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Distress Tolerance and Social Support in Adolescence: Predicting Risk for Internalizing and Externalizing Symptoms Following a Natural Disaster

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Abstract

The purpose of the multi-measure, multi-wave, longitudinal study was to examine the interactive relation between behavioral distress tolerance (DT) and perceived social support (PSS) in 352 tornado-exposed adolescents aged 12–17 years (M = 14.44; SD = 1.74). At baseline, adolescents completed a computer-based task for DT, and self-report measures of PSS, depressed mood, posttraumatic stress disorder (PTSD), substance use, and interpersonal conflict. Symptoms also were assessed 4 and 12 months after baseline. Findings showed that lower levels of DT together with lower levels of PSS conferred risk for elevated symptoms of prospective depression (t(262) = −2.04, p = .04; reffect size = 0.13) and PTSD (t(195) = −2.08, p = .04; reffect size = 0.15) following a tornado. However, only PSS was significant in substance use t(139) = 2.20, p = .03; reffect size=0.18) and conflict (t(138) = −4.05, p < .0001; reffect size=0.33) in our sample. Implications regarding adolescent DT, the transdiagnostic nature of PSS, and the clinical applications of our findings in the aftermath of a natural disaster are discussed.

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Notes

  1. Only 2.1 % of all adolescents contacted were ruled out due to Internet access, suggesting that our inclusion criteria did not have an adverse impact on the generalizability of our results.

  2. Due to budgetary reasons, only 60 % of the original sample was randomly selected to complete the Conflict Behavior Questionnaire (CBQ).

  3. Participants who completed the DT task were compared to those who did not across all study variables. No significant differences were found across constructs (p > .20).

  4. To provide a more stringent test of our findings, all prospective analyses were rerun with the intercept recentered to 0 at Time 2 and subsequently Time 3. Our pattern of findings remained identical across analyses providing further support that significance was maintained across the duration of the study.

  5. Contact the first author for specific estimates for these analyses.

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Acknowledgments

The National Institute of Mental Health supported this study and the team of collaborators: data collection occurred via grants R01MH081056 to KJR and R21MH086313 to CKD. The preparation of this manuscript was partially supported by grant R01DA031285 to CKD, grant K12-DA031794 which supports ZWA, and T32MH18869 which supported JRC.

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Authors and Affiliations

  1. Department of Psychology, University of Illinois, Champaign, IL, USA

    Joseph R. Cohen

  2. National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, 2nd Fl. IOP South Building, Charleston, SC, 29425, USA

    Carla Kmett Danielson & Zachary W. Adams

  3. Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

    Kenneth J. Ruggiero

  4. Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson VAMC, Charleston, SC, USA

    Kenneth J. Ruggiero

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  1. Joseph R. Cohen
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Correspondence to Joseph R. Cohen.

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Joseph R. Cohen, Carla Kmett Danielson, Zachary W. Adams and Kenneth J. Ruggiero have no conflict of interest to report.

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All procedures and protocols for this study were approved by the Institutional Review Board (IRB) at the MedicalUniversity of South Carolina.

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Cohen, J.R., Danielson, C.K., Adams, Z.W. et al. Distress Tolerance and Social Support in Adolescence: Predicting Risk for Internalizing and Externalizing Symptoms Following a Natural Disaster. J Psychopathol Behav Assess 38, 538–546 (2016). https://doi.org/10.1007/s10862-016-9545-y

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