Personality traits and emotional patterns in irritable bowel syndrome

Abstract

The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.

Emotional overactivity in patients with irritable bowel syndrome

“…In the long term, IBS patients can suffer from a chronic experience of negative affects, which is further supported by their higher scores in depressive symptomatology. This finding is corroborated by the literature showing a patient’s disposition to neuroticism, type D personality, , and anxio‐depressive symptomatology (for a recent review, see).…”

“…57,58 Alexithymic individuals tend to misinterpret the somatic sensations related to their affective response and, hence, often suffer from somatization, which is also a frequent issue in IBS. 11,16,56,59 Finally, IBS patients' expressiveness was not correlated with their neurophysiological responses. Despite a clear inclination for excessive neurophysiological responses, 2,4 particularly in challenging situations, 60 a recent study also emphasized a lack of congruency regarding the physiological responses in IBS, with no relationship between parasympathetic tone and the HPA axis or negative affects.…”

“…Difficulty identifying feelings is a core feature of alexithymia, and this outcome is highly relevant as the literature consistently highlights features of alexithymia in IBS patients, and relationships between alexithymia and anger manifestations . Alexithymic individuals tend to misinterpret the somatic sensations related to their affective response and, hence, often suffer from somatization, which is also a frequent issue in IBS . Finally, IBS patients’ expressiveness was not correlated with their neurophysiological responses.…”

Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome

“…Finally, as noted above, research has extensively studied the association between psychological distress and IBS. Despite findings that positive affect (PA) is linked to better health outcomes in coronary problems and stroke [31,32], little empirical work has been conducted in IBS [33]. PA has been found to have indirect health benefits by buffering the adverse consequences of perceived stress and pain in conditions such as coronary artery disease and chronic pain [34,35].…”

A role for the serotonin reuptake transporter in the brain and intestinal features of autism spectrum disorders and developmental antidepressant exposure

“…Further investigation in this area may provide a greater understanding of the link between the anxiety, depression and irritable bowel syndrome (IBS) 54-57 as well as the pathophysiological connection between the stress and “flares”, or increased intestinal inflammation, in inflammatory bowel disease (IBD) 58 . Both IBD and IBS have been linked to changes in 5-HT signaling or SERT in both experimental models and clinical studies 18,59 .…”