Distress Tolerance’s Time Course and Prognostic Utility in Partial Hospital Treatment

This study replicates and extends McHugh et al. (2014) by examining changes in distress intolerance during cognitive-behavioral partial hospitalization treatment. Distress tolerance (DT) refers to the perceived capacity to withstand negative emotional and somatic states. Low DT has been identified as a transdiagnostic factor associated with depression, anxiety disorders, substance use disorders, eating disorders, and borderline personality disorder. McHugh et al. (2014) demonstrated that DT improved during partial hospitalization with a moderate effect size (d = 0.41) and clinically significant change in 30.9% of participants using a 2 SD criterion. Their sample (N = 469 completers) had baseline DII of M = 2.25 (SD = 1.00) on a 0-4 scale, with treatment duration averaging 8.2 days (SD = 3.2). The present study extends this work by: (1) replicating pre-post findings in a new, larger sample from the same treatment setting, (2) examining the trajectory of DT change using interim daily assessments throughout treatment, (3) investigating whether baseline DT and DT change predict both clinician- and patient-rated global clinical improvement, and (4) applying rigorous individual-level clinical significance methodology using the Jacobson-Truax RCI with appropriate consideration of floor effects.