More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS - a case–control study in primary care

Abstract

BackgroundIrritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care.MethodsA case–control study in primary care setting among IBS patients meeting the ROME III criteria (n = 140) compared to controls i.e. non-IBS patients (n = 213) without any present or previous gastrointestinal complaints. The data were collected through self-reported questionnaires of psychosocial factors.ResultsIBS-patients reported significantly more negative self-esteem (p < 0.001), lower scores for positive self-esteem (p < 0.001), and lower sense of coherence (p < 0.001) than the controls. The IBS-cases were also less likely to report ‘good’ health status (p < 0.001) and less likely to report a positive belief in the future (p < 0.001). After controlling for relevant confounding factors in multiple regressions, the elevation in negative self-esteem among IBS patients remained statistically significant (p = 0.02), as did the lower scores for sense of coherence among IBS cases (p = 0.04).ConclusionsThe more frequently reported negative self-esteem and inferior coping strategies among IBS patients found in this study suggest the possibility that psychological therapies might be helpful for these patients. However these data do not indicate the causal direction of the observed associations. More research is therefore warranted to determine whether these psychosocial constructs are more frequent in IBS patients.

The role of high expectations of self and social desirability in emotional processing in individuals with irritable bowel syndrome: A qualitative study

“…Similarly, Grodzinsky and colleagues reported higher levels of negative self-esteem and lower levels of sense of coherence (i.e. an enduring and dynamic feeling of confidence that allows an individual to choose appropriate coping strategies depending on the situation) in an IBS sample compared to individuals with Inflammatory Bowel Disease (Antonovsky & Sagy, 1986;Grodzinsky et al, 2015). Therefore, focusing on self-concept, self-esteem and self-efficacy may represent a more integrative approach to promote patients' well-being through the experience of more positive emotions, more sense of control over IBS symptoms and over negative emotions, and reduction of self-doubt.…”

Connecting Our Gut Feeling and How Our Gut Feels: The Role of Well-being Attributes in Irritable Bowel Syndrome

“…17 Other studies also showed that coping is an important defense mechanism that is negatively affected in those with IBS. 39,40 Not all the well-being attributes that are considered to be associated with general well-being showed a significant correlation with GI symptoms or IBS. In particular, we did not find any significant correlation with having someone to love, belief and practice of a particular faith, perceived generosity, amount of being supportive to others, the satisfaction with the adequateness of formal education, having a regular leisure program, self-recognition of attractiveness, general sense of trusting others, feeling grateful for what we have, and finally feeling closure with death.…”

“…This finding is similar to the finding of Grodzinsky who documented low self-esteem among subjects with IBS. 39 As part of well-being attributes we asked our study subjects a question evaluating the ability to forgive and forget mistakes. Mazaheri et al showed that attributes such as forgiveness were protective factors for emotional dysregulation and IBS.…”

Depressive Symptoms and Coping Behaviors among Individuals with Irritable Bowel Syndrome in Japan

“…These researchers also clarified that the impact of IBS symptoms on health-related quality of life is mediated by irrational beliefs and avoidance-oriented coping. Furthermore, Grodzinsky et al reported that IBS patients reported lower scores for positive self-esteem and coping ability assessed by sense of coherence than control (15). …”