Investigating the relationship between the five-factor model of distress tolerance, anxiety and anxiety sensitivity

Background Distress tolerance (DT) has been conceptualized as a vulnerability factor for several psychopathologies. A five factor model of DT has been suggested, but its associations with anxiety and anxiety sensitivity have yet to be explored. Objectives This study aimed to further validate the five-factor model of DT, identify the associations between its factors and elevated anxiety, and assess if anxiety sensitivity mediates the association between DT and anxiety. Design and methods This observational study included 330 students and university workers (women = 82.7%; mean age = 27.7 years, SD = 9.4). They completed online questionnaires assessing DT, anxiety sensitivity and anxiety levels. Results The five-factor model was a good fit to the data (RMSEA = .04). Two factors, and the sex of the participants, contributed to the variance in anxiety (r2 = .418, p < .001). Tolerance of negative emotion was directly (beta = -1.98, 95% CI = [-2.53, -1.42]) and indirectly (beta = -1.10, 95% CI = [-1.55, -.78]) associated with lower anxiety through anxiety sensitivity. Tolerance of uncertainty was also directly (beta = -.08, 95% CI = [-.10, -.06]) and indirectly (beta = -.04, 95% CI = [-.05, -.02]) associated with lower anxiety through anxiety sensitivity. Conclusions Tolerance of negative emotion and uncertainty were associated with anxiety independently of the other factors of DT. These associations seem partially explained by the effect of anxiety sensitivity.