title: The impact of changes in distress tolerance on PTSD symptom severity post-treatment among veterans in residential trauma treatment.
abstract: Given that rates of PTSD, particularly among military populations, are increasing, it is critical to gain a better understanding of factors associated with treatment response. Low distress tolerance (DT), conceptualized as the perceived or actual inability to tolerate negative emotional states, may impacts veterans' responses to PTSD treatment. Low DT has been associated with more severe PTSD symptoms in clinical and non-clinical samples; however, its impact on PTSD symptomatology across treatment has yet to be assessed. We examined the impact of changes in DT, from intake to discharge, on post-treatment PTSD symptom severity within two samples of veterans recruited from Veterans Affairs residential PTSD treatment facilities in the northwestern and southern United States (Total N=86; 87% male; 46% White, 39% Black, 9% Latino, 6% Other). Veterans completed the Distress Tolerance Scale and PTSD Checklist (PCL) at intake and discharge from residential PTSD treatment. Regression analyses revealed that, within each veteran sample, those with the greatest improvements in DT had the lowest PCL total and subscale scores at discharge after controlling for respective intake PCL scores. This suggests increases in DT across treatment help explain the degree of benefits experienced by veterans following PTSD treatment.
authors.affiliation: National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (NC-PTSD 324), Menlo Park, CA 94025, United States; Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States; G.V. (Sonny) Montgomery Veterans Affairs Medical Center, 1500 E Woodrow Wilson Ave, Jackson, MS 39216, United States; University of Mississippi Medical Center. 2500 N State St. Jackson, MS 39216, United States. Electronic address: anne.banducci@gmail.com.
authors.forename: Anne N
authors.initials: AN
authors.lastname: Banducci
authors.affiliation: G.V. (Sonny) Montgomery Veterans Affairs Medical Center, 1500 E Woodrow Wilson Ave, Jackson, MS 39216, United States; University of Mississippi Medical Center. 2500 N State St. Jackson, MS 39216, United States.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Connolly
authors.affiliation: University of Houston, Department of Psychology, 3695 Cullen Bouleva rd, Houston, TX 772014, United States.
authors.forename: Anka A
authors.initials: AA
authors.lastname: Vujanovic
authors.affiliation: VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Alvarez
authors.affiliation: National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (NC-PTSD 324), Menlo Park, CA 94025, United States; Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road(152-MPD), Menlo Park, CA 94025, United States; Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3440 Market St, Suite 370, Philadelphia, PA 19104, United States.
authors.forename: Marcel O
authors.initials: MO
authors.lastname: Bonn-Miller
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012114:Residential Treatment; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D014481:United States; D014728:Veterans / Q000523:psychology*
keywords: Distress tolerance; Posttraumatic stress disorder; Treatment; Veterans