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. 2013 Jun;74(6):486-92.
doi: 10.1016/j.jpsychores.2013.03.004. Epub 2013 Apr 9.

Which psychological factors exacerbate irritable bowel syndrome? Development of a comprehensive model

Miranda A L van Tilburg  1 , Olafur S Palsson, William E Whitehead
Affiliations

Which psychological factors exacerbate irritable bowel syndrome? Development of a comprehensive model

Miranda A L van Tilburg et al. J Psychosom Res. 2013 Jun.

Abstract

Objective: There is evidence that psychological factors affect the onset, severity and duration of irritable bowel syndrome (IBS). However, it is not clear which psychological factors are the most important and how they interact. The aims of the current study are to identify the most important psychological factors predicting IBS symptom severity and to investigate how these psychological variables are related to each other.

Methods: Study participants were 286 IBS patients who completed a battery of psychological questionnaires including neuroticism, abuse history, life events, anxiety, somatization and catastrophizing. IBS severity measured by the IBS Severity Scale was the dependent variable. Path analysis was performed to determine the associations among the psychological variables, and IBS severity.

Results: Although the hypothesized model showed adequate fit, post hoc model modifications were performed to increase prediction. The final model was significant (Chi(2)=2.2; p=0.82; RMSEA<.05) predicting 36% of variance in IBS severity. Catastrophizing (standardized coefficient (β)=0.33; p<.001) and somatization (β=0.20; p<.001) were the only two psychological variables directly associated with IBS severity. Anxiety had an indirect effect on IBS symptoms through catastrophizing (β=0.80; p<.001); as well as somatization (β=0.37; p<.001). Anxiety, in turn, was predicted by neuroticism (β=0.66; p<.001) and stressful life events (β=0.31; p<.001).

Conclusion: While cause-and-effect cannot be determined from these cross-sectional data, the outcomes suggest that the most fruitful approach to curb negative effects of psychological factors on IBS is to reduce catastrophizing and somatization.

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Figures

Figure 1
Figure 1
Proposed model of psychological effects on IBS severity Note: Direct effects between ‘fairly stable psychological factors’ and IBS severity were tested but for clarity not depicted in the current model
Figure 2
Figure 2
Final model of psychological effects on IBS severity Note: Numbers reflect unstandardized (standardized)coefficients. * P < .01, ** P < .001.
See this image and copyright information in PMC

References

    1. Drossman DA, Corazziari E, Delvaux M, et al. Rome III: The Functional Gastrointestinal Disorders. McLean, Virginia: Degnon Associates; 2006.
    1. Drossman DA, Thompson WG. The Irritable-Bowel-Syndrome - Review and A Graduated Multicomponent Treatment Approach. Annals of Internal Medicine. 1992;116:1009–1016. - PubMed
    1. Drossman DA. Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome? Am J Med. 1999;107:41S–50S. - PubMed
    1. Drossman DA, Chang L, Bellamy N, et al. Severity in irritable bowel syndrome: a Rome Foundation Working Team report. Am J Gastroenterol. 2011;106:1749–1759. quiz 1760. - PubMed
    1. Surdea-Blaga T, Baban A, Dumitrascu DL. Psychosocial determinants of irritable bowel syndrome. World J Gastroenterol. 2012;18:616–626. - PMC - PubMed

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