Original Article

Cognitive Therapy and Research

, Volume 36, Issue 6, pp 593-602

First online:

Evaluating Distress Tolerance Measures: Interrelations and Associations with Impulsive Behaviors

  • Michael D. AnestisAffiliated withFlorida State UniversityUniversity of Mississippi Medical Center Email author 
  • , Jason M. LavenderAffiliated withUniversity of Mississippi Medical CenterUniversity at Albany, State University of New York
  • , Erin C. Marshall-BerenzAffiliated withUniversity of Mississippi Medical CenterUniversity of Vermont
  • , Kim L. GratzAffiliated withUniversity of Mississippi Medical Center
  • , Matthew T. TullAffiliated withUniversity of Mississippi Medical Center
  • , Thomas E. JoinerAffiliated withFlorida State University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


Prior studies have utilized a variety of self-report and behavioral measures of distress tolerance to predict dysregulated behaviors and other problematic outcomes. However, few studies have examined the concurrent associations among these various measures, which may be assessing distinct constructs. The purpose of the present study was to evaluate the concurrent utility of several self-report and behavioral distress tolerance measures in predicting two clinically-relevant outcomes: bulimic symptoms and general impulsive behaviors. Results of hierarchical multiple regression analyses revealed that whereas only self-reported emotional distress tolerance was significantly associated with bulimic symptom severity, self-reported emotional and physical distress tolerance, as well as a behavioral measure of psychological distress tolerance, were significantly associated with impulsive behaviors in general. These findings highlight the need for further explication of the conceptualization and operationalization of the distress tolerance construct, as well as research examining the convergent and discriminant validity of various distress tolerance assessments.


Distress tolerance Emotion dysregulation Experiential avoidance Bulimia Disordered eating Impulsive behaviors