Table of Contents
Abstract
The Distress Tolerance Measure (DTM), developed by Lass and colleagues in 2023, is a novel research instrument designed to assess an individual’s self-reported capacity to withstand negative and uncomfortable emotional states. Unlike traditional quantitative scales, the DTM was explicitly created for a qualitative analysis focusing on the subjective conceptualization of Distress Tolerance.
The instrument was administered to a sample of university students and comprised 11 open-ended questions targeting attitudes toward distress tolerance. The responses were subsequently subjected to systematic coding procedures based on established qualitative methodologies (Braun & Clarke, 2006; Nowell et al., 2017). The study reported robust Interrater Reliability results for these coding procedures, confirming the rigor of the data processing.
Keywords
Distress Tolerance, Concept Attitudes, Definitions, Stress Reactions, Conceptual Clarification, Psychological Assessment, Qualitative Methodology.
Authors
Lass, Alisson N. S., Veilleux, Jennifer C., DeShong, Hilary L., Winer, E. Samuel
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Purpose
The primary purpose of the Distress Tolerance Measure is to undertake a detailed examination of how individuals define and understand the crucial terms utilized in self-report measures of distress tolerance. This includes defining “distress,” “stress,” and “upset” in their own words, thereby providing necessary conceptual clarification within the field.
Furthermore, the instrument aims to explore participants’ metaperceptions regarding their ability to tolerate distress, specifically investigating whether they perceive this ability as a stable, trait-like characteristic or as a variable capacity that fluctuates depending on specific contexts and situations (e.g., stable versus variable tolerance).
Construct
The DTM measures the construct of attitudes toward distress tolerance, focusing on the cognitive and semantic frameworks through which individuals understand their emotional capacity. Rather than measuring the magnitude of distress tolerance, the scale elicits rich qualitative data on the subjective experience of distress, coping behaviors, and the perceived contextual factors that influence tolerance.
The instrument is designed to gather information that aids in refining the psychological definition of distress tolerance, serving as a foundational tool for researchers seeking to develop more conceptually precise quantitative measures in the future.
Validity
No formal psychometric validity indices (such as criterion or construct validity) were reported for the Distress Tolerance Measure. Since the DTM was intentionally designed as an original qualitative survey instrument for conceptual mapping, the focus of the initial study was on the reliability of the data coding process rather than the validation of latent factors.
Reliability
Reliability was established through rigorous evaluation of the qualitative coding procedures, specifically focusing on Interrater Reliability (ICR). This process ensures that multiple independent coders interpret and categorize the open-ended responses consistently.
The results demonstrated excellent intercoder agreement. The average value of Maxwell’s RE (Maxwell, 1977) calculated across all coding categories was 0.95 (SD = 0.05). This high value strongly supports the objectivity and consistency of the coding scheme applied during the qualitative analysis.
Factor Analysis
No formal factor analysis was indicated or performed. Given the instrument’s design—relying predominantly on open-ended, free-response items for qualitative data collection—traditional factor analysis techniques used to identify underlying quantitative dimensions were not applicable to the study methodology.
Instrument
Test Type: Original Survey Instrument (Qualitative)
Format: The DTM consists of 11 items. Most items are open-ended, requiring descriptive responses. Question 8 employs a branching format, generating multiple subsequent parts based on whether participants answer “yes” or “no” to the initial query.
Language Available: English
Population Group: Human (Male; Female)
Age Group: Adulthood (18 yrs & older)
Population Details: The initial respondents were university students located in the United States. The administration method used was electronic.
Test Methodology: The study methodology focused on establishing Test Reliability, specifically Interrater Reliability, to ensure the consistent application of the qualitative coding scheme.
Keywords
Concept Formation, Concepts, Distress, Stress Reactions, Tolerance, Stress and Coping Measures, Qualitative Assessment, Psychological Measurement.
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Authors
The authors of the Distress Tolerance Measure and the associated research article are listed below, along with their professional affiliations and contact information:
Lass, Alisson N. S.
Author ORCID Identifier: http://orcid.org/0000-0002-5263-7228
Affiliation: Mayo Clinic, Department of Psychiatry and Psychology
Email address: [email protected]
Correspondence Address: Mayo Clinic, Department of Psychiatry and Psychology, 200 First St. SW, Rochester, Minnesota, United States, 55902, [email protected]
Veilleux, Jennifer C.
Affiliation: University of Arkansas, Department of Psychology
Email address: No data is Available
DeShong, Hilary L.
Affiliation: Mississippi State University, Department of Psychology
Email address: No data is Available
Winer, E. Samuel
Author ORCID Identifier: http://orcid.org/0000-0002-3817-874X
Affiliation: New School for Social Research, Department of Psychology
Email address: No data is Available
Permissions & Fee and Test Year
The Distress Tolerance Measure is available for non-commercial use.
Permissions: May use for Research/Teaching
Fee: No
Commercial: No
Test Year: 2023
Reference’s
Lass, A. N. S., Veilleux, J. C., DeShong, H. L., & Winer, E. S. (2023). What is distress tolerance? Presenting a need for conceptual clarification based on qualitative findings. Journal of Contextual Behavioral Science, 29, 23–32. The publication is accessible via DOI: https://doi.org/10.1016/j.jcbs.2023.05.003
The coding procedures referenced the following methodological sources:
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1), 1609406917713304.
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Items of the Distress Tolerance Measure
The full set of instructions and the 11 items of the Distress Tolerance Measure are provided below. The original test items can be located in the source publication, specifically identified as 2023-80921-001, Table 1, Page 25.
Instructions and Questions Provided to Participants
The following questions will ask you to describe terms and answer questions in your own words. Please think carefully about each question and provide thorough and thoughtful responses. Try to provide 2–4 sentences for each question.
| Item | Question |
| 1 | What does the term “distress” mean to you? |
| 2 | What do you do when you are distressed? |
| 3 | What is the most distressing part of your day? |
| 4 | What does term “upset” mean to you? |
| 5 | What do you do when you are upset? |
| 6 | What is the most upsetting part of your day? |
| 7 | What kinds of things do you find upsetting? |
| 8 | Do the terms “stress” and “distress” mean the same thing to you? |
| 8 N1 | If no to 8: How do you differentiate between the terms stress and distress? |
| 8 N2 | If no to 8: What kinds of things do you find distressing? |
| 8 N3 | If no to 8: What kinds of things do you find stressful? |
| 8 Y1 | If yes to 8: What kinds of things do you find to be stressful/distressing? |
| 9 | Describe a time in your life when you noticed changes in the types of things you found distressing (i.e., things that didn’t used to be distressing became distressing or you used to be distressed by something, but stopped finding it distressing). |
| 10 | What things make it more difficult for you to tolerate distress? |
| 11 | How does your ability to tolerate distress change in different settings (i.e., at home vs. school; home vs. work)? |
Cite this article
Mohammed looti (2025). Distress Tolerance Measure. Psychological Scales & Instruments Database. Retrieved from https://db.arabpsychology.com/scales/distress-tolerance-measure/
Mohammed looti. "Distress Tolerance Measure." Psychological Scales & Instruments Database, 31 Oct. 2025, https://db.arabpsychology.com/scales/distress-tolerance-measure/.
Mohammed looti. "Distress Tolerance Measure." Psychological Scales & Instruments Database, 2025. https://db.arabpsychology.com/scales/distress-tolerance-measure/.
Mohammed looti (2025) 'Distress Tolerance Measure', Psychological Scales & Instruments Database. Available at: https://db.arabpsychology.com/scales/distress-tolerance-measure/.
[1] Mohammed looti, "Distress Tolerance Measure," Psychological Scales & Instruments Database, vol. X, no. Y, ص Z-Z, October, 2025.
Mohammed looti. Distress Tolerance Measure. Psychological Scales & Instruments Database. 2025;vol(issue):pages.