Short CommunicationTesting an affective judgment model of distress tolerance in college heavy drinkers
Introduction
Distress tolerance (DT) is the perceived and/or actual capacity to withstand aversive experiential states (Brown et al., 2005, Simons and Gaher, 2005). DT has been considered to be a crucial factor that contributes to the manifestation, maintenance, and relapse of alcohol abuse (Buckner et al., 2007, Dennhardt and Murphy, 2011, Gorka et al., 2012, Howell et al., 2010). However, it remains unclear what mechanisms underlie the process of withstanding distress among heavy drinkers.
Trafton and Gifford (2011) theorized one promising proposal regarding mechanisms that underlie DT. The researchers asserted that DT could be defined as the capability of not responding to an immediate negative reinforcement (NR) opportunity (i.e., a behavioral option that could relieve distress immediately) during distressful states. According to the researchers' model, people estimate the expected rewards (ER) to be gained by not responding to a NR opportunity, and they estimate the expected punishments (EP) to be provided by responding to the opportunity while experiencing distress. People's decisions to withstand distress may be influenced by the results of the estimation.
One possible means to assess the ER/EP of an option is by measuring the affects linked to the option. Slovic and his colleagues suggested that affects linked to certain options could be used as a heuristic attribute when people estimate the ER/EP of the options (Slovic, Finucane, Peters, & MacGregor, 2007). Similarly, Damasio (1994) asserted that learning leads certain images to become marked by positive and negative affects, and those affects could be used to predict the future outcomes of taking certain options. Thus, it is reasonable to assume that the ER of taking withstanding options (WO; not responding to a NR opportunity) and the EP of taking avoidance options (AO; responding to a NR opportunity) could be assessed by positive affects linked to WO and negative affects linked to AO. People may use these affects as heuristic attributes when deciding whether to withstand distress.
To examine the relation between affects linked to AO/WO and DT in a more detailed manner, we differentiated the types of AO/WO and DT. There are at least two types of distressful situations. The first type can be described as occurring when a person performs a distressful task; in this case, the AO would be to stop performing the task (Quitting). Most behavioral measures of DT assess this type of AO (Seo & Kwon, 2014). In this type of situation, the WO would be to continue performing the task (WO-Persevering), and the relevant DT would be the capacity to persevere with the task (DT-Persevering Capacity). The second type can be described as when a person is distressed by certain negative events but is not performing any specific tasks. In this situation, a person would relieve distress by performing specific activities (Relieving); for heavy drinkers, one of the most salient relieving behaviors would be to drink alcohol (Carpenter and Hasin, 1999, Conger, 1956, Stockwell et al., 1982). This type of AO could be assessed by the willingness to perform specific relieving behaviors. In this type of situation, the WO would be to endure without relieving distress (WO-Enduring), and the relevant DT would be the capacity to endure ongoing distress (DT-Enduring Capacity).
Our objective was to test the affective judgment model of DT in heavy drinkers. First, we examined whether affects linked to AO-Quitting/WO-Persevering predicted DT-Persevering Capacity using a behavioral measure of DT. Second, we examined whether affective associations of AO-Relieving/WO-Enduring explained DT-Enduring Capacity using a self-report measure that assesses the willingness to drink.
Section snippets
Participants
To recruit participants, we used advertisements in an online research participation system for undergraduates enrolled in psychology classes at a national university in Korea. The minimum drinking level to be included in the study was 12 standard drinks per week for women and 15 for men (Wiers & Kummeling, 2004). A typical standard drink contains 10 g of pure ethanol (Miller, Heather, & Hall, 1991). Forty heavy drinkers (17 women and 23 men) were recruited (alcohol use M = 25.52 standard drinks
Results
Consistent with the assumption, participants showed increased levels of negative affects after the Distress Tolerance Test, as indicated by the pre and post Positive and Negative Affect Schedule-Negative Affect scores [t(39) = 4.13, p < .001]. The descriptive statistics and inter-correlations are presented in Table 1. The Distress Tolerance Test and Willingness to Drink scale scores were significantly related to the Distress Intolerance Index scores, which suggest that the two measures have fine
Discussion
This study examined the relation between affects linked to AO/WO and DT. The results showed that the affects linked to AO-Quitting/WO-Persevering are related to the DT-Persevering Capacity, and the affects linked to AO-Relieving/WO-Enduring are closely associated with the DT-Enduring Capacity. The results also revealed that the affects linked to AO-Relieving/WO-Enduring in distressful situations (post-Distress Tolerance Test), but not in neutral situations (pre-Distress Tolerance Test), could
Role of funding sources
The study was not financially supported by a sponsor.
Contributors
JWS and SMK designed the study and wrote the protocol. JWS conducted literature searches and statistical analyses. JWS and SMK wrote the manuscript.
Conflict of interest
All authors declare that they have no conflicts of interest.
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