Childhood Maltreatment Is Associated with Ulcerative Colitis but Not Crohnʼs Disease

Fuller‐Thomson, Esme; West, Keri J.; Sulman, Joanne; Baird, Stephanie L.

doi:10.1097/mib.0000000000000551

Cited by 39 publications

(19 citation statements)

References 55 publications

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“…A recent study found a significant percentage of IBD patients to have at least one ACE, stressing the possibility that childhood trauma might influence the course of IBD shown by a higher use of health care resources ( 37 ). However, in other population-based studies the link between maltreatment during childhood and IBD later in life was found only for Ulcerative colitis, but not for Crohn's disease ( 4 ). One possible explanation why the prevalence of ACE was not increased in our IBD sample might be that patients reporting current and/or lifetime psychiatric disorders were not included in the study.…”

Section: Discussionmentioning

confidence: 90%

“…Individuals who report experiences of early life stress are more prone to developing chronic inflammation, cardiovascular disease and affective disorders compared to non-traumatized controls ( 36 ). Some authors emphasized a potential role of ACE in gastrointestinal disorders ( 4 , 37 ). A cohort study revealed that the prevalence of at least one type of childhood adversity in IBD patients is above 70% with most of the patients reporting death of a family member during childhood and 12–13% reporting sexual or physical abuse ( 37 ).…”

Section: Introductionmentioning

confidence: 99%

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Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

et al. 2021

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Perception of internal bodily sensations includes three dissociable processes: interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Interoceptive abilities play a crucial role in emotion processing and impairments of these processes have been reported in several psychiatric disorders. Studies investigating interoceptive abilities and their role in emotional experience in individuals with somatic disorders such as inflammatory bowel diseases (IBD) are sparse. Recent findings suggested an association between adverse childhood experiences (ACE) and the development of gastrointestinal disorders. The aim of the current study was to investigate the associations between the different dimensions of interoception and emotional processing in IBD while taking ACE into account. We recruited IBD patients in clinical remission (n = 35) and 35 healthy control participants (HC) matched for age, education and IQ. Interoception was measured as a three-dimensional construct. Interoceptive accuracy was assessed with the heartbeat tracking task and interoceptive sensibility with a self-report measure (Multidimensional Assessment of Interoceptive Awareness questionnaire). Emotional processing was measured using an experimental task, where participants were asked to rate the subjectively perceived valence and arousal when presented with positive, neutral and negative visual stimuli. IBD patients significantly differed in two interoceptive sensibility domains, Emotional awareness and Not-distracting. Patients reported greater awareness of the connection between bodily sensations and emotional states, while showing a stronger tendency to use distraction from unpleasant sensations compared with HC. Higher emotional awareness was linked to higher perceived intensity and arousal of negative stimuli. The strength of this relation was dependent on the severity of ACE, with severer traumatization being associated with a stronger association between emotional awareness and perceived valence and arousal. Our findings suggest that it is the subjective component of interoception, especially the one assessing interoceptive abilities within the scope of emotional experience, which affects emotional processing in IBD. This is the first study providing evidence that IBD patients did not differ in their perception of visceral signals per se but only in the subjective ability to attribute certain physical sensations to physiological manifestations of emotions. Our findings support the hypothesis that ACE affect the association between interoception and emotional processing.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

et al. 2021

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“…This can then lead to a dysregulation of inflammatory feedback mechanisms, which promotes the development of inflammatory-related or immunosuppressed medical conditions. Even years later (91,92), these alterations may persist. Thus, this assumption of repeated or chronic stress in early life in UC patients would not be surprising given that the prevalence of early adversities (i.e., exposure to parental domestic violence, childhood physical abuse, childhood sexual abuse) is high in these patients (93).…”

Section: Discussionmentioning

confidence: 99%

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome

et al. 2020

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Alexithymia is usually described by three main dimensions difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). The most commonly used questionnaire investigating alexithymia, the Toronto Alexithymia Scale (TAS-20), supports this three-factor structure. One important assumption is that alexithymia severity is associated to vulnerability to somatic diseases, among them gastrointestinal disorders. However, the association between alexithymia and gastrointestinal disorders is not systematic, thus questioning the role of alexithymia as a vulnerability factor for those illnesses. A recent factor analysis suggested another fourfactor structure for the TAS-20: difficulties in awareness of feelings (DAF), difficulties in interoceptive abilities (DIA), externally oriented thinking (EOT), and poor affective sharing (PAS). We assume that DIA and DAF might be more relevant to investigate the association between alexithymia and gastrointestinal disorders. The rationale is that DIA and DAF reflect impairments in emotion regulation that could contribute to an inappropriate autonomic and HPA axis homeostasis in irritable bowel syndrome (IBS), ulcerative colitis (UC), or Crohn's disease (CD). The aim of this study was to investigate whether DIA and DAF are associated with the presence of IBS, UC or CD, while checking for anxiety, depression, parasympathetic (vagus nerve) activity and cortisol levels. We recruited control participants (n=26), and patients in remission who were diagnosed with IBS (n=24), UC (n=18), or CD (n=21). Participants completed questionnaires to assess anxiety, depression, and alexithymia. A blood sample and an electrocardiogram were used to measure the level of cortisol and parasympathetic activity, respectively. Logistic regressions with the four-factor structure of the TAS-20 revealed that DIA was a significant predictor of IBS (W(1)=6.27, p=.01). Conversely, DIA and DAF were not significant predictors in CD and UC patients. However, low cortisol level was a Frontiers in Psychiatry | www.frontiersin.org

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“…As has been described elsewhere 6 , [37][38][39][40][41][42] , the present study utilized data from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). The CCHS-MH is a cross-sectional nationally representative survey of the Canadian population, age 15 or older, living in the 10 provinces with an overall response rate of 68.9% 43 .…”

Section: Methodsmentioning

confidence: 99%

Flourishing Despite Migraines: A Nationally Representative Portrait of Resilience and Mental Health among Canadians

Fuller‐Thomson

2021

AHM Journal

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Objective 1) To examine the relationship between migraine status and complete mental health (CMH) among a nationally representative sample of Canadians; 2) To identify significant correlates of CMH among those with migraine. Methods Secondary analysis of the nationally representative Canadian Community Health Survey – Mental Health (CCHS-MH) (N=21,108). Bivariate analyses and a series of logistic regression models were performed to identify the association between migraine status and CMH. Significant correlates of CMH were identified in the sample of those with migraine (N=2,186). Results Individuals without a history of migraine had 72% higher odds of being in CMH (OR=1.72; 95% CI=1.57, 1.89) when compared with those with a history of migraine. After accounting for physical health and mental health problems, the relationship between migraine status and CMH was reduced to non-significance, with both groups having an approximately equal likelihood of achieving CMH (OR=1.03; 05% CI=(0.92, 1.15). Among those with migraine, factors that were strongly associated with CMH were a lack of a history of depression, having a confidant, and having an income of $80,000 or more. Conclusion Clinicians and health care providers should also address co-occurring physical and mental health issues to support the overall well-being of migraineurs.

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Childhood Maltreatment Is Associated with Ulcerative Colitis but Not Crohnʼs Disease

Abstract: Childhood physical and sexual abuse are related to ulcerative colitis, but not Crohn's disease. Future research that can address epigenetic and neuroendocrine factors should investigate pathways through which early adversities may translate into one type of IBD but not another.

Cited by 39 publications

References 55 publications

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome

Flourishing Despite Migraines: A Nationally Representative Portrait of Resilience and Mental Health among Canadians

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