Distress Tolerance Predicts Substance Use Motivations and Problems in Young Adults Across Four Continents

Introduction: People low in trait distress tolerance are at higher risk for harmful patterns of substance use. Some evidence suggests that maladaptive motives for substance use account for this correlation. However, the generality of these associations remains in doubt because virtually all available data come from North American samples. Method: Using data from 7 countries (total N = 5,858; US, Argentina, Uruguay, Spain, South Africa, Canada, and England), we examined distress tolerance’s association with alcohol- and cannabis-related problems in young adults. We then investigated whether motivational dimensions for substance use (i.e., coping, conformity, social, enhancement, expansion) mediated this association. Results: We found that distress tolerance was inversely related to problematic alcohol and cannabis use (rs = -.14 and -.13). Mediation analyses were consistent with the possibility that people with low distress tolerance experience more substance-related problems because they are driven to use alcohol and cannabis to neutralize negative emotions and avoid social rejection. Zero-order and indirect effects did not vary substantially across regions of the world. Conclusions: Distress tolerance’s role in substance-use problems probably generalizes beyond North America, and distress tolerance’s connection with negative reinforcement processes (e.g., coping and conforming motives) may create vulnerability to problematic substance use.