Distress Tolerance Moderates the Relationship Between PTSD and Substance Use in a Sample of Inpatient Adolescents



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This study examined the moderating role of distress tolerance (DT) in the association between posttraumatic stress disorder (PTSD) symptom severity and history of illicit substance use in a sample of 66 trauma-exposed inpatient adolescents. Participants completed a battery of questionnaires that included the Child PTSD Symptom Scale (CPSS; Foa, et al., 2001), the Children’s Depression Inventory (CDI; Kovacs, 1992), and a modified version of the Youth Risk Behavior Survey (M-YRBS; Brener et al., 2004). Participants also completed the Paced Auditory Serial Addition Task—computerized version (PASAT-C; Lejuez, et al., 2003) as a measure of behavioral distress tolerance. Results revealed a borderline significant interaction between PTSD and distress tolerance predicting history of illicit substance use (p = .067). Examination of the conditional effects revealed that the relation between PTSD symptoms and illicit substance use was significantly positive among those with high (vs. low) levels of distress tolerance. Contrary to expectations, an increased ability to tolerate frustration during cognitively demanding tasks may represent a vulnerability factor for substance use among adolescents exposed to trauma. Replication with a larger sample is needed to test the generalizability of the findings.