Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people

Sophie Mattingley, George J. Youssef, Liam Graeme, Elise Sloan, Victoria Manning, Kate Hall

Research output: Contribution to journalArticleResearchpeer-review


Objective: Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. Method: Participants (N = 385; 62.3% female; aged 16–25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. Results: Both NU (adjusted odds ratio [ORadj] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. Conclusions: These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.

Original languageEnglish
Pages (from-to)261-278
Number of pages18
JournalJournal of Clinical Psychology
Issue number2
Publication statusPublished - Feb 2024


  • borderline personality disorder
  • distress tolerance
  • dysregulated eating behaviors
  • negative urgency
  • substance use disorder

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