1 - (SYM 4) Effects of Mindfulness Training on Distress Tolerance in At-risk Youth

Background: Distress tolerance (DT) refers to the perceived capacity to withstand negative emotional or other aversive states. Low levels of DT may contribute to the onset and maintenance of anxiety-related psychopathology. Mindfulness practice may enhance DT by promoting exposure to internal experiences, particularly unpleasant ones. Little research has examined whether DT changes over the course of mindfulness training and, if so, whether these changes are related to time spent practicing mindfulness—i.e., dose response.

Method: Youth were screened for scoring high on trait negative affectivity, and thus being at risk for internalizing disorders, but did not currently meet criteria for a clinically significant internalizing disorder. Participants were recruited from the Los Angeles, CA., Chicago, IL., and Nashville, TN geographic areas. Participants (n = 102; mean age = 14.8, SD = 1.7, 72% female, 42% non-Hispanic white) were randomly assigned to either a 9-week, app-based mindfulness program or a no-intervention control. Participants completed the Distress Tolerance Scale (DTS) at baseline (T1) and following the 9-week program (T2); control participants completed the DTS on a similar timeline.

Results: Both the mindfulness (t(35) = -3.35, p = .002) and control groups (t(38) = -3.83, p = .0005) increased in DT over the 9-week interval with no group differences at either T1 or T2. Baseline DT significantly predicted DT scores at T2 (b = .37, p = .02). The effect of condition (b = -1.02, p = .12) and the interaction between baseline DT and condition (b = .32, p = .11) were not significant. When mindfulness group participants were divided into those who did or did not increase in DT, results showed that those who increased in DT recorded significantly more time using the guided mindfulness practices as compared to those who did not increase in DT (t(36.79) = 4.3, p < .001; d = 1.01). The correlation between total mindfulness practice time and change in DT was not significant, however (r = .26, p = .13).

Conclusions: Whereas an increase in DT over the course of the mindfulness intervention is consistent with our hypothesis, the fact that those in the control condition also showed this effect casts doubt on mindfulness playing a key role in this change. Those who increased in DT spent significantly more time practicing mindfulness than those who did not increase in DT. The relatively low sample size might have reduced the power to detect significant effects of the mindfulness intervention.