Distress tolerance

Objective: This study aimed to assess the effectiveness of Cognitive-Behavioral Stress Management (CBSM) on distress tolerance, pain perception, and interleukin-12 (IL-12) in patients with Multiple Sclerosis (MS). Method: The present study was a quasi-experimental design with pretest-posttest and follow-up with control group. The statistical population included all female patients with relapsing-remitting MS who had referred to Neuroscience and Rehabilitation Research Centers of Tehran University of Medical Sciences. 20 patients were selected by convenience sampling and were randomly assigned into experimental (10 patients) and control groups (10 patients). The experimental group received the CBSM. Participants completed scales. To measure IL-12, the Enzyme-Linked Immunosorbent Assay (ELISA) was used. The data were analyzed using multivariate analysis of covariance (MANCOVA) and Bonferroni post-hoc test. Results: CBSM increased the distress tolerance and components of pain perception (perceived influence of important people and doing daily affairs) (p <0.001) and it decreased pain severity and IL-12. Also, these changes remained stable during follow-up. Conclusions: CBSM is an effective to influence on distress tolerance, pain perception, and IL-12 in MS patients.

Aim: The sudden outbreak of Covid-19 virus in March and April 2020, sparked an emotional state of anxiety among different groups of society. The aim of the present study was to investigate the psychological predictors of coronavirus anxiety in Iranian young adults. Method: The sample included 517 women and men who responded to four electronic questionnaires which posted on the researchers' Instagram pages between March 11th and 28th 2020. The e-questionnaires included the Corona Anxiety Inventory, the Distress Tolerance Scale (DTS), Revised Health Hardiness (RHHI-24) and the Health-Promoting Lifestyle Profile (HPLP-II). Results: Data was analyzed by using multi regression method in SPSS -24. The results of regression analysis showed that tolerating emotional distress, health hardiness, and a lifestyle that promotes health can significantly predict the anxiety caused by the coronavirus pandemic. In addition, it turned out that women experience more coronavirus anxiety than their male counterparts. Discussion & Conclusion: It can be concluded that psychological variables in stressful and ambiguous situations can determine the levels of anxiety that individuals experience. Implications for these results and limitations of the present study have been discussed.

This study aimed to examine the mediating effect of family emotional atmosphere on the association between communication patterns and distress tolerance in married women. The study employed a correlational design and utilized path analysis. The research sample comprised 217 married women residing in Tehran in the year 1400, who were selected using convenience sampling methodology. The research instruments included the Couple's Communication Patterns, the Family Emotional Atmosphere, and Distress Tolerance. The results of the path analysis revealed a statistically significant association between communication patterns and distress tolerance, with the emotional atmosphere of the family serving as a mediator in this relationship. The mediating role of family emotional atmosphere is found to be significant in the relationship between non-reciprocal constructive relationship and distress tolerance (P=0.22, β=0.001) and the relationship between mutual avoidance and distress tolerance (P=0.001, β=-0.19). The research findings suggest an idea for implementing an intervention targeting contributing and causal factors, specifically communication patterns and the emotional atmosphere within families, which impact the distress tolerance of married women.

Objective: The aim of this study was to investigate the role of object relations in predicting emotional expression, distress tolerance and marital quality.Methods: The research method was quantitative, applied and descriptive-correlational. The statistical population of the study was all 257 couples which formally married in the first three months of 2022 in Ardabil. The non-random available sampling method was used due to the limitations of the corona pandemic. The sample size was 110 couples, including 110 males and 110 females. Bell Object Relationships Inventory (1995), King & Ammons Emotional Expression Questionnaire (1990), Distress Tolerance Scale (DTS) and Basby Marital Quality Questionnaire (1995) were used for data collection. In the descriptive part, we used the central and dispersion indices. Also, in the inferential part, multiple regression was used.  The data were analyzed using SPSS software.Results: The results of this study showed there is a significant negative relationship between social incompetence with emotional expression, distress tolerance and marital quality (p<0.01), and a significant negative relationship between egocentricity with emotional expression, distress tolerance and marital quality (p<0.01). Also, there is a significant negative relationship between insecure attachment with emotional expression, distress tolerance and marital quality (p<0.01) and finally there is a significant negative relationship between alienation with emotional expression, distress tolerance and marital quality (p<0.01).Conclusion: Considering the results, couple therapy based on object relations can be used to improve emotional expression, distress tolerance and marital quality of couples.

Objective: The present study aimed to investigate the effectiveness of positive psychotherapy on cognitive flexibility and distress tolerance in divorced women. Methods: The study population consisted of all divorced women in Damghan City in 2020, from which 30 individuals were randomly selected and assigned to the control and experimental groups (15 individuals in each group). The Distress Tolerance Scale, Cognitive Flexibility Inventory, and Positive Psychotherapy Protocol were used to collect the data, and the ANCOVA test was used to analyze the data. The ANCOVA results showed that the intervention group obtained significantly higher scores in cognitive flexibility and distress tolerance than the control group (p<0.01). Results: According to the findings, cognitive flexibility and distress tolerance significantly increased in the experimental group. According to the findings of the present study, positive psychotherapy and improvement of psychological components such as psychological flexibility and distress tolerance can play an important role in improving the mental health of divorced women. Conclusion: By focusing on talents and abilities, a positive therapeutic approach can use the potential capacities of people in order to improve psychological problems to a significant extent.

This study aimed to examine the relationship between perceived family functioning, distress tolerance, and academic self-discipline, with the mediating role of mental vitality. The research method was correlational using structural equation modeling. The statistical population included all students at Imam Khomeini International University during the 2023-2024 academic year. A total of 260 students were selected as the study sample using cluster random sampling. Research instruments included the Family Functioning Questionnaire (Epstein et al., 1980), Academic Self-discipline Questionnaire (Afrooz, 2007), Distress Tolerance Scale (Simons & Gaher, 2005), and Mental Vitality Scale (Ryan & Frederick, 1997). Data were analyzed using structural equation modeling in AMOS 24 software. The findings indicated that the conceptual model had good fit indices. Examination of direct pathways showed that family functioning and distress tolerance were significantly related to academic self-discipline. Furthermore, analysis of indirect pathways revealed that mental vitality mediates the relationship between academic self-discipline and both family functioning and distress tolerance. The results suggest that students' academic self-discipline can be enhanced by improving their perceptions of family functioning, increasing their distress tolerance, and fostering their mental vitality.

This study aimed to examine the effectiveness of play therapy in improving sensory processing and distress tolerance in adolescents with mild intellectual disabilities. A randomized controlled trial was conducted with 30 adolescents aged 12 to 17 years, randomly assigned to either an intervention group (n = 15) receiving eight 90-minute sessions of play therapy or a control group (n = 15) receiving no intervention. Sensory processing and distress tolerance were assessed at baseline, post-intervention, and five-month follow-up using standardized measures. Data analysis was performed using repeated-measures analysis of variance (ANOVA) and Bonferroni post-hoc tests in SPSS-27 to evaluate within-group and between-group differences over time. The results indicated a significant main effect of time for both sensory processing (F(2, 84) = 92.32, p < 0.001) and distress tolerance (F(2, 84) = 111.60, p < 0.001), demonstrating substantial improvements across timepoints. The intervention group showed a notable increase in sensory processing scores from baseline (M = 48.72, SD = 5.91) to post-intervention (M = 64.15, SD = 6.38) and follow-up (M = 69.03, SD = 5.79), whereas the control group exhibited minimal change. Similarly, distress tolerance scores improved significantly in the intervention group (baseline: M = 42.85, SD = 6.27; post-intervention: M = 58.74, SD = 5.69; follow-up: M = 63.92, SD = 6.08), with no substantial improvement in the control group. The Bonferroni post-hoc test confirmed significant pairwise differences between baseline and subsequent assessments. Play therapy was found to be an effective intervention for enhancing sensory processing and distress tolerance in adolescents with mild intellectual disabilities, with improvements sustained at follow-up. These findings suggest that play-based interventions can be a valuable therapeutic approach for promoting sensory integration and emotional regulation in this population.

Objective: The present study aimed to examine the effectiveness of Choice Theory-based parenting education on distress tolerance, family cohesion, and maternal parenting self-efficacy in mothers of children exhibiting oppositional defiant behaviors. Method: This quasi-experimental study employed a pre-test, post-test, follow-up, and control group design. The sample population included all mothers of children aged 7-12 years with oppositional defiant behaviors covered by the Imam Khomeini Relief Committee in Sari during the 2021-2022 academic year. Using purposive non-random sampling based on scores from the Distress Tolerance Scale (Simons & Gaher, 2005), the Family Cohesion Scale (Shakeri, 2003), and the Parenting Self-Efficacy Questionnaire (Dumka, 1996) at pre-test, 30 eligible mothers were selected. These mothers were then randomly assigned into two groups of 15 each (experimental and control groups). Data were analyzed using repeated measures ANOVA with the assistance of SPSS version 27 software. Findings: Results indicated that Choice Theory-based parenting education significantly improves distress tolerance, family cohesion, and maternal parenting self-efficacy in mothers of children with oppositional defiant behaviors. Conclusions: Given these results, the use of this educational approach is recommended to enhance distress tolerance, family cohesion, and maternal parenting self-efficacy in mothers of children with oppositional defiant behaviors.

Objective: The aim of the present study was to predict distress tolerance in the elderly based on experiential avoidance and spiritual intelligence. Method: This was a descriptive correlational study. The population included all elderly individuals aged between 65 and 80 years who visited community centers in Tehran in 2022, from whom a sample of 300 was selected using cluster sampling. The Emotional Distress Tolerance Scale by Simons and Gaher (2005), the Spiritual Intelligence Scale by King (2008), and the Experiential Avoidance Questionnaire by Gámez et al. (2011) were utilized for data collection. Data were analyzed using regression analysis. Findings: The results indicated that experiential avoidance significantly negatively predicted distress tolerance. Additionally, spiritual intelligence significantly positively predicted distress tolerance. Conclusions: Based on the findings of the current study, it can be concluded that this predictive model could serve as an effective framework in counseling and psychotherapy centers to enhance distress tolerance among the elderly.

Objective: Dealing with stress is one of the transformative changes that divorce introduces in personal and family lives, leading to the disruption of mental health, cognitive conflicts, and identity crises among women. Thus, the current study aimed to investigate the effectiveness of a strength-based approach on distress tolerance and frustration tolerance in divorced women. Methods: The research was applied in nature and semi-experimental in design, featuring a pre-test and post-test with one experimental group and one control group, along with a two-month follow-up. Consequently, the study population consisted of all divorced women who visited counseling centers in District 6 of Tehran in 2022. From this population, 40 women were selected through purposive sampling and randomly assigned to an experimental group (20 participants) and a control group (20 participants). The experimental group underwent a strength-based approach program based on a protocol developed by Darbani and Parsakia (2022). Data collection tools included the Harrington Frustration Tolerance Questionnaire (2005) and the Simons and Gahr Distress Tolerance Questionnaire (2005). Descriptive statistics utilized frequency distribution tables, and inferential analysis was conducted using mixed ANOVA with repeated measures and Bonferroni post-hoc tests, employing SPSS software version 26. Findings: Considering the F-values and significance levels in the mixed ANOVA for frustration tolerance (F = 10.49, p = 0.002) and distress tolerance (F = 8.81, p = 0.003), it can be concluded that the intervention employed in this study, namely the strength-based approach as an independent variable, significantly altered the dependent variables (frustration tolerance and distress tolerance). Conclusion: Based on the findings, it can be concluded that the strength-based approach is effective in improving distress tolerance and frustration tolerance among divorced women. Therefore, techniques from this approach can be utilized in post-divorce counseling for divorced women.

Objective: The current study aimed to investigate the effectiveness of solution-focused couples therapy on psychological well-being and distress tolerance. Methods: This was a quasi-experimental study using a pre-test and post-test design with a control group and a follow-up phase. The population consisted of all couples attending counseling centers in Tehran during the last two months of the year 2021. A sample of 30 couples was selected using convenience sampling and randomly assigned to an experimental group (15 couples) and a control group (15 couples). The research instruments included the Ryff Psychological Well-being Scale (1988) and the Simons and Gaher Distress Tolerance Scale (2005). The experimental group received eight sessions of McDonald's (2007) solution-focused training in a group setting, whereas the control group received no intervention. Data were analyzed using covariance analysis with SPSS software version 21. Findings: The results showed that solution-focused couples therapy had a significant effect on the dimensions of psychological well-being (F = 15.78, p = .001) and distress tolerance (F = 12.00, p = .001); these effects were maintained during the follow-up phase (p < .001). Conclusion: Given the results, therapists can employ solution-focused couples therapy to enhance psychological well-being and distress tolerance among couples, which significantly affects the stability and strength of families.

Objective: This study aimed to investigate the effectiveness of Dialectical Behavior Therapy (DBT)-based skill training on distress tolerance, emotional cognitive regulation, and marital quality of life in women with recurrent miscarriages. Methods: The population consisted of all women attending infertility clinics in Tehran during 2019-2020. A sample of 30 women was selected through convenience and purposive sampling based on inclusion and exclusion criteria, and randomly assigned to experimental and control groups (15 in each group). The instruments used in this study included: the Distress Tolerance Scale by Simons and Gaher (2005), Cognitive and Emotional Regulation Scale by Garnefski, Kraaij, and Spinhoven (2006), and Marital Quality of Life Scale by Fletcher, Simpson, and Thomas (2000). Repeated measures and a significance level of .05 were used for statistical analysis. Findings: The results showed significant differences in means between the two groups at pre-test, post-test, and follow-up stages, with significant improvements in distress tolerance, emotional cognitive regulation, and marital quality of life. The effect sizes of this treatment were 0.885, 0.910, and 0.983, respectively. Conclusion: Given the confirmed effectiveness of the treatment, it is recommended that these women receive psychological treatments in conjunction with medical treatments.

Objective: The study aimed to evaluate the impact of life skills training on distress tolerance, psychological adaptation, and high-risk behaviors among incarcerated women. Methods: This was an applied, experimental study. The study population consisted of incarcerated women in Kerman Central Prison in 2022. Sixty participants exhibiting high-risk behaviors were randomly assigned into an experimental group (30 women) and a control group (30 women). The experimental group received the World Health Organization's (WHO, 1998) ten-session life skills training program, each lasting 90 minutes, while the control group was placed on a waiting list. Both groups were assessed using the Simons and Gaher Distress Tolerance Scale (2005), the Derogatis Psychological Adaptation Scale (1986), and the Rajaee and Shafiei High-Risk Behavior Questionnaire (2011) before and after the intervention. Data were analyzed using multivariate analysis of covariance with SPSS software. Findings: Results indicated that life skills training significantly impacted distress tolerance, psychological adaptation, and high-risk behaviors in incarcerated women (p < .01). Conclusion: Life skills training can be effectively utilized to enhance distress tolerance and psychological adaptation, and to reduce high-risk behaviors.

Objective: The aim of this study was to examine the effectiveness of dialectical behavior therapy-based skills training on distress tolerance, cognitive emotion regulation, and marital quality of life in women with recurrent miscarriages. Methods: The statistical population consisted of all women who visited infertility clinics in Tehran in 2019-2020. A sample of 30 women was selected using convenience and purposive sampling methods, based on inclusion and exclusion criteria, and was randomly assigned to experimental and control groups (15 women in each group). The questionnaires used in this study were the Distress Tolerance Questionnaire by Simons and Gaher (2005), the Cognitive Emotion Regulation Questionnaire by Garnefski, Kraaij, and Spinhoven (2006), and the Marital Quality of Life Questionnaire by Fletcher, Simpson, and Thomas (2000). The statistical method used was repeated measures, with a significance level of 0.05. Findings: According to the results, the differences in means between the two groups in the pre-test, post-test, and follow-up stages were significant. There were significant differences in distress tolerance, cognitive emotion regulation, and marital quality of life between the two groups. The dialectical behavior therapy-based skills training had an impact on the variables of distress tolerance, cognitive emotion regulation, and marital quality of life, with effect sizes of 0.885, 0.910, and 0.983, respectively. Conclusion: Given the confirmed effectiveness of this therapy, it is recommended that these women receive appropriate psychological treatments alongside medical treatments.

Objective: The objective of this study was to evaluate the effectiveness of an educational program based on the Marital Distress Tolerance Model on reducing marital conflicts among conflicting couples in Tehran. Methods and Materials: This research employed a quasi-experimental design with a pretest-posttest control group. The statistical population included all conflicting couples who visited psychological and counseling centers in Tehran. One center was randomly selected, and 30 couples were chosen through convenience sampling and randomly assigned to experimental and control groups (15 couples each). The experimental group received a 9-session intervention based on a structured educational package developed from the causal model of marital distress tolerance, focusing on cognitive flexibility, family health, and social problem-solving skills. Data were collected using the Barati and Sanaei Marital Conflict Questionnaire and a researcher-developed content validity instrument evaluated by experts. Descriptive statistics and multivariate analysis of covariance (MANCOVA) were used to analyze the data through SPSS software. Findings: The results of the MANCOVA indicated that the educational program had a statistically significant effect on all dimensions of marital conflict, including reduced sexual relations (F = 28.438, p < .001), increased emotional reactions (F = 18.448, p < .001), separation of financial matters (F = 29.932, p < .001), reduced cooperation (F = 22.822, p < .001), reduced relationships with spouse’s relatives (F = 18.549, p < .001), increased relationships with one’s own relatives (F = 10.030, p = .005), and increased seeking support from children (F = 65.565, p < .001). Conclusion: The study confirmed that the educational program based on the marital distress tolerance model significantly reduced marital conflicts across multiple dimensions, supporting the model’s applicability in therapeutic interventions for couples experiencing relational distress.