The double-edged sword of distress tolerance: Exploring the role of distress overtolerance in nonsuicidal self-injury

초록

Background: While low distress tolerance has been widely studied as a risk factor for nonsuicidal self-injury (NSSI), recent attention has shifted toward distress overtolerance-an individual's excessive endurance to distress despite severe adverse effects. Understanding this double-edged nature of distress tolerance is critical for developing effective intervention strategies to address the growing burden of NSSI. This study investigated the role of distress overtolerance in NSSI pathology. Methods: The study comprised 1818 female participants, including 918 and 900 participants with and without a history of NSSI, respectively. Binary logistic regression models were utilized to analyze distress overtolerance as a predictor of NSSI engagement, versatility, and frequency while controlling for demographic variables, depression, anxiety, and emotion dysregulation. Among the participants with a history of NSSI, Pearson's correlation analyses were conducted to identify the functions of NSSI that were the most associated with distress overtolerance. Results: Distress overtolerance was identified as a significant predictor of NSSI engagement, versatility, and frequency even after controlling for other risk factors. Distress overtolerance was most strongly linked to selfpunishment function in individuals with a history of NSSI. Conclusions: Distress overtolerance is a distinct and significant risk factor for NSSI, highlighting the need for its inclusion in mechanisms and intervention models for NSSI. Addressing distress overtolerance in therapeutic settings to achieve an optimal balance in distress regulation could provide innovative and more effective strategies for the treatment of NSSI.

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