Research has demonstrated that values and acceptance interventions can increase distress tolerance, but the individual contribution of each remains unclear. The current study examined the isolated effect of a values intervention on immersion time in a cold pressor. Participants randomized to Values (n = 18) and Control (n = 14) conditions completed two cold pressor tasks, separated by a 30-min values or control intervention. Immersion time increased 51.06 s for participants in the Values condition and decreased by 10.79 s for those in the Control condition. Increases in self-reported pain and distress predicted decreases in immersion time for Control, but not Values, participants. The best-fitting model accounted for 39% of the variance in immersion time change. Results suggest that a brief isolated values exercise can be used to improve distress tolerance despite increased perceptions of pain and distress, such that values alone may be sufficient to facilitate openness to difficult experiences.
AllanN. P.MacateeR. J.NorrA. M.SchmidtN. B. (2014). Direct and interactive effects of distress tolerance and anxiety sensitivity on generalized anxiety and depression. Cognitive Therapy and Research, 38, 530-540. doi:10.1007/s10608-014-9623-y
Branstetter-RostA.CushingC.DoulehT. (2009). Personal values and pain tolerance: Does a values intervention add to acceptance?Journal of Pain, 10, 887-892. doi:10.1016/j.jpain.2009.01.001
4.
ChorpitaB. F.DaleidenE. L.WeiszJ. R. (2005). Modularity in the design and application of therapeutic interventions. Applied and Preventive Psychology, 11, 141-156. doi:10.1016/j.appsy.2005.05.002
5.
CioffiD.HollowayJ. (1993). Delayed costs of suppressed pain. Journal of Personality and Social Psychology, 64, 274-282. doi:10.1037/0022-3514.64.2.274
6.
CorriganP. W.WatsonA. C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16-20.
7.
CraskeM. G.TreanorM.ConwayC. C.ZbozinekT.VervlietB. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behavior Research and Therapy, 58, 10-23. doi:10.1016/j.brat.2014.04.006
8.
DaughtersS. B.SargeantM. N.BornovalovaM. A.GratzK. L.LejuezC. W. (2008). The relationship between distress tolerance and antisocial personality disorder among male inner-city treatment seeking substance users. Journal of Personality Disorders, 22, 509-524.
9.
FeldnerM. T.HekmatH.ZvolenskyM. J.VowlesK. E.SecristZ.Leen-FeldnerE. W. (2006). The role of experiential avoidance in acute pain tolerance: A laboratory test. Journal of Behavior Therapy and Experimental Psychiatry, 37, 146-158. doi:10.1016/j.jbtep.2005.03.002
10.
ForsythL.HayesL. L. (2014). The effects of acceptance of thoughts, mindful awareness of breathing, and spontaneous coping on an experimentally induced pain task. The Psychological Record, 64, 447-455. doi:10.1007/s40732-014-0010-6
11.
GlassmanL. H.MartinL. M.BradleyL. E.IbrahimA.GoldsteinS. P.FormanE. M.HerbertJ. D. (2016). A brief report on the assessment of distress tolerance: Are we measuring the same construct?Journal of Rational-Emotive & Cognitive-Behavior Therapy, 34, 87-99. doi:10.1007/s10942-015-0224-9
12.
HambrookD.OldershawA.RimesK.SchmidtU.TchanturiaK.TreasureJ.. . . ChalderT. (2011). Emotional expression, self-silencing, and distress tolerance in anorexia nervosa and chronic fatigue syndrome. British Journal of Clinical Psychology, 50, 310-325. doi:10.1348/014466510X519215
13.
HarringtonN. (2006). Frustration intolerance beliefs: Their relationship with depression, anxiety, and anger, in a clinical population. Cognitive Therapy and Research, 30, 699-709. doi:10.1007/s10608-006-9061-6
14.
HayesS. C.BissettR. T.KornZ.ZettleR. D.RosenfarbI. S.CooperL. D.GrundtA. M. (1999). The impact of acceptance versus control rationales on pain tolerance. The Psychological Record, 49, 33-47.
15.
HayesS. C.LuomaJ. B.BondF. W.MasudaA.LillisJ. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behavior Research and Therapy, 44, 1-25. doi:10.1016/j.brat.2005.06.006
16.
HayesS. C.SmithS. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.
17.
HayesS. C.StrosahlK. D.WilsonK. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.
18.
HolawayR. M.HeimbergR. G.ColesM. E. (2006). A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 20, 158-174. doi:10.1016/j.janxdis.2005.01.002
19.
KeyesC. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207-222. doi:10.2307/3090197
20.
KohlA.RiefW.GlombiewskiJ. A. (2012). How effective are acceptance strategies? A meta-analytic review of experimental results. Journal of Behavior Therapy and Experimental Psychiatry, 43, 988-1001. doi:10.1016/j.jbtep.2012.03.004
21.
KohlA.RiefW.GlombiewskiJ. A. (2013). Acceptance, cognitive restructuring, and distraction as coping strategies for acute pain. Journal of Pain, 14, 305-315. doi:10.1016/j.jpain.2012.12.005
22.
LeyroT. M.ZvolenskyM. J.BernsteinA. (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. Psychological Bulletin, 136, 576-600. doi:10.1037/a0019712
23.
LillisJ.HayesS. C.BuntingK.MasudaA. (2009). Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model. Annals of Behavioral Medicine, 37, 58-69. doi:10.1007/s12160-009-9083-x
24.
MacateeR. J.CapronD. W.SchmidtN. B.CougleJ. R. (2013). An examination of low distress tolerance and life stressors as factors underlying obsessions. Journal of Psychiatric Research, 47, 1462-1468. doi:10.1016/j.jpsychires.2013.06.019
25.
MasedoA. I.EsteveM. R. (2007). Effects of suppression, acceptance and spontaneous coping on pain tolerance, pain intensity and distress. Behavior Research and Therapy, 45, 199-209. doi:10.1016/j.brat.2006.02.006
26.
McCrackenL. M.VowlesK. E. (2008). A prospective analysis of acceptance of pain and values-based action in patients with chronic pain. Health Psychology, 27, 215-220. doi:10.1037/0278-6133.27.2.215
27.
McGuireB.MooreH.StewartI.Barnes-HolmesD.Barnes-HolmesY. (2015). Comparison of acceptance and distraction strategies in coping with experimentally induced pain. Journal of Pain Research, 8, 139-151. doi:10.2147/JPR.S58559
28.
McMullenJ.Barnes-HolmesD.Barnes-HolmesY.StewartI.LucianoC.CochraneA. (2008). Acceptance versus distraction: Brief instructions, metaphors and exercises in increasing tolerance for self-delivered electric shocks. Behavior Research and Therapy, 46, 122-129. doi:10.1016/j.brat.2007.09.002
Páez-BlarrinaM.LucianoC.Gutiérrez-MartínezO.ValdiviaS.Rodríguez-ValverdeM.OrtegaJ. (2008). Coping with pain in the motivational context of values: Comparison between an acceptance-based and a cognitive control-based protocol. Behavior Modification, 32, 403-422. doi:10.1177/0145445507309029
31.
PennebakerJ. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162-166.
32.
R Core Team. (2015). R: A language environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.
SchmidtN. B.RicheyJ. A.FitzpatrickK. K. (2006). Discomfort intolerance: Development of a construct and measure relevant to panic disorder. Journal of Anxiety Disorders, 20, 263-280. doi:10.1016/j.janxdis.2005.02.002
35.
SlagelD. M.GrayM. J. (2007). The utility of motivational interviewing as an adjunct to exposure therapy in the treatment of anxiety disorders. Professional Psychology: Research and Practice, 38, 329-337.
36.
TimpanoK. R.ShawA. M.CougleJ. R.FitchK. E. (2014). A multifaceted assessment of emotional tolerance and intensity in hoarding. Behavior Therapy, 45, 690-699. doi:10.1016/j.beth.2014.04.002
37.
TolinD. F.AbramowitzJ.BrigidiB. D.FoaE. B. (2003). Intolerance of uncertainty in obsessive-compulsive disorder. Journal of Anxiety Disorders, 17, 233-242. doi:10.1016/S0887-6185(02)00182-2
38.
VillatteJ. L.VilardagaR.VillatteM.Plumb VilardagaJ. C.AtkinsD. C.HayesS. C. (2016). Acceptance and commitment therapy modules: Differential impact on treatment processes and outcomes. Behavior Research and Therapy, 77, 52-61.
39.
VowlesK. E.McCrackenL. M. (2008). Acceptance and values-based action in chronic pain: A study of treatment effectiveness and process. Journal of Consulting and Clinical Psychology, 76, 397-407. doi:10.1037/0022-006X.76.3.397
40.
VowlesK. E.McCrackenL. M.O’BrienJ. Z. (2011). Acceptance and values-based action in chronic pain: A three-year follow-up analysis of treatment effectiveness and process. Behavior Research and Therapy, 49, 748-755. doi:10.1016/j.brat.2011.08.002
41.
VujanovicA. A.Bonn-MillerM. O.PotterC. M.MarshallE. C.ZvolenskyM. J. (2011). An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample. Journal of Psychopathology and Behavioral Assessment, 33, 129-135. doi:10.1007/s10862-010-9209-2
42.
WestraH. A.ArkowitzH.DozoisD. J. A. (2009). Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: A preliminary randomized controlled trial. Journal of Anxiety Disorders, 23, 1106-1117. doi:10.1016/j.janxdis.2009.07.014
ZeileisA.HothornT. (2002). Diagnostic checking in regression relationships. R News, 2(3), 7-10. Retrieved from https://CRAN.R-project.org/doc/Rnews/
45.
ZettleR. D.HockerT. R.MickK. A.ScofieldB. E.PetersenC. L.SongH.SudarijantoR. P. (2005). Differential strategies in coping with pain as a function of level of experiential avoidance. The Psychological Record, 55, 511-524.
46.
ZvolenskyM. J.VujanovicA. A.BernsteinA.LeyroT. (2010). Distress tolerance: Theory, measurement, and relations to psychopathology. Current Directions in Psychological Science, 19, 406-410. doi:10.1177/0963721410388642
