What is it about?
This article presents a review of the literature on distress tolerance/intolerance and self-injurious thoughts and behaviors (SITB). As we might expect, findings generally indicate that greater intolerance is associated with SITB across both suicide-related and nonsuicidal self-injury outcomes; however, there are notable exceptions and significant limitations that make interpretation challenging.
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Why is it important?
Significant limitations impact the available literature, leaving many important questions unanswered. The vast majority of available studies use a single self-report measure at one point in time. Available self-report measures also appear to assess distress intolerance rather than high tolerance or endurance abilities. Laboratory paradigms reviewed seem to have limited relevance to the contexts in which SITBs emerge, and produced mixed findings. Within-person variability in distress tolerance has largely gone unexamined, and important mediators and moderators are underexplored.
Perspectives
I hope this article draws attention to an important area of research. Although most assume improving distress tolerance is important to improving outcomes for those who experience self-injurious thoughts and behaviors, there are many important areas for further development and many methodological challenges to address.
Erin Kaufman
University of Utah
Read the Original
This page is a summary of: Distress tolerance and self-injurious thoughts and behaviors: A systematic review and commentary on methodological challenges., Clinical Psychology Science and Practice, July 2026, American Psychological Association (APA),
DOI: 10.1037/cps0000378.
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