Distress tolerance is linked with 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 = 5858; U.S., Argentina, Uruguay, Spain, South Africa, Canada, and England), we examined distress tolerance's association with alcohol- and cannabis-related problems in young adults. On an exploratory basis, we examined how distress tolerance related to different substance-use motivations. Results: We found that distress tolerance was inversely related to problematic alcohol and cannabis use (rs = −0.14 and − 0.13). There was notable variation across countries in the magnitude of these effects, particularly for cannabis-related problems. Additionally, exploratory analyses revealed statistically significant (cross-sectional) indirect effects of distress tolerance on substance-related problems via substance-use motivations related to neutralizing negative emotions. Conclusions: Distress tolerance's role in substance-use problems appears to generalize beyond North America, although effect sizes were generally small and varied notably across geographical regions. Distress tolerance's connection with negative reinforcement processes (e.g., coping motives) warrants attention as a possible mediator of its association with problematic substance use.