Elsevier

Behavior Therapy

Volume 40, Issue 3, September 2009, Pages 291-301
Behavior Therapy

Integrating Anxiety Sensitivity, Distress Tolerance, and Discomfort Intolerance: A Hierarchical Model of Affect Sensitivity and Tolerance

https://doi.org/10.1016/j.beth.2008.08.001Get rights and content

Abstract

The purpose of the present investigation was to concurrently examine the latent dimensional and hierarchical structure of anxiety sensitivity (AS) and two key theoretically relevant and related affect (in)tolerance and sensitivity constructs: distress tolerance and discomfort intolerance. These constructs were measured using the Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986), the Distress Tolerance Scale (Simons & Gaher, 2005), and the Discomfort Intolerance Scale (Schmidt, Richey, & Fitzpatrick, 2006). A total of 229 individuals (124 females; Mage = 21.0 years, SD = 7.5) without current Axis I psychopathology participated by completing a battery of self-report questionnaires. A two-stage exploratory factor analysis was conducted to examine the lower- and higher-order latent structural relations among the variables. The factor solution was subsequently evaluated in relation to negative affectivity, anxious arousal, and anhedonic depression. AS and distress tolerance appeared to be related to one another as distinct lower-order facets of a common higher-order affect tolerance and sensitivity factor, whereas discomfort intolerance did not appear to demonstrate similar relations with either AS or distress tolerance at the lower-order or higher-order levels. A unique pattern of association with theoretically-relevant criterion variables was observed between the affect tolerance and sensitivity higher-order factor, the AS and distress tolerance lower-order factors, and the discomfort intolerance factor. Findings are discussed in the context of theoretical and clinical implications and future directions for the study of affect tolerance and sensitivity in relation to emotional vulnerability.

Section snippets

Participants

A total of 229 participants (124 females; Mage = 21.0 years, SD = 7.5) were recruited via announcements in university classes, flyers placed in public spaces throughout the greater Burlington, VT community, and advertisements in local newspapers. Advertisements focused on recruitment for a laboratory study on emotion for monetary reward (see Procedure section for details). The racial distribution of the sample generally reflected that of the Vermont population (State of Vermont Department of

Factor Analyses

First, a PAF with an oblique rotation was conducted to identify the latent factor structure of the ASI, DTS, and DIS items that were combined into a single item-pool. An oblique rotation was used in line with first-order EFA guidelines for the study of theoretically related, and potentially covarying, variables (Gorsuch, 1983). Extraction of three factors was indicated by visual inspection of the Scree Plot (Cattell, 1966). PAF pattern matrices (loadings) and communalities of the 3-factor

Discussion

AS is an important explanatory factor for disorders of emotion by promoting amplified affective reactions and avoidance-oriented coping with aversive stimuli (see Bernstein and Zvolensky, 2007, Taylor, 1999, McNally, 2002, for reviews). In addition, distress intolerance and discomfort intolerance may reflect psychological constructs that also serve to amplify emotional reactions and escape and avoidance behavior to emotional and somatic cues (Schmidt et al., 2007, Simons and Gaher, 2005).

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