Background: Distress tolerance, defined as the ability to withstand emotional distress, is a mechanism that has been related to a wide array of psychiatric and substance use disorders. Distress tolerance is lower in individuals with psychiatric and substance use disorders and has also been found to predict opioid misuse and alcohol use problems. However, sex differences in distress tolerance have not been well characterized. Several studies suggest that a similar construct, anxiety sensitivity (fear of the sensations associated with anxiety), is higher in women compared to men. The objective of the present study is to examine whether there are sex differences in distress tolerance in adults with and without psychiatric disorders. We hypothesized that compared to women, distress tolerance will be greater among men.
Methods: We conducted a secondary analysis of five studies of distress tolerance in people with and without psychiatric and substance use disorders. Datasets were combined to increase statistical power to detect whether there are sex differences in distress intolerance using both self-report and behavioral measures (Ns=535 and 108 for self-report and behavioral measures).
Results: Bivariate analysis of self-reported distress tolerance found no significance difference between men and women (t=-1.47, p=.14). Bivariate analyses of behavioral measures indicated men had higher tolerance of pain compared to women (t=2.88, p<.01), however, there was no sex difference in tolerance of negative affect (t=1.04, p=.30). Results of an analysis of variance controlling for study indicated that there was no significant effect of sex on behavioral or self-reported distress tolerance when controlling for study type. A study by sex interaction, suggested that there may be a modest sex difference (characterized by higher tolerance) among men in self-reported distress tolerance.
Conclusion: There was some indication that men with substance use disorders had higher distress tolerance than women in self-report, but not behavioral measures. Results of this study can help to inform future research on distress tolerance in men and women.