1st Edition

Distress Tolerance Theory, Research, and Clinical Applications

    This state-of-the-art volume synthesizes the growing body of knowledge on the role of distress tolerance—the ability to withstand aversive internal states such as negative emotions and uncomfortable bodily sensations—in psychopathology. Prominent contributors describe how the construct has been conceptualized and measured and examine its links to a range of specific psychological disorders. Exemplary treatment approaches that target distress tolerance are reviewed. Featuring compelling clinical illustrations, the book highlights implications of the research for better understanding how psychological problems develop and how to assess and treat them effectively.

    I. Theory, Assessment, and Conceptualization
    1. Historical Perspectives, Theory, and Measurement of Distress Tolerance, Michael J. Zvolensky, Teresa M. Leyro, Amit Bernstein, and Anka A. Vujanovic
    2. Anxiety Sensitivity as a Specific Form of Distress Tolerance in Youth: Developmental Assessment, Origins, and Applications, Carl F. Weems
    3. Distress Overtolerance and Distress Intolerance: A Behavioral Perspective, Thomas R. Lynch and Guy A. Mizon
    4. Biological Bases of Distress Tolerance, Jodie A. Trafton and Elizabeth V. Gifford
    II. Distress Tolerance and Psychopathology: Empirical and Clinical Approaches
    5. Anxiety and Its Disorders, Norman B. Schmidt, Melissa Mitchell, Meghan Keough, and Christina Riccardi
    6. Traumatic Stress, Anka A. Vujanovic, Amit Bernstein, and Brett T. Litz
    7. Major Depressive Disorder, Shauna L. Clen, Douglas S. Mennin, and David M. Fresco
    8. Substance Use Disorders, Jessica M. Richards, Stacey B. Daughters, Marina A. Bornovalova, Richard A. Brown, and Carl W. Lejuez
    9. Borderline Personality Disorder, Kim L. Gratz and Matthew T. Tull
    10. Chronic Musculoskeletal Pain and Related Health Conditions, Gordon J. G. Asmundson, Daniel L. Peluso, R. Nicholas Carleton, Kelsey C. Collimore, and Patrick G. Welch
    11. Eating Disorders, Michael D. Anestis, Erin L. Fink, April R. Smith, Edward A. Selby, and Thomas E. Joiner
    III. Future Directions
    12. Research Synthesis and Future Directions, Amit Bernstein, Anka A. Vujanovic, Teresa M. Leyro, and Michael J. Zvolensky

    Biography

    Michael J. Zvolensky, PhD, is Richard and Pamela Ader Green and Gold Distinguished Professor in the Department of Psychology and Director of the Anxiety and Health Research Laboratory at the University of Vermont. His research program cuts across basic and applied work in the area of anxiety disorders. Specifically, his work is focused principally on examining vulnerability processes involved with the onset and maintenance of these disorders. Dr. Zvolensky has been especially involved in better understanding the role of cigarette smoking in terms of the etiology and maintenance of panic psychopathology and, at the same time, the role that panic vulnerability factors may play in smoking cessation.
    Amit Bernstein, PhD, is Senior Lecturer and Yigal Alon Fellow in the Department of Psychology and Director of the International Research Collaborative on Anxiety Laboratory at the University of Haifa, Israel. Previously, he was a postdoctoral fellow at the Center for Health Care Evaluation at the VA Palo Alto Health Care System and the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. Dr. Bernstein’s research is focused on specific and transdiagnostic vulnerability and resilience processes underlying anxiety and related disorders, such as addiction.
    Anka A. Vujanovic, PhD, is Staff Research Psychologist at the National Center for PTSD--Behavioral Science Division, VA Boston Healthcare System, and Assistant Professor in the Division of Psychiatry, Boston University School of Medicine. Dr. Vujanovic's research program focuses on cognitive-affective and behavioral risk and maintenance factors related to posttraumatic stress disorder and co-occurring posttraumatic stress and substance use disorders.

    With the prominence of distress tolerance in so many problems, including anxiety, traumatic stress, depression, substance use disorders, and personality disorders, this book fills a vacuum in the literature. It brings together new insights regarding the onset and maintenance of psychopathology and presents direct implications for prevention and treatment. The volume contains a wealth of useful information, including measures of distress tolerance, tables summarizing the literature in each area, developmental and theoretical perspectives, biological underpinnings, and applications to specific disorders. Every clinician and clinical researcher would profit from reading this book, and it is a 'must read' for clinicians-in-training. This book will change how you think about the patients you treat--appropriate distress tolerance is at the center of what we do as clinicians.--Barbara O. Rothbaum, PhD, ABPP, Director, Trauma and Anxiety Recovery Program, Emory University School of Medicine 
     
    The first volume of its kind. The contributors are experts in their respective areas who provide valuable information on the nature and clinical relevance of distress tolerance. Illuminating the broad impact that distress tolerance and its associated features have on the development, maintenance, and treatment of psychological disorders, this text would be a welcome addition to the reading list of an advanced psychopathology course.--Shireen L. Rizvi, PhD, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey

    Given the growing interest in and widespread applicability of distress tolerance, the field has desperately needed a book like this one. A major strength of this book is its careful, theoretically coherent approach to defining the construct under discussion. Chapters address what distress tolerance is, what it is not, and how it relates to similar constructs, along with implications for assessment and treatment of a variety of clinical problems. The editors do an excellent job of synthesizing all of this material and highlighting innovative directions for future research and treatment. This book would greatly enhance graduate-level courses in psychological intervention. It is essential reading for clinicians who want to approach emotions, distress, and distress tolerance with their clients in a theoretically and empirically grounded manner, as well as for researchers.--Alexander L. Chapman, PhD, Department of Psychology, Simon Fraser University, Canada

    This important volume cogently describes the role of distress tolerance in psychological adaptation. It shows how learning to tolerate the distress associated with emotional learning is a hallmark of most empirically validated treatments. The editors and authors make a compelling case for this construct's pivotal role in psychopathology and in treatment research.--Zindel V. Segal, PhD, Cameron Wilson Chair in Depression Studies, University of Toronto, Canada
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    This book is both timely and important....This book represents a thoughtful, well-written review of the literature on distress tolerance and related constructs, including the theories of the role of distress tolerance in psychological disorders and treatment, research testing these theories, and clinical implications of this work....A well-organized, comprehensive review of the current literature on distress tolerance. It will be an invaluable tool for researchers, clinicians, and students interested in the relations of emotional regulation broadly and distress tolerance specifically to psychopathology.
    --Cognitive Behaviour Therapy, 11/18/2010ƒƒThis book offers an excellent opportunity to understand the historical perspectives and understanding of the role of distress tolerance and its relationship to key psychopathological emancipations such as anxiety disorders, traumatic stress, major depressive disorders, substance use disorders, borderline personality disorder, chronic muscular skeletal pain, and related health conditions, as well as eating disorders. Finally, it also offers some interesting clinical and research models for future exploration. I very much enjoyed reading this book and strongly recommend it to educators, clinicians, and investigators--The Journal of Nervous and Mental Disease, 10/16/2013