(PS3-A5) Correspondence Between Retrospective and Momentary Reports of Distress Tolerance in Adults with Recurrent Self-harm

Difficulties with distress tolerance (DT), or one’s willingness to experience  internal discomfort (e.g., negative emotion, pain, traumatic memories), has been linked to various forms of psychopathology (e.g., harmful substance use, depression, suicidality). The majority of literature examining DT relies on retrospective self-report measures, often administered in relatively neutral laboratory settings. Ecological momentary assessment (EMA) may offer a more accurate, ecologically valid assessment method for DT, given that people are reporting on DT levels in the flow of daily life. Given the difference in data-collection settings, we expect that DT reports from standard/retrospective versus EMA measurements will not be perfectly aligned.  Further, we examine typical levels of negative affect during the EMA period as a moderator of this alignment.

The sample consisted of 61 adults from the Bronx, NY (56% female, 85% people of color, Mage= 36.2 years) who endorsed past-month non-suicidal self-injury or suicidality. Each participant reported on global/lifetime DT at baseline and momentary DT, negative affect, and interpersonal stress 4x/day over a 10-day EMA period.

We computed the between-person correlation between global DT and the aggregate of momentary DT reports. We then examined what aggregated momentary affect and interpersonal stress moderated this association.  

Overall, there was a moderate, positive correlation between global/baseline distress tolerance and the aggregate of momentary DT scores (r = .35, p< .01). Moderation analysis showed that people who experienced above-(sample-)average negative affect during the overall EMA period had a stronger correspondence between global and (aggregated) momentary DT levels (r = .47), whereas those below average on negative affect had virtually no correspondence between global and momentary ratings (r = .00). 

Baseline DT scores were positively associated with moment-to-moment DT scores, but only moderately so. This suggests that retrospective self-reports of trait-level DT offer a somewhat, but not perfectly, accurate window into how people tend to rate their DT in the flow of daily life. The moderation finding (i.e., significant correlation between baseline and momentary DT scores in conditions of high, but not low, negative affect and interpersonal stress), suggests that individuals asked to provide a global self-report of their DT skills tend to base their responses on how well they tolerate distress during high-intensity rather than low-intensity emotions. Given the reliance on self-report measures of global DT in cross-sectional studies, these results are crucial to interpreting the research literature on DT and its associations with clinically relevant phenomena.