Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational/correlational studies (by design analogy)
PubMed 34986376 · doi:10.1016/j.jad.2021.12.126
What was done
A systematic search of five electronic databases evaluated the association between distress tolerance (DT) and problematic substance use (PSU), disordered eating behaviours (DEB), and borderline personality disorder (BPD) symptomatology. A series of meta-analyses were conducted on correlation coefficients from 81 studies to examine associations with each psychopathology domain and impulsive-type psychopathology overall. Moderator analyses examined DT measurement type, sample type, age, and gender.
What was found
DT demonstrated significant, negative correlations with PSU (r = -0.18), DEB (r = -0.20), and BPD symptomatology (r = -0.27). The magnitude of associations did not differ significantly across the three diagnostic domains. DT measurement type, age, and sample type moderated several of these associations, though numerical moderator estimates were not reported in the abstract.
Why it matters
This review provides quantitative evidence that low distress tolerance is a shared transdiagnostic feature across substance misuse, eating disorders, and borderline personality pathology, supporting cross-cutting clinical interventions.
Limits
Most primary studies sampled adults from Western countries, restricting developmental and cross-cultural generalizability. Total participant n was omitted in the abstract, and the underlying correlational data preclude causal inferences.
Cited by
- supports Distress tolerance is a transdiagnostic factor where lower distress tolerance is associated with increased risk and prevalence of mental illnesses.