Distress Tolerance and Social Support in Adolescence: Predicting Risk for Internalizing and Externalizing Symptoms Following a Natural Disaster.

The purpose of the multi-measure, multi-wave, longitudinal study was to examine the interactive relation between behavioral distress tolerance (DT) and perceived social support (PSS) in 352 tornado-exposed adolescents aged 12-17 years (M=14.44; SD=1.74). At baseline, adolescents completed a computer-based task for DT, and self-report measures of PSS, depressed mood, posttraumatic stress disorder (PTSD), substance use, and interpersonal conflict. Symptoms also were assessed 4 and 12 months after baseline. Findings showed that lower levels of DT together with lower levels of PSS conferred risk for elevated symptoms of prospective depression (t(262)= -2.04, p=.04; reffect size=0.13) and PTSD (t(195)= -2.08, p=.04; reffect size=0.15) following a tornado. However, only PSS was significant in substance use t(139)=2.20, p=.03; reffect size=0.18) and conflict (t(138)=-4.05, p<.0001; reffect size=0.33) in our sample. Implications regarding adolescent DT, the transdiagnostic nature of PSS, and the clinical applications of our findings in the aftermath of a natural disaster are discussed.