THE INTERACTION OF DISTRESS TOLERANCE AND INTOLERANCE
OF UNCERTAINTY IN
CBT FOR SOCIAL ANXIETY

July 6, 2017

Dear Colleagues,

As part of the National Social Anxiety Center’s (NSAC) service of disseminating and promoting evidence-based treatment, I’d like to share and receive feedback regarding emerging research focused specifically on the constructs of Distress Tolerance and Intolerance of Uncertainty for Social Anxiety Disorder (SAD). This study provided further evidence that levels of Distress Tolerance (low), as well as Intolerance of Uncertainty (high) were both predictive of post-treatment symptom severity in CBT group therapy for SAD. Interestingly, the author’s results supported an interaction among the two constructs in that higher Intolerance of Uncertainty levels were only predictive of greater symptom severity when Distress Tolerance levels were lower.

This suggests that patients with greater skill with Distress Tolerance in particular would likely be more willing to engage in and gain more benefit from interventions requiring uncertainty, i.e. exposure exercises and treatment adherence, and vice versa. Are these results evidence of a need for a distinct Distress Tolerance component for effective cognitive-behavioral therapy for social anxiety disorder?

“The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder”

Danielle Katz, Neil A. Rector & Judith M. Laposa (2017): Cognitive Behaviour Therapy, online, 22 June, 2017. Link to abstract.


Robert Yeilding, Psy.D.
Clinical Psychologist

Representative of NSAC Newport Beach / Orange County (Anxiety and
Depression Center)