A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood

Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.     

Examination of the Relationship Between PTSD and Distress Tolerance in a Sample of Male Veterans With Comorbid Substance Use Disorders

Distress tolerance (DT), the perceived or actual ability to tolerate negative emotional or physical states, is inversely related to posttraumatic stress disorder (PTSD) symptoms in civilian, community samples. No studies to date have examined the relationship between DT and PTSD in clinical samples of veterans with a comorbid diagnosis of PTSD and a substance use disorder (SUD). Thus, the present study examined the relationship between DT and PTSD in a sample of predominately African American, male veterans (n = 75) diagnosed with comorbid PTSD and SUD (according to a structured clinical interview). Results of hierarchical linear regression models indicated that DT was inversely related to total PTSD symptom severity score, above and beyond depressive symptoms and SUD severity. Of the 4 symptom clusters, DT was inversely associated with intrusions and hyperarousal. These findings are discussed in light of previous work with civilian samples. Determining whether treatment incorporating DT skills would be useful for veterans undergoing PTSD treatment should be evaluated.     

Single-session anxiety sensitivity reduction program for trauma-exposed adults: a case series documenting feasibility and initial efficacy

The present case series examined a single-session, cognitive-behavioral anxiety sensitivity (AS) reduction program among five trauma-exposed adults. Participants (age range=19-37 years) reported significantly elevated levels of AS at baseline, a history of posttraumatic stress disorder Criterion A trauma exposure, and no current Axis I psychopathology. The outcomes of the preventive intervention were examined with regard to 3-month postintervention changes in AS, posttraumatic stress, panic attack frequency and severity, negative affect levels, and behavioral functioning and impairment. Results demonstrated decreases in each of the studied outcomes over the examined time period. This preliminary yet uncontrolled data provides empirical evidence of the feasibility and support for the utilization of a brief AS reduction intervention program to target anxiety-related vulnerability among trauma-exposed adults.     

Main and Interactive Effects of Distress Tolerance and Negative Affect Intensity in Relation to PTSD Symptoms among Trauma-Exposed Adults

The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; M _age?=?25.3 years, SD?=?11.4) recruited from the community. Distress tolerance (i.e., perceived ability to withstand distressing emotional states) demonstrated significant incremental associations with global PTSD symptom severity as well as Re-Experiencing, Emotional Numbing, and Hyperarousal symptom cluster severity. Negative affect intensity (i.e., perceived intensity of negative emotional responses) demonstrated significant incremental associations with each of the PTSD symptom outcomes. Moreover, the incremental interactive effect of distress tolerance and negative affect intensity was significantly associated with PTSD symptom severity as well as PTSD—Emotional Numbing symptom cluster severity. These incremental effects were evident after accounting for the variance explained by anxiety sensitivity (i.e., fear of anxiety-related sensations). Post hoc probing analyses supported the moderating role of negative affect intensity in the association between distress tolerance and PTSD symptom severity, such that low levels of distress tolerance, in the context of elevated levels of negative affect intensity, were associated with the greatest levels of PTSD symptoms.     

Anxiety sensitivity and distress tolerance typologies and relations to posttraumatic stress disorder: A cluster analytic approach

A growing literature suggests a relationship between a high anxiety sensitivity (AS; the fear of anxiety and its related consequences)/low distress tolerance (DT; the capacity tolerate internal negative states) profile and posttraumatic stress disorder (PTSD) symptoms. However, specific profiles have not been identified or examined specifically in Veteran samples. Thus, the aims of the present study were to establish empirically derived profiles created from response patterns on the Anxiety Sensitivity Index and Distress Tolerance Scale and to examine associations with PTSD symptom clusters among a sample of combat-exposed Veterans (N = 250). A cluster analytic approach was used to identify AS/DT profiles, and a series of multivariate analyses of variance with post hoc analyses was conducted to examine the relationship between each AS/DT profile and each PTSD symptom cluster. Results indicated a 3-cluster solution including a high AS/low DT “at risk” profile, a low AS/high DT “resilient” profile, and an average AS/DT “intermediate” profile. The at-risk profile was associated with significantly greater symptoms in each PTSD cluster (i.e., hyperarousal, avoidance, re-experiencing) when compared to the other two profiles. The at-risk profile was also associated with greater depressive symptoms and lower self-reported resilience. These findings extend the previous literature by identifying a high AS/low DT “at risk” profile and its associations with PTSD symptoms, underscoring the potential utility in targeting these affect-regulation constructs for clinical intervention.     

Examination of the Association Among Personality Traits,Anxiety Sensitivity,and Cannabis Use Motives in a Community Sample

Personality factors, such as neuroticism, are important for understanding motives for cannabis use; however, few studies have examined the role of neuroticism in the context of other personality factors, or possible mechanisms accounting for an association between neuroticism and motives for use. The present study examined concurrent associations between personality traits (i.e., conscientiousness, extraversion, agreeableness, and neuroticism) and cannabis use motives, and the role of anxiety sensitivity (AS) in the association between neuroticism and coping cannabis use motives. Seventy young adults endorsing past-month cannabis use (58.6 % female, M _age = 20.91) completed self-report measures. Linear regressions were conducted to examine the concurrent associations between personality factors and cannabis use motives. Higher levels of neuroticism, but no other personality traits, were significantly associated with greater coping (β = 45, p < .01) and expansion (β = 0.29, p = <.05) motives. Bootstrap analysis (10,000 re-samples) revealed that a significant portion of the relationship between neuroticism and coping motives was explained by AS (point estimate = 0.029, PB 95 % CI: 0.0089 to 0.0615). Greater neuroticism may result in heightened sensitivity to arousal, which may then increase motivation to use cannabis to alleviate such arousal.     

Investigating Relationships Among Distress Tolerance,PTSD Symptom Severity,and Alcohol Use

Journal of Psychopathology and Behavioral Assessment - Exposure to trauma (particularly interpersonal trauma), post-traumatic stress disorder (PTSD) symptoms, and low distress tolerance (DT; the...     

Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M _age  = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p < .001), generalized anxiety disorder (OR = .65, p < .001), social anxiety disorder (OR = .74, p < .001), panic disorder (OR = .65, p <. 001), and alcohol dependence (OR = .85, p < .001). Discrepancy between expected and observed PTSD symptom severity based on IP trauma load may represent a useful, quantitative measure of resilience.     

Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population

Individual differences in cognitive processes and coping behaviors play a role in the development and maintenance of posttraumatic stress disorder (PTSD). Given the large numbers of combat-exposed service members returning from the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) conflicts, exploring individual differences in cognitive-affective processes is important for informing our understanding of PTSD etiology and early intervention in military samples. The present study examined the unique main and interactive effects of negative posttrauma cognitions (i.e., negative beliefs about self [NS], the world [NW], and self-blame [SB]) and coping strategies (i.e., positive behavioral, positive cognitive, avoidant coping, and social and emotional coping) on PTSD diagnosis within 155 (M_age = 30.7, SD = 4.48) OEF/OIF/OND combat trauma-exposed Veterans recruited from an ongoing study examining the effects of combat trauma and stress reactivity. In the final, stepwise logistic regression analysis, avoidant coping, but no other coping strategy, was significantly positively related to PTSD diagnosis in the initial step. Higher levels of NS, but not NW, were significantly associated with having a PTSD diagnosis, whereas SB was associated with decreased likelihood of PTSD, above and beyond coping strategies. A significant interaction effect was found between NS and positive cognitive coping, such that greater positive cognitive coping weakened the relationship between NS and PTSD. Examining and addressing coping behaviors and negative thoughts of self jointly may benefit assessment and intervention approaches in a combat-trauma population.     

Exploration of a factor mixture-based taxonic-dimensional model of anxiety sensitivity and transdiagnostic psychopathology vulnerability among trauma-exposed adults

The aim of this study was to evaluate the associations between a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) and posttraumatic stress, panic, generalized anxiety, depression, psychiatric multimorbidity, and quality of life among a young adult sample exposed to traumatic stress (N = 103, n (females) = 66, M (age) = 23.68 years, SD (age) = 9.55). Findings showed support for the conceptual and operational utility of the AS taxonic-dimensional model with respect to concurrent transdiagnostic vulnerability among trauma-exposed adults. Specifically, relative to the low-AS group, the high-AS group demonstrated elevated levels of panic, depressive, and posttraumatic stress symptom severity as well as greater psychiatric multimorbidity and poorer quality of life. Furthermore, past-month MDD, GAD, PTSD, and panic attacks occurred nearly exclusively among the high-AS group. Continuous AS physical and psychological concerns scores were found to be significantly related to levels of panic and posttraumatic stress symptom severity, psychiatric multimorbidity as well as panic attack status only among the high-AS group and not among the low-AS group. Findings are discussed with respect to their implications for the conceptual and operational utility of the FMM-based taxonic-dimensional model of AS, related vulnerability for psychopathology in the context of trauma, and the clinical implications of these findings for assessment and intervention.