion in cancer research since 1946, all to find more and better treatments, uncover factors that may cause cancer, and improve cancer patients quality of life. The publisher's final edited version of this article is available at. The DERS-16 generates a sum score that ranges from 16 to 80, where a higher score indicates more difficulties in emotion regulation. Neither of these factor structures have been assessed among individuals with a history of self-injury. already built in. First, to test and compare the higher-order model of the Distress Tolerance Scale to the lower-order four factor model to determine the best fitting model among a sample of university students, as well as within subgroups of individuals with and without a history of NSSI. Note: You are now also subscribed to the subject areas of this publication Int J Psychol. Of note, an inability to tolerate distress (thought to underlie NSSI) may limit an individuals 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. You can see and learn more about the Distress Thermometer and Problem List on the National Comprehensive Cancer Network website. Participants who completed a brief or a full-scale skills training group (n=27) reported a significant improvement in SE in regard to DT (t(19)=4.89, p=.001, d=0.82), when comparing the SE-DT scores before (M=16.63, SD=4.28) and after (M=22.52, SD=5.40) treatment. Dahlin C. Anxiety. First, the current sample was demographically homogenous with regard to age and race/ethnicity. You can add specific subject areas through your profile settings. Baer RA, Smith GT, Allen KB. 2022 May;52(3):511-525. In: StatPearls [Internet]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Assessment. 2006;5(1):30737. Despite this improvement, the higher-order model still remained a poor fit among individuals with a history of NSSI (Table 2). Distress tolerance skills refer to a type of intervention in Dialectical Behavioral Therapy (DBT) where clients learn to manage distress in a healthy way. Using multivariate statistics: international edition. Fourth, the lack of a significant effect for the behavioral measures of distress tolerance may be due, in part, to the relatively small sample size in the current investigation. Background: Regardless, whether this item intercept was freed or not, there were still significant mean differences on the appraisal subscale with individuals with a history of NSSI tending to appraise their distress as more unacceptable than individuals with no history of NSSI. Discomfort intolerance: Development of a construct and measure relevant to panic disorder. The factor structure of the SE-DT was investigated through explorative factor analysis using principal component analysis with promax rotation [52]. Participants scored an average of 13.87 (SD = 17.10) on CAPS severity ratings (frequency + intensity), indicating generally low levels of posttraumatic stress (e.g., minimum score of 45 reliably corresponds to PTSD diagnosis; Weathers, Ruscio, & Keane, 1999), with 4.7% (n = 4) meeting criteria for a current (past month) PTSD diagnosis. Replication of the current findings in larger samples is a key step in furthering this line of scientific inquiry, particularly given the effect size detected for breath-holding duration and PTSD symptom severity in the current study. Temperature When we're upset, our bodies often feel hot. Since DBT includes skills training in a group format, it offers an excellent opportunity to improve SE levels. Clin Psychol Rev. BMC Psychol. Of these, 209 were female (66.1%), 239 (75.6%) were born in Australia, and 308 (97.5%) were studying an undergraduate bachelor degree. All items had factor loadings of between .70 and .83 on this single factor. The Distress Tolerance Scale (DTS; Simons & Gaher, 2005) is a 15-item scale that assesses an individual's perceived ability to tolerate, appraise, absorb and regulate their distress.. First, zero-order relations were evaluated among the distress tolerance predictor variables. Given item 7 My feelings of distress or being upset are not acceptable and 11 I am ashamed of myself when I feel distressed or upset were both on the appraisal subscale and had error covariance larger than 0.40, these two items were allowed to correlate. equal factor loadings), scalar (i.e. Further studies are needed to investigate whether these results are valid in other populations. Simons JS, Gaher RM. The analyses showed that the SE-DT is unidimensional with high internal consistency (Cronbach's alpha = .92) and good test-retest reliability (intraclass correlation = .74). Utilizing behavioral measures of distress tolerance for a range of emotions would be an informative next step in this line of work. A chi-square difference test was conducted to statistically compare the two models. Age of onset ranged from 4 to 23 years (M = 13.69, SD = 2.99). The test-retest reliability was ICC=.74. Imagine a world free from cancer. Bernstein A, Zvolensky MJ, Vujanovic AA, Moos R. Integrating anxiety sensitivity, distress tolerance, and discomfort intolerance: A hierarchical model of affect sensitivity and tolerance. The factor loadings (full sample) for both the higher-order and lower-order factor models are illustrated in Figs. A common one used by many cancer care teams is the Distress Thermometer (see example below). Consequently, this may result in inaccurate conclusions regarding the effectiveness of an intervention (Putnick & Bornstein, 2016). Results indicated that configural, metric, scalar, and residual error invariance across gender were all supported, and thus we conclude males and females do not respond differently to items on this scale (see, Structural Equation Modeling: A Multidisciplinary Journal, European Journal of Psychological Assessment, Journal of Psychopathology and Behavioral Assessment, Journal of Personality and Social Psychology, Eating and Weight DisordersStudies on Anorexia, Bulimia and Obesity, International Society for the Study of Self-Injury, Journal of Consulting and Clinical Psychology, International Society for the Study of Self-Injury, 2018, The importance of high distress tolerance in the relationship between nonsuicidal self-injury and suicide potential, Changes in ecological momentary assessment reported affect associated with episodes of nonsuicidal self-injury, The development of the toronto structured interview for alexithymia: item selection, factor structure, reliability and concurrent validity, Nonsuicidal self-injury-related differences in the experience of negative and positive emotion, Five indices of emotion regulation in participants with a history of nonsuicidal self-injury: a daily diary study, Confirmatory factor analysis for applied research, Solving the puzzle of deliberate self-harm: the experiential avoidance model, Sensitivity of goodness of fit indexes to lack of measurement invariance, The cognitive emotion regulation questionnaire: psychometric features and prospective relationships with depression and anxiety in adults, The associations among self-criticism, hopelessness, rumination, and NSSI in adolescents: a moderated mediation model, The moderating role of borderline personality in the relationships between deliberate self-harm and emotion-related factors, Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale, Measurement invariance of two measures of alexithymia in students who do and who do not engage in non-suicidal self-injury and risky drinking, Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being, A cognitive-emotional model of NSSI: using emotion regulation and cognitive processes to explain why people self-injure. 2022 American Cancer Society, Inc. All rights reserved. ITEM CODING The IUS has 27 items- none reversed scored. The short version of the borderline symptom list (BSL-23): development and initial data on psychometric properties. Many studies use the self-report Distress Tolerance Scale to examine group differences in distress tolerance between individuals with and without a history of self-injury (Anestis et al., 2013; Horgan & Martin, 2016; Lin et al., 2018; Slabbert, Hasking & Boyes, 2018). Distress Tolerance Scale (DTS) . The aim of the present study was to develop and evaluate the psychometric properties of a Swedish adaptation of the General Self-Efficacy scale (GSE) for skills use in distress tolerance - the Self-Efficacy in Distress Tolerance scale (SE-DT). Therefore, it is necessary to evaluate the fit of each of these models among individuals with a history of NSSI to further our theoretical understanding of the nature of the relationship between distress tolerance and self-injury, and consequently inform researchers about the optimal way to utilise this scale with samples of individuals with a history of NSSI. 2015;72(5):47582. A mean score of 2.05 (SD=0.90) has been reported among BPD patients and the internal consistency for the instrument is high, with a Cronbachs alpha of .94.97 [10]. Goldin PR, Ziv M, Jazaieri H, Werner K, Kraemer H, Heimberg RG, et al. **. Descriptive statistics disaggregated by history of NSSI. These results support findings suggesting that the distress tolerance construct is likely multifaceted (Bernstein et al., 2009; Schmidt et al., in press), with distinctions between perceived and actual ability to tolerate distress (Bernstein, Vujanovic, Leyro, & Zvolensky, in press). physical discomfort), and the behavioral act of withstanding distressing internal states elicited by some type of stressor." Schmidt NB, Richey JA, Fitzpatrick KK. Partial invariance will be addressed using a sequential backwards approach where items are freed until partial invariance is achieved (Putnick & Bornstein, 2016). The Distress Tolerance Scale (DTS; Simons & Gaher, 2005) is a 15-item measure of levels of distress and readiness to tolerate distress. In: Barlow DH, editor. 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