Piloting a School-Based Distress Tolerance Skills Program for Adolescents (STRIDE)

The STRIDE Study (Strengthening Tolerance and Resilience in Dealing with Emotions): Pilot Testing of a School-Based Distress Tolerance Skills Program for Reducing Risk of Psychopathology in Adolescence

Research suggests that an individual's perceived ability to withstand distressing or upsetting emotions (i.e., distress tolerance; DT) is a common risk factor across several mental health conditions that commonly emerge during adolescence. This study aims to evaluate the acceptability, feasibility, and initial efficacy of a classroom-based DT skills training program for middle school students. This study will also explore associations between changes in DT and internalizing symptoms (e.g., anxiety, depression).

Study Overview

• Status: Active, not recruiting
• Conditions: Distress, Emotional; Internalizing Mental Health Symptoms
• Intervention / Treatment: Behavioral: Distress Tolerance Skills Training

Detailed Description

A variety of deleterious mental health conditions have their peak age of onset in adolescence, including depression and anxiety. Distress tolerance (DT) - defined as the perceived or actual ability to withstand aversive emotional states - has been postulated as a transdiagnostic risk factor across several "emotional" disorders that typically emerge during adolescence. Importantly, while there is compelling evidence that DT is associated with emotion dysregulation and symptom severity, it is unclear whether modifying DT can reduce future risk for psychopathology in adolescent populations. This proposal aims to evaluate the feasibility, acceptability, and initial efficacy of a classroom-based DT intervention for middle school students. Additionally, this proposal will examine associations between changes in DT and internalizing symptoms.

Primary Objective:

To evaluate the acceptability, feasibility, and efficacy of a classroom-based DT skills training program for middle school students.

Secondary Objectives:

To examine whether participation in the DT skills training program is associated with lower severity of internalizing symptoms over the course of the academic year.

• Study Type: Interventional
• Enrollment (Actual): 74
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Oregon
    • Beaverton, Oregon, United States, 97078
      • Valley Catholic Middle School

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Middle school aged-youth attending Valley Catholic Middle School in grade 6, 7, or 8

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Distress Tolerance Skills Training; Students will participate in a series of classroom-based lessons aimed at increasing distress tolerance.	Behavioral: Distress Tolerance Skills Training; These lessons are adapted from "DBT Skills in Schools: Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A)" by Mazza et al. and include elements of mindfulness training, psychoeducation about emotions, and techniques/skills for managing extreme emotions.
No Intervention: Standard Curriculum (Control); Students will not participate in the distress tolerance skills training. They will receive only their standard curriculum during class time.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility	Consent rates during enrollment and attrition rates during the study will be used to assess the feasibility of the intervention.	Pre-intervention and immediately post-intervention
Acceptability	The investigators will use a brief feedback survey at the end of the study to gather information about participants' experiences of the intervention. Responses on this survey will be used to determine the acceptability of the intervention.	Immediately post-intervention
Distress Tolerance	The investigators will assess change in distress tolerance from pre-intervention to post-intervention. Distress tolerance will be indexed by total scores on the Distress Tolerance Scale (DTS), which is a 15-item self-report measure that assesses the respondent's perceived ability to withstand distressing or upsetting emotional states. Possible total scores can range from 15 to 75. Higher scores indicate higher distress tolerance. This outcome measure will be examined and compared for both the intervention group and the control group.	Pre-intervention, immediately post-intervention, 3-month follow-up, and 6-month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Internalizing Symptoms	The investigators will assess change in internalizing symptoms from pre-intervention to post-intervention and periodically during follow-up. Internalizing symptoms will be measured using the ASEBA Youth Self-Report (YSR). Possible raw scores on the Internalizing Symptoms Subscale can range from 0 to 62. Raw scores are transformed to standardized T-scores normed by age and gender and can range from 26 to 100. Higher scores indicate greater symptoms. This outcome measure will be examined and compared for both the intervention group and the control group.	Pre-intervention, immediately post-intervention, 3-month follow-up, and 6-month follow-up

Collaborators and Investigators

• Sponsor: Oregon Health and Science University
• Collaborators: Valley Catholic Middle School
• Investigators: Principal Investigator: Bonnie Nagel, PhD, Oregon Health and Science University

Study record dates

Study Major Dates

• Study Start (Actual): October 25, 2024
• Primary Completion (Estimated): June 1, 2025
• Study Completion (Estimated): June 1, 2025

Study Registration Dates

• First Submitted: October 9, 2024
• First Submitted That Met QC Criteria: October 10, 2024
• First Posted (Actual): October 15, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 19, 2025
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: STUDY00027611

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No