Previous research suggests an association between psychological dysfunction and Irritable Bowel Syndrome (IBS). We sought to confirm this relationship and examine the mechanisms by which psychosocial factors may amplify or maintain IBS complaints, and influence disability. One hundred and thirteen female participants, (45 IBS; 34 Crohn's; 34 healthy controls) were evaluated by psychological assessment which measured: symptom reporting, anxiety, depression, and impact of physical symptoms on daily activities. The assessment also evaluated the ways in which patients interpreted, understood and coped with unpleasant symptoms as well as the support and reactions from significant others to their symptoms. Subjects also participated in an experimental task designed to elicit physical sensations. Following the task, subjects were interviewed regarding cognitions and symptoms associated with the task. Results indicated that both patient groups had significantly greater physical and emotional symptomatology than healthy controls. The IBS patients were largely indistinguishable from the Crohn's patients, except that IBS patients were more likely to perceive their condition as more serious than Crohn's patients, and reported less personal control and responsibility in managing their symptoms. IBS patients also perceived far less social support from individuals close to them than did the Crohn's patients. Both IBS and Crohn's patients engaged in greater dysfunctional cognitive activity than did the controls during the experimental task. While anxiety, depression and coping attempts did not distinguish between patient groups, they were significantly associated with the amount of disability in daily activities regardless of diagnosis. These results suggest that the uncertain etiology of IBS may create additional sources of stress for the IBS patient. Consequently IBS patients may be more prone to misinterpret their IBS as a serious health threat and feel less able to control their symptoms. Furthermore, because of the uncertain etiology, the IBS patient may receive less support from significant others, thereby compounding stress and further taxing coping efforts. Our findings suggest that rather than a psychologic/psychiatric problem the IBS is better viewed as a medical problem within a biopsychosocial context. Psychosocial factors play a crucial role in the manifestation of disability regardless of the nature of the disease. However, the IBS is a unique medical problem in that the patient is placed at risk for stressors related to the uncertainty of the symptoms and the reactions of others.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/10846 |
| Date | January 1992 |
| Creators | Pigeon-Reesor, Helen. |
| Publisher | University of Ottawa (Canada) |
| Source Sets | Université d’Ottawa |
| Detected Language | English |
| Type | Thesis |
| Format | 151 p. |
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