Distress Tolerance, PTSD symptoms, and Suicidal Ideation among Trauma-Exposed Inpatient Adolescents

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Objective: The present investigation examined the moderating role of behaviorally-indexed distress tolerance (DT; operationalized herein as persistence in a cognitively demanding serial addition task) in the association between posttraumatic stress disorder (PTSD) symptom severity and suicidal ideation in a sample of trauma-exposed inpatient adolescents. It was hypothesized that the relation between PTSD symptoms and suicide ideation would be positive among those with high (vs. low) behaviorally-indexed DT. Method: The sample included 50 adolescents ages 12-17 years (52.0% female; Mage = 15.1 years, SD = 0.51, range = 12 - 17 years) with exposure to at least one traumatic event. Participants completed measures of PTSD symptom severity, health-risk behaviors, DT, and depressive symptomatology. Results: Adolescents who endorsed a history of suicidal ideation reported significantly greater PTSD symptoms (M = 19.76, SD = 12.47) compared to adolescents who denied suicidal ideation (M = 9.24, SD = 9.16), t = -3.44, p = .001. Although moderation analyses yielded a nonsignificant interaction, visual inspection and statistical analyses of the simple slopes revealed a trending conditional effect of DT on the relationship between PTSD and suicidal ideation, such that the relation was positive at high and moderate levels of DT (ps = .06). Conclusions: Findings revealed a positive relationship between PTSD and suicidal ideation at moderate and high levels of DT; however, statistical significance was not achieved. Replication with a larger sample is needed. The findings emphasize the need for early intervention focused on use of appropriate ways to regulate distress, especially among adolescents with high DT.

Posttraumatic stress disorder (PTSD), Suicide ideation, Distress tolerance, Trauma, Adolescents