Objective: Irritable bowel syndrome (IBS) is a chronic disorder of brain–gut interaction. Previous studies suggest that mindfulness could be therapeutic for IBS patients, however no study has evaluated the effects of mindfulness-based cognitive therapy adapted for patients with IBS (MBCT-IBS). A 6-week MBCT-IBS course was designed to reduce symptoms and increase quality of life. This study aimed to evaluate the effects of MBCT-IBS and to investigate its therapeutic mechanisms in a randomized controlled trial. Method: Sixty-seven female patients with IBS were randomized to MBCT-IBS (MG; n = 36) or a waitlist (WL; n = 31) control condition. Patients completed standardized self-report measures of IBS symptom severity, IBS quality of life, maladaptive illness cognitions (catastrophizing, visceral anxiety sensitivity) and mindfulness at baseline, after 2 treatment sessions, at posttreatment, and at 6-week follow-up. Self-referential processing of illness and health was measured with an implicit association test (IAT). Results: The MG reported significantly greater reductions in IBS symptoms (p = .003) and improvements in quality of life (p < .001) at follow-up compared with the WL. Changes in visceral anxiety sensitivity and pain catastrophizing at posttreatment and reductions in the IAT-score after 2 sessions combined with increases in nonjudgmental awareness at posttreatment mediated reductions in IBS symptoms. Conclusions: MBCT-IBS has the potential to reduce IBS symptoms and increase quality of life. MBCT-IBS may exert its effect on IBS symptoms via reducing maladaptive illness cognitions and activating changes in self-processing (reducing biases in self-referent processing of illness and health and increasing nonjudgmental awareness).

Leading suicide theories and research in adults suggest that pain may exacerbate an individual's suicidal risk. Although pain and suicidality both increase in prevalence during adolescence, their relationship remains unclear. We aimed to systematically review the empirical evidence for an association between pain and suicidality in adolescence (PROSPERO: CRD42018097226). In total, 25 observational studies, published between 1961 and December 2018, exploring the potential pain-suicidality association in adolescence (10-19 years) were included. Across various samples and manifestations of pain and suicidality, we found that pain approximately doubles adolescents' suicidal risk, with a few studies suggesting that pain may predict suicidality longitudinally. Although depression was an important factor, it did not fully explain the painsuicidality association. Evidence on associations between pain characteristics and suicidality is sparse and inconclusive, potentially hiding developmental differences. Identification of psychological mediators and moderators is required to develop interventions tailored to the needs of adolescents in pain.

In the highly sensitive person, cognitive reactivity might be a driving mechanism in the relationship between sensory processing and psychological distress, write Hedda Bratholm Wyller and colleagues.