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Rumination Mediates the Relationship Between Distress Tolerance and Depressive Symptoms Among Substance Users

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Abstract

Distress tolerance has been implicated in the emergence of internalizing symptomatology, notably depressive symptoms. However, few studies have tested potential mechanisms underlying the relationship between distress tolerance and depressive symptoms, and further, this has not been tested among substance users, who commonly experience both low distress tolerance and elevated depressive symptoms. The current study focused on the construct of rumination, which has been suggested to be a coping response to stress associated with substance use and depression. Two forms of rumination, brooding and reflection, were tested as potential mediators of the relationship between distress tolerance and self-reported depressive symptoms among 128 individuals entering substance abuse treatment. Brooding (i.e., to overly focus on symptoms of distress) mediated the relationship between distress tolerance and depressive symptoms. However, reflection (i.e., to attempt to gain insight into problems) was unrelated to distress tolerance. Findings suggest the important role of brooding as a mechanism underlying the relationship between distress tolerance and depressive symptomatology.

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Notes

  1. BDI scores were slightly positively skewed (skewness = 1.02, SE = 0.21). As such, we log transformed BDI scores, which improved skewness (skewness = −0.62, SE = 0.21). Transforming scores did not affect results across all analyses. To preserve the clinical significance of depression scores, the non-transformed data are reported here.

  2. We conducted the same analyses with a contrast between the two indirect effects of brooding and reflection. In these analyses, there remained a significant indirect effect of brooding, but the indirect effect of reflection was non-significant (using both bias-corrected and percentile-based 95 % CIs).

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Acknowledgments

This work was supported by National Institute of Drug Abuse Grants R01 DA026424 and R01 DA022974 (PI: Daughters).

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Authors and Affiliations

  1. Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA

    Jessica F. Magidson, Alyson R. Listhaus, C. J. Seitz-Brown, Katelyn E. Anderson, Briana Lindberg & Alexis Wilson

  2. Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA

    Jessica F. Magidson

  3. Department of Psychology, University of North Carolina, Chapel Hill, NC, USA

    Stacey B. Daughters

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  1. Jessica F. Magidson
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  2. Alyson R. Listhaus
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Correspondence to Jessica F. Magidson or Stacey B. Daughters.

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Magidson, J.F., Listhaus, A.R., Seitz-Brown, C.J. et al. Rumination Mediates the Relationship Between Distress Tolerance and Depressive Symptoms Among Substance Users. Cogn Ther Res 37, 456–465 (2013). https://doi.org/10.1007/s10608-012-9488-x

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