The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies.

Erickson et al. (2016) asked college students to fill out four short surveys. One survey measured how well they handle feeling upset. The other surveys asked what they do when emotions hit—do they push feelings down, avoid them, replay them, or try to see the bright side?

The team wanted to know if low distress tolerance predicts more use of unhelpful strategies.

People who said “I can’t stand feeling bad” used more suppression, avoidance, and rumination. Surprisingly, distress tolerance did not predict bright-side thinking (reappraisal).

In plain words, low tolerance nudges people toward unhelpful moves, but it does not block helpful ones.

van Timmeren et al. (2016) extends the same idea to a tougher sample. They linked low distress tolerance to higher PTSD symptoms in adults who use cocaine and have trauma histories. Same trait, different fallout.

Dudley et al. (2019) flipped the script. Instead of measuring tolerance, they boosted it. A 30-minute values exercise kept hands in ice water 50 seconds longer. The survey says low tolerance predicts bad strategies; the lab shows you can raise tolerance fast.

Luciano et al. (2010) adds a tool. Acceptance instructions cut discomfort more than avoidance instructions. If R’s clients score low on tolerance, Carmen’s brief acceptance script is a ready-made fix.

Screen distress tolerance during intake. One quick scale flags clients likely to suppress, avoid, or ruminate. Pair that score with brief acceptance drills like those in Luciano et al. (2010) or Dudley et al. (2019) to give clients a first-line skill before problem behavior shows up.