Inflammatory bowel disease symptoms and cognitive fusion's impact on psychological health: An 18-month prospective study

Although inflammatory bowel disease (IBD) is known to be associated with lower psychological health, research regarding which specific symptoms may lead to psychological dysfunction in IBD patients is inexistent. Further, the role played by emotion regulation, including the maladaptive process of cognitive fusion, in IBD patients’ psychological functioning is also scarcely explored in this population. The present study aimed at filling these research gaps. Two hundred and sixteen patients diagnosed with IBD filled self-report instruments on an online platform in three times. These waves of assessment occurred at baseline, and 9 and 18 months later. Results revealed that of the 10 measured IBD symptoms, only fatigue, bloody stools and abdominal distension at baseline were negatively associated patients’ level of psychological health at Wave 3. Nevertheless, a hierarchical regression analysis demonstrated that none of these symptoms were significant predictors of psychological health measured 18 months later. When cognitive fusion at baseline was added to the model, it became the only significant predictor of psychological health at Wave 3, with an effect of −0.34 (P < 0.001). These findings suggest that it is not the experience of physical symptomatology that directly leads to lower psychological health in IBD patients, but rather the way patients deal with adverse internal experiences, i.e., the type of emotion regulation involved. This study reveals cognitive fusion as a harmful process for the determination of IBD patients’ psychological functioning. Future studies should thus explore the meditational effect of cognitive fusion in the association between IBD symptomatology and decreased psychological health.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A172 THE ASSOCIATION OF EFFICACY, OPTIMISM, UNCERTAINTY AND HEALTH ANXIETY IN INFLAMMATORY BOWEL DISEASE ACTIVITY OVER TIME

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.170 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 183-184

Author(s):

J Stone ◽

L Shafer ◽

L A Graff ◽

K Witges ◽

L Lix ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Bowel Disease ◽

Psychological Functioning ◽

Self Efficacy ◽

Health Anxiety ◽

Self Report ◽

Psychological Attributes ◽

Inflammatory Bowel ◽

Active Disease

Abstract Aims We aimed to assess if the presence of positive or negative psychological attributes are associated with disease activity in a prospective inflammatory bowel disease (IBD) cohort using validated psychological assessment tools and various measures of disease activity. Methods The study included 146 adults with confirmed and recently active IBD enrolled in a prospective longitudinal cohort study. Demographics, disease information, validated measures of psychological functioning related to self-efficacy, optimism, health anxiety and intolerance of uncertainty were collected at baseline, week 26 and week 52. Disease activity indicators included fecal calprotection (FCAL), the Inflammatory Bowel Disease Symptom Inventory (IBDSI), and self-reported flares and were collected at study baseline, week 26 and week 52. Logistic regression was used to identify the relationship between psychological functioning and disease activity. Results Participants’ mean age was 42.9 years (SD 12.6; range 18–70), with 70.5% women. Almost two thirds (65.1%) had a diagnosis of Crohn’s disease (CD), 34.2% had ulcerative colitis (UC), and 0.7% (n=1) was IBD unclassified. 22% had income <$50,000 and 63% were in a current relationship. Patient-reported active disease (i.e., IBDSI; flare self-report) was significantly less likely with higher self-efficacy [OR= 0.87, 95% CI 0.82–0.93 (IBDSI); OR= 0.86, 95% CI 0.81–0.91 (self-report)] and significantly more likely with higher health anxiety (OR=1.09, 95% CI 1.04–1.15) with the association remaining for self-reported flares after adjusting for demographic variables. The psychological attributes were not associated with active disease based on FCAL levels. Conclusions Higher health anxiety increases the likelihood of experiencing an IBD flare, while higher general self-efficacy may be protective of a disease flare. Funding Agencies None

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Shame and emotion regulation in inflammatory bowel disease: Effects on psychosocial functioning

Journal of Health Psychology ◽

10.1177/1359105317718925 ◽

2017 ◽

Vol 25 (4) ◽

pp. 511-521 ◽

Cited By ~ 9

Author(s):

Inês A Trindade ◽

Cláudia Ferreira ◽

José Pinto-Gouveia

Keyword(s):

Inflammatory Bowel Disease ◽

Chronic Illness ◽

Psychological Health ◽

Bowel Disease ◽

Indirect Effects ◽

Psychosocial Functioning ◽

Online Survey ◽

Self Report ◽

Inflammatory Bowel ◽

The Impact

Although patients with inflammatory bowel disease seem to be prone to high levels of shame, the mechanisms behind the impact of chronic illness–related shame on patients’ functioning have not been explored yet. This study aims to address these gaps using a sample of 161 patients with inflammatory bowel disease who completed self-report measures on an online survey. The results from path analyses showed that chronic illness–related shame presented direct and indirect effects on psychological health ( R2 = .66) and social relationships ( R2 = .46). The indirect effects were mediated by experiential avoidance and uncommitted living. Possible explanations to these findings and clinical implications are discussed.

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The longitudinal effects of emotion regulation on physical and psychological health: A latent growth analysis exploring the role of cognitive fusion in inflammatory bowel disease

British Journal of Health Psychology ◽

10.1111/bjhp.12280 ◽

2017 ◽

Vol 23 (1) ◽

pp. 171-185 ◽

Cited By ~ 8

Author(s):

Inês A. Trindade ◽

Cláudia Ferreira ◽

José Pinto-Gouveia

Keyword(s):

Inflammatory Bowel Disease ◽

Emotion Regulation ◽

Psychological Health ◽

Growth Analysis ◽

Cognitive Fusion ◽

Latent Growth ◽

Longitudinal Effects ◽

Physical And Psychological Health ◽

Inflammatory Bowel

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The Longitudinal Effects of Experiential Avoidance on Depression Symptoms in Patients with Inflammatory Bowel Disease

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.254 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S80-S80

Author(s):

I.A. Trindade ◽

C. Ferreira ◽

J. Pinto-Gouveia

Keyword(s):

Inflammatory Bowel Disease ◽

Emotion Regulation ◽

Depressed Mood ◽

Bowel Disease ◽

Experiential Avoidance ◽

Depressive Symptomatology ◽

Self Report ◽

Depression Symptoms ◽

Longitudinal Effects ◽

Inflammatory Bowel

Inflammatory bowel disease (IBD) has been vastly associated with the development of depression and it is thus considered that the mechanisms that underlie this link should be explored. The present study aimed to examine the longitudinal effects of IBD symptoms and a maladaptive emotion regulation process, experiential avoidance (defined as the tendency to attempt to control internal experiences), on depression symptoms. The sample comprised 116 IBD patients of both sexes that completed validated self-report measures on an online platform in three different times (equally spaced 9 months apart) during an 18-month period. Results demonstrated that IBD symptomatology at baseline was linked to experiential avoidance and depressed mood 9 and 18 months later. The level of experiential avoidance at baseline was also correlated with the subsequent experience of depression symptoms, 9 and 18 months later. Results also revealed that, although IBD symptomatology at baseline predicted depressive symptomatology 18 months later (β = 0.24; P = 0.008), when experiential avoidance at baseline was added to this model, this process became the only predictor of the outcome (β = 0.60; P < 0.001; R2 = 0.41). These results corroborate previous literature by indicating that IBD symptomatology may lead to depression symptomatology. Nevertheless, the current study additionally revealed that the engagement in experiential avoidance – that is, in attempts at controlling the frequency, form or intensity of internal experiences – might have a greater role on the determination of patients’ depressed mood than the experience of adverse physical symptomatology. Maladaptive forms of emotion regulation in IBD patients should be targeted to prevent depression symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Inflammatory Bowel Disease Symptoms and Cognitive Fusion’s Impact On Psychological Health: an 18-month Prospective Study

10.26226/morressier.588f0651d462b8028d892f06 ◽

2017 ◽

Author(s):

Cláudia Ferreira

Keyword(s):

Inflammatory Bowel Disease ◽

Prospective Study ◽

Psychological Health ◽

Bowel Disease ◽

Disease Symptoms ◽

Inflammatory Bowel

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Aerobic Exercise Training in Children and Adolescents with Inflammatory Bowel Disease: Influence on Psychological Functioning, Sleep and Physical Performance

10.26226/morressier.588f064fd462b8028d891fb4 ◽

2017 ◽

Author(s):

Serge Brand

Keyword(s):

Inflammatory Bowel Disease ◽

Exercise Training ◽

Aerobic Exercise ◽

Children And Adolescents ◽

Physical Performance ◽

Bowel Disease ◽

Psychological Functioning ◽

Aerobic Exercise Training ◽

Inflammatory Bowel

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The Inflammatory Bowel Disease Symptom Inventory: A Patient-report Scale for Research and Clinical Application

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz038 ◽

2019 ◽

Vol 25 (8) ◽

pp. 1277-1290 ◽

Cited By ~ 7

Author(s):

Kathryn A Sexton ◽

John R Walker ◽

Laura E Targownik ◽

Lesley A Graff ◽

Clove Haviva ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Factor Analysis ◽

Bowel Disease ◽

Convergent Validity ◽

Short Form ◽

Self Report ◽

Measurement Properties ◽

Systemic Complications ◽

Patient Reported ◽

Inflammatory Bowel

Abstract Objectives Existing measures of inflammatory bowel disease (IBD) symptoms are not well suited to self-report, inadequate in measurement properties, insufficiently specific, or burdensome for brief or repeated administration. We aimed to develop a patient-reported outcome measure to assess a broader range of IBD symptoms. Methods The IBD Symptoms Inventory (IBDSI) was developed by adapting symptom items from existing clinician-rated or diary-format inventories; after factor analysis, 38 items were retained on 5 subscales: bowel symptoms, abdominal discomfort, fatigue, bowel complications, and systemic complications. Participants completed the IBDSI and other self-report measures during a clinic visit. A nurse administered the Harvey Bradshaw Index (HBI) for Crohn’s disease (CD) or the Powell-Tuck Index (PTI) for ulcerative colitis (UC), and a gastroenterologist completed a global assessment of disease severity (PGA). Results The 267 participants with CD (n = 142) or UC (n = 125), ages 18 to 81 (M = 43.4, SD = 14.6) were 58.1% female, with a mean disease duration of 13.9 (SD = 10.5) years. Confirmatory factor analysis supported the 5 subscales. The total scale and subscales showed good reliability and significant correlations with self-report symptom and IBD quality of life measures, the HBI, PTI, and PGA. Conclusions The IBDSI showed strong measurement properties: a supported factor structure, very good internal consistency, convergent validity, and excellent sensitivity and specificity to clinician-rated active disease. Self-report HBI and PTI items, when extracted from this measure, produced scores comparable to clinician-administered versions. The 38-item IBDSI, or 26-item short form, can be used as a brief survey of common IBD symptoms in clinic or research settings.

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Prevalence of Anxiety and Depression in Patients with Inflammatory Bowel Disease

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2017/6496727 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 50

Author(s):

Glynis Byrne ◽

Greg Rosenfeld ◽

Yvette Leung ◽

Hong Qian ◽

Julia Raudzus ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Multivariable Analysis ◽

Significant Proportion ◽

Mental Illnesses ◽

Self Report ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Psychiatric Interview ◽

Inflammatory Bowel

Background. Inflammatory bowel disease (IBD) patients are not routinely screened for depression and anxiety despite knowledge of an increased prevalence in people with chronic disease and negative effects on quality of life. Methods. Prevalence of anxiety and depression was assessed in IBD outpatients through retrospective chart review. The presence of anxiety and/or depression was determined using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 self-report questionnaires or by diagnosis through psychiatric interview. Patient demographics, disease characteristics, and medication information were also collected. Multivariable analysis was used to determine associations between patient factors and depression and anxiety. Results. 327 patient charts were reviewed. Rates of depression and anxiety were found to be 25.8% and 21.2%, with 30.3% of patients suffering from depression and/or anxiety. Disease activity was found to be significantly associated with depression and/or anxiety (p=0.01). Females were more likely to have anxiety (p=0.01). Conclusion. A significant proportion of IBD patients suffer from depression and/or anxiety. The rates of these mental illnesses would justify screening and referral for psychiatric treatment in clinics treating this population. Patients with active disease are particularly at risk for anxiety and depression.

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