Effect of Illness Representations and Catastrophizing on Quality of Life in Adults With Irritable Bowel Syndrome

Sherwin, LeeAnne B.; Leary, Emily; Henderson, Wendy A.

doi:10.3928/02793695-20160803-01

Cited by 20 publications

(19 citation statements)

References 58 publications

(71 reference statements)

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“…We found in this cohort that both males and females with IBS reported similar impairment of all eight subscales as well as overall QOL. For instance, scores on the food avoidance subscale demonstrated significant QOL impairment for IBS sufferers of both genders, reflecting similar results found in previous studies [ 18 , 19 ]. In our previous work in a separate study population, we found that individuals with IBS who catastrophized often reported significantly greater impairment of the food avoidance subscale compared to those who did not catastrophize [ 8 ].…”

Section: Discussionsupporting

confidence: 89%

Gender and Weight Influence Quality of Life in Irritable Bowel Syndrome

Sherwin

Ozoji

Boulineaux

et al. 2017

JCM

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Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain and bowel dysfunction in the absence of structural abnormality. Diagnosis can be challenging and often leads to extensive medical tests, non-effective therapeutic modalities, and reduced quality of life (QOL). Identifying factors associated with dysfunction have the potential to enhance outcomes. Participants with IBS (n = 41) and healthy volunteers (n = 74) were recruited into this cross-sectional, descriptive, natural history protocol at the National Institute of Health, Clinical Center. Demographic characteristics were self-reported. QOL was assessed with the Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire. Statistical analysis included descriptive statistics, factorial ANOVA, and multiple regression. Individuals with IBS reported lower QOL scores across all QOL-subscales compared to healthy controls. Normal-weight women and overweight men with IBS reported the greatest QOL impairment. Body fat percent had confounding effects on the relationship between IBS and QOL. The disparity between QOL scores in participants with IBS by both gender and weight groups may reflect different social pressures perceived by normal and overweight women and men. These findings enhance the recognition of the disparities in patients with chronic symptoms and thereby lead to personalized assessment and interventions to improve their QOL.

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Section: Discussionsupporting

confidence: 89%

Gender and Weight Influence Quality of Life in Irritable Bowel Syndrome

Sherwin

Ozoji

Boulineaux

et al. 2017

JCM

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“…Illness representations have been noted to impact outcomes in such disorders as heart disease [36], rheumatoid arthritis [37], cancer [38, 39], and limited reports in IBS [3, 4]. There is persistent evidence for the theoretical predictable relations between illness perceptions, coping, and outcomes across these studies.…”

Section: Discussionmentioning

confidence: 99%

“…Impairment of quality of life and maladaptive coping have been found in those who suffer from irritable bowel syndrome [3, 4]. Additionally, Rutter and Rutter [3] found that adaptive coping can enhance outcomes such as quality of life and satisfaction with health.…”

Section: Introductionmentioning

confidence: 99%

The association of catastrophizing with quality-of-life outcomes in patients with irritable bowel syndrome

2017

Self Cite

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BackgroundCatastrophizing is a cognitive process characterized by a propensity to concentrate on and magnify the value of an actual or anticipated painful stimulus and negatively assesses one’s ability to cope. Catastrophizing is an important predictor of pain-related outcomes. A cornerstone symptom of irritable bowel syndrome (IBS) is abdominal pain or discomfort. Also individuals with IBS have been reported to have a tendency to catastrophize. In a sample of individuals who suffer from IBS, we hypothesized that those individuals who catastrophize (catastrophizers) would have worse outcomes as compared to those who do not catastrophize (non-catastrophizers).MethodsOne hundred and one adults with IBS (79% female, mean age 42 years, 97% Caucasian) were recruited from outpatient clinics and data were collected through self-report measures. Catastrophizing was measured with the catastrophizing subscale of the Coping Strategies Questionnaire, illness representations were measured with The Revised Illness Perception Questionnaire (IPQ-R), psychological distress was measured with the Brief Symptom Inventory 18 (BSI-18), and health-related quality of life was measured using the Irritable Bowel Syndrome-Quality of Life (IBS-QOL) measure. Descriptive statistics, correlations, and multiple linear regression analyses were completed to describe participants, the associations of the variables of interest, and the unique relationship between psychosocial variables and HRQOL.ResultsOverall, participants reported poor HRQOL (M = 63.32, range 0–100). Catastrophizers differed significantly on IBS-QOL from non-catastrophizers (M = 48.98 vs. non-catastrophizers M = 78.53; p < 0.001), BSI-18 (M = 21.35 vs. non-catastrophizers M = 6.76; p < 0.001), and IPQ-R, specifically the consequences (M = 21.75 vs. non-catastrophizers M = 17.20; p < 0.001) and emotional representations (M = 20.90 vs. non-catastrophizers M = 15.43; p < 0.001). Catastrophizing was positively correlated with the consequences (r = .54; p < 0.01) and emotional representations (r = .65; p < 0.01) and negatively correlated with total HRQOL (r = −0.76; p < 0.01).ConclusionThe findings indicated that participants who catastrophized reported worse psychosocial and functional outcomes. Thus, catastrophizing, in addition to psychological distress variables, may be an important factor to address in optimizing health outcomes in individuals with IBS. In addition, illness perceptions were strongly related to catastrophizing and HRQOL; assessment and integration of illness perceptions as well as catastrophizing into the management of individuals who suffer with IBS may maximize the health outcomes.

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“…Maladaptive coping is widely associated with both intestinal and extraintestinal symptom severity in IBS [261]. Particularly catastrophizing, a prime maladaptive coping strategy, is overrepresented in IBS and related to diminished quality of life [212,213] and increased IBS symptom severity [56,247]. On the other hand one of the most effective IBS treatments, cognitive behavioral therapy is mainly based on implementing adaptive coping, in order to face and handle the pain, and demonstrates long-term positive effects on both IBS symptoms as well as quality of life [118,209].…”

Section: Psychological Comorbiditiesmentioning

confidence: 99%

“…The impact of mood and emotional states on pain perception is widely recognized, both for chronic and acute pain states [243]. Similarly, the influence of adaptive and maladaptive coping is pivotal in IBS pathophysiology and treatment [56,118,209,212,213,247,261].…”

Section: Brain-gut Axis: Psychological Aspectsmentioning

confidence: 99%

Peripheral and Central Mechanisms in Irritable Bowel Syndrome : in search of links

Bednarska

2019

Linköping University Medical Dissertations

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Irritable bowel syndrome (IBS) is a chronic visceral pain disorder with female predominance, characterized by recurrent abdominal pain and disturbed bowel habits in the absence of an identifiable organic cause. This prevalent and debilitating disease, which accounts for a substantial economic and individual burden, lacks exact diagnostic tools and effective treatment, since its pathophysiology remains uncertain. The bidirectional and multilayered brain-gut axis is a well-established disease model, however, the interactions between central and peripheral mechanisms along the brain-gut axis remain incompletely understood. One of the welldescribed triggering factors, yet accounting for only a fraction of IBS prevalence, is bacterial gastroenteritis that affects mucosal barrier function. Altered gut microbiota composition as well as disturbed intestinal mucosal barrier function and its neuroimmune regulation have been reported in IBS, however, the impact of live bacteria, neither commensal nor pathogenic, on intestinal barrier has not been studied yet. Furthermore, abnormal central processing of visceral sensations and psychological factors such as maladaptive coping have previously been suggested as centrally-mediated pathophysiological mechanisms of importance in IBS. Brain imaging studies have demonstrated an imbalance in descending pain modulatory networks and alterations in brain regions associated with interoceptive awareness and pain processing and modulation, particularly in anterior insula (aINS), although biochemical changes putatively underlying these central alterations remain poorly understood. Most importantly, however, possible associations between these documented changes on central and peripheral levels, which may as complex interactions contribute to disease onset and chronification of symptoms, are widely unknown. VMpo ventromedial thalamic nucleus posterior portion VPAC vasoactive intestinal polypeptide receptor VSI Visceral Sensitivity Index Recurrent abdominal pain or discomfort** at least 3 days per month in the last 3 months associated with 2 or more of the following: 1. Improvement with defecation 2. Onset associated with a change in frequency of stool 3. Onset associated with a change in form (appearance) of stool *Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis. **Discomfort means an uncomfortable sensation not described as pain. In pathophysiology research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening evaluation for subject eligibility.

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Effect of Illness Representations and Catastrophizing on Quality of Life in Adults With Irritable Bowel Syndrome

Cited by 20 publications

References 58 publications

Gender and Weight Influence Quality of Life in Irritable Bowel Syndrome

Gender and Weight Influence Quality of Life in Irritable Bowel Syndrome

The association of catastrophizing with quality-of-life outcomes in patients with irritable bowel syndrome

Peripheral and Central Mechanisms in Irritable Bowel Syndrome : in search of links

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