PASAT-C

Background

The Computerized Paced Auditory Serial Addition Test (PASAT-C) is a cognitive-behavioral measure of distress tolerance, the ability to stay on task while continuously feeling stressed or frustrated. It was introduced in 2003 by C.W. Lejuez and collegues who adapted the design of the commonly considered challenging and stressful Paced Auditory Serial Addition Test (PASAT), originally used to assess processing speed and working memory health.

The PASAT requires participants to work on simple addition tasks under time pressure. Specifically, the PASAT presents participants with a series of digits at a constant pace. Participants have to respond with the sum of the last two presented digits as fast as possible. Different levels of the task are run, each time increasing the speed with which the digits are presented.

The PASAT-C adapts this general design with the following changes, intended to increase frustration:

• an aversive error sound is played for each missed or incorrect response
• participants see their total score the entire time on screen
• the last and most challenging level (usually level 3) presents participants with an Escape button

Task Procedure

A participant is presented with a circle of response buttons from 1 to 18. Every 2 seconds or so a digit appears in the center of the circle. As soon as the participant has calculated the sum of the last two presented digits, they need to press the respective response button as fast as possible before the next digit is spoken. If a mistake is made or the participant is not fast enough, an aversive error sound is played.

Participants work through three levels of the task. Level 1 starts with a relatively moderate presentation rate of one digit every 3 seconds. The presentation rate increases in level 2 to one digit every 2 seconds and finally to a challenging 1.5 seconds on level 3. Each level runs for a specified duration, with level 3 being the longest at 10 minutes. Level 3 (but not level 1 or level 2) can be cut short by pressing the escape button at any point.

What it Measures

Computerized Paced Auditory Serial Addition Test (PASAT-C) is a cognitive-behavioral measure of distress tolerance.

Psychological Domains

• Emotion Regulation: Ability to monitor, evaluate, and modify one's emotional responses in a way that aligns with one's goals and values
• Distress Tolerance: Ability to stay on a goal-oriented task while enduring emotional distress
• Impulsivity: Tendency toward rapid reactions to internal or external stimuli without considerations of negative long-term consequences

Main Performance Metrics

• Quitting: whether the escape button is pressed
• Level 3 Duration: time spent on the last, most challenging level

Psychiatric Conditions

Lower distress tolerance is linked to

• Depression
• Anxiety
• Drug Abuse
• Alcoholism
• Psychopathy