Title

Which Psychological Factors Exacerbate Irritable Bowel Syndrome? Test of a Comprehensive Model

Document Type

Article

Date of Publication

6-2013

Publication Title

Journal of psychosomatic research

First Page

486

Last Page

492

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 (Chi2 = 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.

DOI

10.1016/j.jpsychores.2013.03.004

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