Evaluating competing models of distress tolerance via structural equation modeling

Area of Science:

• Psychology
• Clinical Psychology
• Psychopathology

Background:

• Distress Tolerance (DT) is a key factor in internalizing (INT) disorders.
• The lower-order dimensions of DT, such as negative emotion tolerance, are debated.
• The inclusion of intolerance of uncertainty (IU) and anxiety sensitivity (AS) in DT models is contested.

Purpose of the Study:

• To compare the two leading hierarchical models of DT.
• To propose and test a novel "combined" DT model incorporating IU and AS as lower-order dimensions.
• To evaluate the fit of competing DT models in a clinical sample.

Main Methods:

• Structural equation modeling was used to construct latent models.
• A clinical sample (N=278) completed self-report measures of DT dimensions.
• Competing hierarchical DT models, including a novel combined model, were evaluated.

Main Results:

• The proposed "combined" model, including IU and AS, demonstrated superior fit indices for INT disorders.
• Regression analysis showed the combined DT model retained moderate association with INT even after accounting for shared variance with the Distress Intolerance Index (DII).
• The findings suggest the DII may not fully capture the latent structure of DT.

Conclusions:

• A DT model incorporating intolerance of uncertainty and anxiety sensitivity as lower-order dimensions provides a better fit for internalizing disorders.
• This combined model explains unique variance in internalizing disorders not captured by the Distress Intolerance Index.
• Future research should explore the clinical implications of this refined DT model for internalizing spectrum disorders.