Distress tolerance has historically and presently been a focus of interest for clinical scientists and practitioners (Zvolensky et al. 2011). Indeed, the distress tolerance construct has been theorized to contribute to (a) the development and maintenance of a wide range of psychopathology phenotypes (Otto et al. 2005) and (b) serve as a key mechanism underlying therapeutic change for psychological health (Linehan 1993). Thus, distress tolerance has been involved in models of risk and resilency for psychopathology.

Although there has been long-standing interest in elucidating the role of distress tolerance in psychopathology (e.g., Frenkel-Brunswik 1948), there has, in fact, been relatively little empirical work focused on the subject matter. Although limited, scientific attention has focused on distress tolerance in regard to its potential role as a clinical target for intervention/prevention programs (Linehan 1993). This scientific attention has been presumably influenced by the lack of theoretically grounded conceptualizations and corresponding instrumentation development for the construct (Zvolensky et al. 2010). Over the past decade, there has been a marked improvement in distress tolerance theory and development of self-report and behavioral tools that can tap the construct from various viewpoints (Leyro et al. 2010). This work, in turn, has served as a major catalyst for behaviorally-oriented, and more recently, neurobehavioral study of the role of distress tolerance in psychopathology ranging from laboratory-based experimental (e.g., Bernstein et al. 2008) to field-based clinical research (e.g., Bornovalova et al. 2012). Presently, scholars have conceptualized a wide variety of distress tolerance constructs that differ primarily in their focus of distress (e.g., somatic vs. emotional) and measurement approach (e.g., self-report vs. behavioral; Zvolensky et al. 2010). Further, current research suggests that self-report and behavioral indices of distress tolerance are often only modestly related, suggesting that thery are related, but distinct aspects of the latent construct (Bernstein et al. 2011).

Notably, although nested conceptually within a broader network of risk and protective processes, distress tolerance is theorized to be related to, though conceptually distinct from, other variables (e.g., avoidant coping, anxiety sensitivity, emotion regulation, experiential avoidance; Leyro et al. 2010). Many theories posit that individuals with lower levels of distress tolerance may be prone to maladaptively respond to distress and distress-eliciting contexts (Linehan 1993; Lynch and Mizon 2011; Trafton and Gifford 2011). As a result, individuals with lower distress tolerance may attempt to avoid negative emotions or related aversive states in a rigid or context insensitive manner. In contrast, persons with higher levels of distress tolerance may be more able to adaptively respond to distress or distress-eliciting contexts. Theoretically, distress tolerance may affect, and be affected by, a variety of other processes involved in self-regulation, including attention, cognitive appraisals of distressing emotional and physical states, and emotional, as well as behavioral, responses to distress (Leyro et al. 2010). Individual differences in the experience of emotions (e.g., strength frequency), as one example, can influence the nature of distress tolerance (Marshall et al. 2008). Despite initial evidence suggesting distress tolerance may be an individual difference variable that could potentially influence vulnerability to psychopathology (Leyro et al. 2010), questions remain regarding the latent structure of distress tolerance as well as its potential as a mechanism of change in interventions.

The overarching aim of the present special series is to provide a forum for the systematic presentation of emerging theory, empirical evidence, and directions for future work pertaining to distress tolerance and psychopathology by some of the leading research groups carrying out such work. To accomplish this aim, articles were invited to highlight a range of distress tolerance conceptualizations and showcase findings across psychopathology phenotypes. Although the articles differ in their approach and content, the special issue collectively suggests that focusing on distress tolerance processes and the contexts in which they operate is a highly valuable and promising pursuit in efforts to uncover some of the enigmas of psychopathology. Additionally, the present series includes papers that cover basic and clinical research, and in so doing, attempts to highlight the importance of translating research findings and ideas from basic to applied and from applied to basic work in this area of study. Overall, by covering a range of issues interconnected by their focus on distress tolerance in relation to psychopathology, it is hoped that such “broad coverage” will: (1) alert readers to the significance of this work at a variety of different levels of analysis; (2) illustrate current research questions being explored via innovative approaches; and (3) identify promising areas for future research and clinical advances.