Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Abstract

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10-20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ (8) = 11.91, p = .16, χ/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = -.28, p < .001; β = -.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.

Anxiety‐related factors associated with symptom severity in irritable bowel syndrome

“…21 We did not find any evidence that either total VSI or VSI factor one mediated the relationship between HADS-anxiety scores and total IBS-SSS, which is in contrast to previous investigators. 21 29 and quality of life. 30,31 As our study is cross-sectional in nature, we are unable to comment on the direction of the associations we have observed.…”

“…21 To our knowledge, the relationship between general anxiety, gastrointestinal symptom-specific anxiety, and somatization has not been fully explored, although there have been several relatively small cross-sectional studies that have examined the relationship between anxiety and gastrointestinal symptomatology. [29][30][31][32] In the present study, we first aimed to establish the factor structure of the VSI in a large UK cohort of individuals who meet the current gold standard for diagnosing IBS, the Rome IV criteria, 1 and then examined the relationship between IBS symptom severity, the VSI (and its different factors), general anxiety, and somatization.…”

Inaccuracy of patient‐reported descriptions of and satisfaction with bowel actions in irritable bowel syndrome

“…The major impact of IBS is on quality of life, with several studies showing this to be comparable to patients with migraines and asthma . Many patients experience a fear of symptoms and even social phobia, in which an excessive fear of symptoms leads to avoidance of social situations .…”

“…The major impact of IBS is on quality of life, with several studies showing this to be comparable to patients with migraines and asthma. [14][15][16] Many patients experience a fear of symptoms 17 and even social phobia, in which an excessive fear of symptoms leads to avoidance of social situations. 18 For this reason, it may be that selfassessment of symptoms may be the most appropriate for clinical management as treatments are aimed to improve symptoms to the patients' level of satisfaction.…”

Validation of the Persian Version of Inflammatory Bowel Disease Questionnaire in Patients Who Referred to Clinics and Hospitals of Birjand University of Medical Sciences, Iran

“…Inflammatory bowel disease (IBD) includes the Crohn disease and ulcerative colitis that affects about 10% to 20% of the world population (1). The prevalence of IBD is increasing in the world for unknown reasons (2).…”