Leiden University Student Repository

Schutjes, Lotte (2025)

Does distress tolerance predict or moderate treatment outcomes of two variants of exposure therapy?

Master thesis | Psychology (MSc)

While exposure therapy is one of the first-line interventions for PTSD, efficacy is attenuated for some patients. This study investigated whether distress tolerance (DT) predicted exposure outcomes, and whether this effect differed across treatment conditions. We aimed to explore DT as an opportunity to improve exposure therapy for PTSD patients. We expected that lower DT predicted a decreased reduction of PTSD symptoms. Secondly, we hypothesised that this effect was stronger after an exposure session with an emphasis on expectancy violation than after an exposure session with no particular emphasis on expectancy violation. In a treatment- seeking PTSD sample of 57 participants, outcomes of one session of exposure treatment (clinical assay) were compared across two conditions. One focused on expectancy violation by optimally testing threat expectancies, while the other involved systematic repetitions of recounting the traumatic event. The Distress Tolerance Scale was administered...Show moreWhile exposure therapy is one of the first-line interventions for PTSD, efficacy is attenuated for some patients. This study investigated whether distress tolerance (DT) predicted exposure outcomes, and whether this effect differed across treatment conditions. We aimed to explore DT as an opportunity to improve exposure therapy for PTSD patients. We expected that lower DT predicted a decreased reduction of PTSD symptoms. Secondly, we hypothesised that this effect was stronger after an exposure session with an emphasis on expectancy violation than after an exposure session with no particular emphasis on expectancy violation. In a treatment- seeking PTSD sample of 57 participants, outcomes of one session of exposure treatment (clinical assay) were compared across two conditions. One focused on expectancy violation by optimally testing threat expectancies, while the other involved systematic repetitions of recounting the traumatic event. The Distress Tolerance Scale was administered before the exposure and PTSD symptoms were assessed using the PTSD Checklist for DSM-5, both before the exposure and one week afterwards. Our multilevel mixed model analysis showed that people with higher DT reported less severe PTSD symptoms. DT did not influence the extent in which PTSD symptom severity was reduced following the exposure session. Additionally, DT did not moderate an association between treatment condition and PTSD symptom reduction. The small sample size, lack of observable measure of DT, use of a clinical assay, and possible overlap between the conditions may have influenced our findings. Further research is necessary to explore DT as an underlying mechanism of exposure therapy.Show less

Author

Schutjes, Lotte

Faculty

Faculty of Social & Behavioural Sciences

Specialisation

Clinical Psychology

Supervisors

Kooistra, M.J.
De Kleine, R.A.

ECTS Credits

20

Language

en