How Distress Tolerance Mediates the Relationship Between Posttraumatic Stress Disorder and the Interpersonal Theory of Suicide Constructs in a U.S. Military Sample

Abstract

Objectives Despite the general suicide rate within the military being comparable to the general population when comparing peers, there are certain branches of the military that have elevated risk. Specifically, the U.S. National Guard has suicide rates that are constantly higher than other military branches and civilian peers. The National Guard are a unique military population in which they frequently transition between military and civilian life. With these unique experiences and heightened risk, military suicide prevention efforts may benefit from further research within this population. Posttraumatic stress disorder (PTSD) is another concern amongst military personnel and has been linked to suicidal behavior. Methods The current study examined the indirect effects that distress tolerance, a protective factor against suicide, has on the relationship between PTSD and constructs within a well‐validated theory for suicide (the Interpersonal‐Psychological Theory for suicidal behaviors) in a sample of U.S. Army National Guard personnel. Results Results indicated that distress tolerance had a significant indirect effect on the relationship between PTSD and thwarted belongingness, perceived burdensomeness, and capability for suicide. Conclusions These findings are consistent with previous literature examining the relationship between distress tolerance and our outcome variables. These results could have important clinical implications, mainly that intervention strategies targeting distress tolerance could have significant impacts on suicide‐relate thoughts.

The moderating role of resilience factors for at-risk U.S. army soldiers-in-training: An expansion of a person-centered approach to adverse childhood experiences.

“…Stress tolerance moderated connections between profiles and anxiety, depression, and PTSD, similar to links found between stress tolerance and mental health in both civilian populations (Welle & Graf, 2011) and military populations (Martin et al, 2019). Specifically, stress tolerance had a mitigating effect for moderate structural (anxiety only), moderate emotional and elevated emotional (anxiety and depression), and high cumulative adversity (PTSD only) groups.…”

The protective effects of grit on suicidal ideation in individuals with trauma and symptoms of posttraumatic stress

“…In terms of primary prevention, it may be helpful for researchers and clinicians to work toward the development and implementation of effective interventions designed to promote grit and other constructs of resiliency, such as distress tolerance, particularly for trauma‐exposed individuals. Distress tolerance, specifically, has been shown to exert an indirect effect on the relationship between PTSD and capability for suicide (Martin et al, ). It seems reasonable to extend the application of such research to other domains, such as the school system or other educational and social support services.…”

Distress Tolerance and Emotion Regulation as Potential Mediators Between Secondary Traumatic Stress and Maladaptive Coping

“…For instance, low DT is associated with more severe PTSD symptoms in both veteran (Banducci et al, 2016) and civilian samples (Fetzner et al, 2014; Marshall-Berenz et al, 2011). Furthermore, among military personnel (Martin et al, 2018) and acute-care psychiatric inpatients (Vujanovic et al, 2017), DT mediated the relationship between PTSD and suicidality. Finally, longitudinal research has indicated that greater increases in DT during a residential treatment program lead to lower PTSD symptoms at discharge as compared to intake (Banducci et al, 2017).…”