Second, as expected, PTS symptom severity demonstrated a significant, concurrent (positive) association with DT, even after accounting for the significant variance in DT explained by marijuana use frequency. This finding is consistent with prior work documenting the association between PTS and perceived tolerance of emotional distress (Marshall et al., in press; Vujanovic, Bonn-Miller, et al., in press). Notably, the reliance on cross-sectional methodology in the extant empirical literature related to DT and PTS underscores the importance of evaluating the temporal and causal directionality underlying the observed effects, using experimental and prospective designs. Theoretically, there are several possibilities regarding the directionality of the observed DT-PTS association (Vujanovic et al., 2010). First, it is plausible that DT levels may change (increase or decrease) as a function of exposure to traumatic stressors. Second, PTS symptom severity may promote less tolerance of distress over time. Third, lower or higher levels of DT prior to trauma exposure may predispose an individual to a course toward risk or resilience, respectively. Fourth, DT and PTS symptom levels may relate bi-directionally or transactionally, as noted in prospect work related to similar emotional vulnerability processes (e.g., Marshall, Miles, & Stewart, 2010).
