Temporal Precedence of Distress Tolerance in Predicting Anxiety and Depression: A Daily Diary Approach During Mindfulness-Based Intervention.
Yanjuan Li, Amy Hu, Yiran Ding, Xinyi Tang, Xin Jiang, Yu Leng, Mo Chen, Stefan G Hofmann, Xinghua Liu
Behavior therapy May 1, 2026 DOI: 10.1016/j.beth.2025.11.006 (opens in new tab) via PubMed
Summary
AI-generated from the abstractDuring a mindfulness-based intervention, daily distress tolerance predicted next-day anxiety and, in later weeks, next-day depression, but the reverse relationships were not significant. Eighty-three adults with high emotional distress completed daily diaries before, during, and after the intervention. Distress tolerance, anxiety, and depression all improved one week after the intervention. In the first three weeks no time-lagged effects appeared; in the last four weeks, higher distress tolerance on one day predicted lower anxiety and depression the next day. The findings support distress tolerance as a temporal precursor to emotional distress, particularly when interventions aim to enhance it.
Study at a glance
| Characteristics | Daily diary study Peer reviewed |
|---|---|
| Sample size | 83 |
| Population | Adults with high emotional distress |
| Intervention | mindfulness-based intervention |
| Duration | One week before, during, and after the intervention |
| Keywords | Distress tolerance Emotional distress Mechanism Mindfulness-based intervention Temporal precedence |
| Key finding | Daily distress tolerance at time t significantly predicted daily anxiety (β = -0.06) but not daily depression (β = -0.03) the next day overall; in the last four weeks, daily distress tolerance at time t significantly predicted both next-day anxiety (β = -0.11) and next-day depression (β = -0.08). |
Abstract
This study used a daily diary method to examine the temporal relationship between distress tolerance (DT), anxiety, and depression during a mindfulness-based intervention (MBI). A total of 83 participants with high emotional distress completed daily diaries of mindfulness, DT, anxiety and depression over one week before, during, and after the intervention. Linear mixed models showed significant improvements in all measured variables (p < 0.001) one week after the intervention. Dynamic structural equation modeling found that daily DT at time t significantly predicted daily anxiety (β = -0.06, p = 0.006), but not daily depression (β = -0.03, p = 0.076) at time t + 1. In the first three weeks, no significant time-lagged relationships were observed. However, in the last four weeks, daily DT at time t significantly predicted both daily anxiety (β = -0.11, p < 0.001) and daily depression (β = -0.08, p = 0.002) at time t + 1. Reverse relationships were not significant. These findings support the temporal precedence of DT over anxiety and depression, especially when interventions target DT enhancement.