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

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.