Validation of the DistressRx™ Assessment Tool
Development and Psychometric Evaluation of a Framework to Identify Distress Tolerance Subtypes Among Women Physicians
IRB Exempt – No identifiers were collected.
Abstract
Background: Physicians experience persistent cognitive and emotional load, yet few instruments capture the nuanced ways they internalize and transform distress. The DistressRx™ Assessment was developed to address this gap by operationalizing six distinct distress-tolerance subtypes within the Transform® Tolerance Distress Model—a framework integrating stress-and-coping theory, emotion-regulation research, and developmental coaching science.
Methods: Item development drew on eight years of qualitative coaching data from women physicians and was informed by established models of stress and emotion regulation. Data from 350 women physicians were analyzed using exploratory and confirmatory factor analyses (EFA/CFA) to evaluate factorial validity and internal reliability.
Results: Analyses supported a coherent six-factor structure with excellent fit indices (CFI = 1.00, TLI = 1.00, RMSEA = 0.004, SRMR = 0.033). Subscale reliabilities were strong (α = .73–.86), confirming conceptual clarity.
Conclusions: The DistressRx™ Assessment demonstrates exceptional factorial validity and reliability as an evidence-based tool for identifying patterned emotional responses to stress among physicians.
Introduction
Physicians face chronic emotional intensity, time pressure, and responsibility for high-stakes outcomes. Despite shared external stressors, physicians differ markedly in how they internalize and respond to distress...
Theoretical Framework
The DistressRx™ integrates three foundational theories—stress appraisal, emotion regulation, and distress tolerance—within a developmental lens informed by adult learning and coaching psychology.
DistressRx™ Subtypes
- Isolation Distress: Emotional withdrawal and self-protection through detachment.
- Assertive Distress: Effort to regain control or authority when stability feels threatened.
- Validation Distress: Reliance on external reassurance to affirm self-worth.
- Control Distress: Overplanning or perfectionism to mitigate uncertainty.
- Impulsivity Distress: Rapid action to discharge tension or avoid vulnerability.
- Catastrophizing Distress: Anticipation of worst-case outcomes to regain predictability.
Methods
Participants: N = 350 women physicians from The FIT Collective® professional development programs participated...
| Criterion | Benchmark | Result | Outcome |
|---|---|---|---|
| KMO | ≥ .70 | .75 | Acceptable |
| Bartlett’s Test | p < .001 | < .001 | Pass |
| EFA Structure | ≥ 6 factors, > 55% variance | 6 factors, 57% | Strong |
| Subscale α | .65–.85 | .73–.86 | Excellent |
| CFA Fit | CFI ≥ .94, RMSEA ≤ .06 | 1.00 / 0.004 | Excellent |
Discussion
The DistressRx™ uniquely bridges clinical psychology and coaching science. It reframes distress not as dysfunction, but as data for growth...
Conclusion
The DistressRx™ Assessment represents a significant advancement in understanding distress tolerance among physicians. It integrates psychometric rigor with developmental insight, providing a framework that honors distress as an intrinsic part of human performance.
Acknowledgements
The authors thank the women physicians of The FIT Collective® for their generous participation and reflection throughout this validation process.
Funding and Conflict of Interest
No external funding was received. The authors declare no conflict of interest.