Reductions in Distress Intolerance via Intervention: A Review

Purpose People who seek psychotherapy often have problems tolerating distress. The purpose of the current systematic review was to understand whether treatments successfully reduce distress intolerance. We intentionally focused both on treatments developed specifically to target distress intolerance and we also evaluated whether any type of treatment resulted in reduced distress intolerance. Methods We reviewed 106 papers covering (a) interventions specific to improving distress intolerance, and (b) pre-post reductions in distress intolerance over the course of any intervention, with a transdiagnostic and trans-intervention lens. Intervention was broadly construed to include laboratory single-session experimental treatments. Included studies required a measure of distress intolerance, and both self-report and behavioral measures were examined. Results Across all papers reviewed, there were a variety of samples (people with psychopathology, non-clinical samples, etc.) and treatments (mindfulness-and-acceptance based treatment, cognitive-behavioral treatments, one-time workshops, etc.) relevant for distress intolerance. Findings generally support the notion that self-reported distress intolerance declines as a function of treatment across modalities, while studies that included behavioral measures were less consistent. Specifically, mindfulness and acceptance-based approaches appear to be at the core of most successful treatments for distress intolerance. Conclusion Distress intolerance may be a useful transdiagnostic treatment target, with reductions in distress intolerance indicating decreased avoidance and greater psychological flexibility.