Stigmatization toward irritable bowel syndrome and inflammatory bowel disease in an online cohort

Abstract

Background Stigma is associated with many negative health outcomes. Research has examined perceived and internalized stigma in individuals with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), but less has been done to evaluate levels of enacted stigma associated with these conditions. The aim of this study was to evaluate the presence of enacted stigma toward IBS and IBD in the general population compared to an adult-onset asthma (AOA) control group. Methods Participants were recruited via social media and a research-dedicated website and completed all measures online. Participants were randomized to one of six clinical vignettes: (i) IBD male, (ii) IBD female, (iii) IBS male, (iv) IBS female, (v) AOA male, or (vi) AOA female. Participants read the assigned vignette and then completed measures of emotional empathy, level of familiarity, and enacted stigma. Key Results Participants reported higher levels of enacted stigma toward IBS compared to both IBD and AOA. No differences in stigma were found between IBD and AOA. Higher levels of familiarity were most strongly correlated with reduced IBD-related stigma, with weaker but still significant correlations between level of familiarity and IBS and AOA. Higher levels of emotional empathy were associated with reduced stigma for IBD, IBS, and AOA. Conclusions & Inferences Individuals with IBS experience greater levels of enacted stigma compared to IBD and AOA. This finding is consistent with previous research that has shown greater levels of perceived and internalized stigma in IBS compared to IBD.

Perceptions of IBD within patient and community samples: a systematic review

“…pouch that allows bodily waste to enter through the abdominal wall), indicating stronger stigmatising attitudes towards those with this condition. Another study (Taft et al, 2017) also found that a community sample indicated the highest level of enacted stigmatisation towards men with Irritable Bowel Syndrome (IBS), compared to other chronic conditions. IBS shares similar symptoms to IBD (e.g.…”

“…Whilst few studies have examined societal perceptions of IBD, societal perceptions have been the focus of attention for other conditions (Anagnostopoulos & Spanea, 2005;Kouznetsova, Stevenson, Oaten, & Case, 2012;Smith et al, 2007;Taft, Bedell, Naftaly, & Keefer, 2017). For example, literature suggests that the general population demonstrates negative, stigmatising attitudes towards those with infectious conditions such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS; Huskin, Reiser-Robbins, & Kwon, 2018;Katz et al, 1987;Mak et al, 2006), severe acute respiratory syndrome (SARS; Lau, Yang, Wong, & Tsui, 2006) and tuberculosis (TB; Baral, Karki, & Newell, 2007).…”

“…Four studies reported on enacted stigma (Czuber-Dochan et al, 2014;Moody, Probert, Jayanthi, & Mayberry, 1992;Rohde et al, 2018;Taft et al, 2017) and preliminary findings suggested that the general population directs little enacted stigma towards IBD. Research evidence suggested factors that contribute to higher levels of enacted stigma towards IBD, these were: lower familiarity and knowledge of IBD, being male, possessing low levels of empathy, and the condition resulting in lower work performance (Moody et al, 1992;Rohde et al, 2018;Taft et al, 2017). Lastly, only one study investigated societal emotional reactions towards IBD (refer to Table S6; Magro et al, 2009).…”

“…Taft et al's (2017) findings indicated that the public direct more enacted stigma towards those with IBS than those with IBD. Additionally, the level of familiarity of IBD was found to be an important contributor to enacted stigma, as community members who were more familiar with IBD, displayed lower enacted stigma (Rohde et al, 2018;Taft et al, 2017). However, it should be noted that Taft and colleagues' study design used vignettes that described the symptoms of IBD to their participants (2017).…”

Psychological Considerations and Interventions in Inflammatory Bowel Disease Patient Care

“…A 2016 comprehensive review of IBD stigma finds IBD patients perceive that others hold stigmatizing views toward them and the disease, some patients internalize these negative beliefs while others resist them, and stigmatizing attitudes and behaviors exist among those without IBD 59, 60 . Like stigma toward other diseases, IBD stigma is associated with poorer outcomes 61 and may cause or exacerbate feelings of depression or anxiety.…”