Distressed Drinking: The Moderating Impact of Distress Tolerance on the Relation Between Anxiety Sensitivity, Panic Symptoms, and Alcohol Use and Problems

Objective: Undergraduate students are at particular risk for greater alcohol use, which is linked to anxiety disorders among a variety of other negative consequences. Understanding transdiagnostic factors underlying alcohol use problems and other disorders, such as anxiety and mood disorders, can help identify potential targets for in-tervention. Method: The present study (N = 208 undergraduates; 76.9% female) tested relations between self-reported anxiety sensitivity, panic symptoms, alcohol use and problems, and two different measures of distress tolerance. Specifically, the distress tolerance measures assessed (a) perceived ability to handle negative emotion states (emotional dis-tress tolerance), measured via self-report, and (b) behavioral ability to tolerate discomforting physical sensations (physical distress tolerance), measured via a breath-holding duration task. Results: Consistent with expectations, anxiety sensitivity was associated with greater panic symp-toms, which in turn was associated with greater alcohol use problems, for individuals with low but not high levels of physical distress tolerance. Contrary to expectations, there was no evidence that panic symptoms explained the relation between anxiety sensitivity and alcohol use and problems at either low or high levels of emotional distress tolerance. Conclusions: Taken together, these results suggest that a possible target to decrease alcohol use problems is to increase capacity to withstand or engage with discomforting physiological and panic sensations (i.e., to cultivate greater physical distress tolerance). (J. Stud. Alcohol Drugs, 84, 928-935, 2023)