Reduction of Distress Intolerance With Salutotherapeutic Interventions: Results From a Randomized Controlled Clinical Trial.

Background: Distress tolerance is the ability to pursue one's goals in the presence of (chronic) stressors, hardship, adversities and negative internal states, and psychological distress. By contrast, distress intolerance is a transdiagnostic indicator of mental illness and a mediator in coping with problems in life, work demands, or stress in general. There is a lack of data regarding intervention strategies. The objective of the present study is to test the differential effects of two treatment approaches: "regeneration fostering" versus "resistance training."

Methods: Inpatients of a psychosomatic hospital were randomly allocated to either a resistance training group therapy (n = 65)-that is, active coping with demands and endurance-or a regeneration fostering group therapy (n = 62)-that is, recovery, mindful indulgence, and creative activities. They were compared with a group of patients who received treatment as usual (n = 43), without special treatments for distress intolerance, and the outcome was measured with the "Distress Intolerance Scale." One-way and repeated measure analyses of variance and paired t tests were used for the analysis.

Results: The "regeneration" group showed a significant improvement in distress intolerance, whereas there was no significant change for the treatment-as-usual group and in the "resistance" group. Post hoc tests were conducted with paired sample t tests for pre-post comparisons for each group. No differences were found for the treatment-as-usual group (mean difference: 0.03, SD (mean difference): 0.89; t(42) = 0.266, p = 0.792, d = 0.04) and for the resistance group (mean difference:-0.07, SD (mean difference): 0.73; t(63) = -0.736, p = 0.464, d = 0.08). The regeneration group showed a significant decline in distress intolerance (mean difference: 0.29, SD (mean difference): 0.72; t(61) = 3.156, p = 0.002, d = 0.38).

Conclusions: In the treatment of distress intolerance, it seems promising to focus on positive psychology interventions and resources. Limitations of the study are that it was conducted with psychosomatic inpatients only and that no follow-up data are available.