Is childhood abuse or neglect associated with symptom reports and physiological measures in women with irritable bowel syndrome?

Abstract

Purpose: Early childhood traumatic experiences (e.g., abuse or neglect) may contribute to sleep disturbances as well as to other indicators of arousal in patients with irritable bowel syndrome (IBS). This study compared women with IBS positive for a history of childhood abuse and/or neglect to women with IBS without this history on daily gastrointestinal (GI), sleep, somatic, and psychological symptom distress, polysomnographic sleep, urine catecholamines (CAs) and cortisol, and nocturnal heart rate variability (HRV).

Methods: Adult women with IBS recruited from the community were divided into two groups: 21 with abuse/neglect and 19 without abuse/neglect based on responses to the Childhood Trauma Questionnaire (CTQ; physical, emotional, sexual abuse, or neglect). Women were interviewed, maintained a 30-day symptom diary, and slept in a sleep laboratory. Polysomnographic and nocturnal HRV data were obtained. First-voided urine samples were assayed for cortisol and CA levels.

Results: Women with IBS positive for abuse/neglect history were older than women without this history. Among GI symptoms, only heartburn and nausea were significantly higher in women with abuse/neglect. Sleep, somatic, and psychological symptoms were significantly higher in women in the abuse/neglect group. With the exception of percentage of time in rapid eye movement (REM) sleep, there were few differences in sleep-stage variables and urine hormone levels. Mean heart rate interval and the natural log of the standard deviation of RR intervals for the entire sleep interval (Ln SDNN) values were lower in those who experienced childhood abuse/neglect.

Conclusion: Women with IBS who self-report childhood abuse/neglect are more likely to report disturbed sleep, somatic symptoms, and psychological distress. Women with IBS should be screened for adverse childhood events including abuse/neglect.

Figure 1

Scatterplot of average 4 daily depression (decreased desire to talk or move, depressed/sad or blue, hopelessness) rating for 28 days on a scale of 0 ‘not present’ to 4 ‘severe’ in women with IBS with a history of abuse/neglect (n=21) and women with IBS without this history (n=17).