(PS2-A25) Does Distress Tolerance Moderate the Relationship Between Life Events and Anxiety Symptoms?

Background: Distress tolerance (DT) is the ability to manage stressful life events through emotion regulation and self-soothing. DT predicts risk for anxiety disorders, and worse DT is negatively associated with anxiety symptoms. Stressful life events have also been shown to be a predictor of higher levels of anxiety. DT may mitigate anxiety symptoms in the face of stressful life events, as it enhances ability to self-regulate and cope with feelings of discomfort. This analysis investigated if DT mediates the relationship between past year stressful life events and anxiety severity in individuals with anxiety disorders. We predicted that those with better DT would be better able to cope with stressful life events, resulting in lower levels of anxiety.

Methods: 261 individuals with a primary anxiety disorder diagnosis (61.7% female, 33% male, 5.4% missing; Mean (SD) age= 27.98(10.38)) of generalized anxiety disorder (n=118), social anxiety disorder (n=130), or panic disorder (n=13), as determined by structured diagnostic interviews completed the Distress Tolerance Scale (DTS), Life Events Scale (LES), and Beck Anxiety Inventory (BAI). DTS assesses ability to tolerate emotional distress; higher scores indicate better DT. LES is a self-report about the occurrence of 12 potentially stressful life events over the past year (e.g., ‘Did a pet die?’, ‘Did your spouse or partner have a serious illness?’). Scoring was total number of life events. The BAI is a 21-item self-report of anxiety severity. Only participants who completed all three measures were included in analyses. A mediation analysis was conducted through four separate regressions to examine the mediation pathways with LES as predictor, BAI as outcome, and DTS as mediator.

Results: Linear regression analyses showed that LES was positively associated with BAI (b=1.06, SE=.31, p< .001), but LES was not significantly associated with DTS (b=-.03, SE=.03, p=.22). DTS was negatively associated with BAI (b=-4.61, SE=.65, p< .001). A linear regression of LES and DTS as predictors BAI showed LES was positively associated with BAI (b=.91, SE=.26, p=.002) and DTS was negatively associated with BAI (b=-4.45, SE=.64, p< .001).

Conclusions: These results suggest that both DT and a greater number of stressful life events individually predict higher anxiety symptoms. Therefore, treatment targeted at increasing DT may result in symptom reduction in a clinically anxious population irrelevant of how many stressful life events a person has experienced. In this sample, the level of DT was not associated with number of life events. A limitation to this study was non-equivalent levels of event severity and non-specificity of event items. The three most endorsed LES items were major problems with money (47.1%), death or illness of a close friend or family member (33.3%), and death of a pet (28%); no one endorsed death of a spouse/partner. Additionally, this study was limited by its cross-sectional nature. Future studies should examine DTS and LES longitudinally, and should investigate if varying levels of DT impact response to a range of life events.