Cognitive behavioral approach to understanding irritable bowel syndrome

Hauser, Goran; Pletikosić, Sanda; Tkalčić, Mladenka

doi:10.3748/wjg.v20.i22.6744

Cited by 38 publications

(40 citation statements)

References 141 publications

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“…The biopsychosocial model of IBS maintains that symptom onset is then followed by unhelpful coping behaviours and illness cognitions, which can perpetuate symptoms and increase psychological distress [73][74][75]. This conceptualisation of IBS provides support for the relationships found between IBS related variables and distress in our alternate models, highlighting the psycho-emotional effects of IBS [76,77].…”

Section: Alternative Modelssupporting

confidence: 56%

Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome

Sibelli

Chalder

Everitt

et al. 2018

Journal of Psychosomatic Research

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Section: Alternative Modelssupporting

confidence: 56%

Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome

Sibelli

Chalder

Everitt

et al. 2018

Journal of Psychosomatic Research

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“…This attentional bias was moreover associated with symptom severity, illness behaviors and anxiety (49,80,81). Hence, increased attention to interoceptive, visceral sensations may lead to the exacerbation of symptoms and distress (82) in line with the fear avoidance model, which has yet to be more fully tested in the context of chronic visceral pain and the gut-brain axis. Neuroimaging studies support this assumption by demonstrating increased functional connectivity in the salience network in IBS patients during resting state (83), rectal stimulation (84) and contextual threat situations (85).…”

Section: Discussionmentioning

confidence: 97%

Sex Differences Linking Pain-Related Fear and Interoceptive Hypervigilance: Attentional Biases to Conditioned Threat and Safety Signals in a Visceral Pain Model

2020

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Although the broad role of fear and hypervigilance in conditions of the gut-brain axis like irritable bowel syndrome is supported by converging evidence, the underlying mechanisms remain incompletely understood. Even in healthy individuals, it remains unclear how pain-related fear may contribute to pain-related attentional biases for acute visceral pain. Building on our classical fear conditioning work in a clinically relevant model of visceral pain, we herein elucidated pain-related attentional biases shaped by associative learning in healthy women and men, aiming to elucidate possible sex differences and the role of psychological traits. To this end, we compared the impact of differentially conditioned pain-predictive cues on attentional biases in healthy women and men. Sixty-four volunteers accomplished a visual dot-probe task and subsequently underwent pain-related fear conditioning where one visual cue (CS + ) was contingently paired with a painful rectal distention (US) while another cue remained unpaired (CS − ). During the following test phase, the dot-probe task was repeated to investigate changes in attentional biases in response to differentially valenced cues. While pain-related learning was comparable between groups, men revealed more pronounced attentional engagement with the CS + and CS − whereas women demonstrated stronger difficulties to disengage from the CS + when presented with a neutral cue. However, when both CS + and CS − were presented together, women revealed stronger difficulties to disengage from the CS − . Regression analyses revealed an interaction of sex, with negative affect predicting stronger avoidance of the CS + and stronger difficulties to disengage attention from the CS − in men. These results provide first evidence that pain-related fear conditioning may induce attentional biases differentially in healthy women and men. Hence, sex differences may play a role in attentional mechanisms underlying hypervigilance, and may be modulated by psychological vulnerability factors relevant to chronic visceral pain.

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“…Perpetuating factors, such as anxiety, depression, negative perceptions of symptoms and illness behaviours contribute to the maintenance of symptoms over time (Hauser, Pletikosic, & Tkalcic, 2014;Spence & Moss-Morris, 2007).…”

Section: Introductionmentioning

confidence: 99%

The role of high expectations of self and social desirability in emotional processing in individuals with irritable bowel syndrome: A qualitative study

Sibelli

Chalder

Everitt

et al. 2017

British J Health Psychol

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ObjectivesAlthough high levels of distress are associated with the onset and severity of IBS, it is unclear how this relates to emotional processing, particularly in relation to maintenance of symptoms and treatment outcome. This qualitative study embedded within a randomised controlled trial aimed to explore how individuals with refractory IBS experience, express and manage their emotions after either therapist-delivered Cognitive Behavioural Therapy (TCBT) or webbased CBT (WBCBT) compared to Treatment as Usual (TAU). DesignCross-sectional qualitative study. MethodsFifty two semi-structured interviews were conducted at post-treatment with 17 TCBT participants, 17 WBCBT and 18 TAU. The transcripts were analysed using inductive thematic analysis with grounded theory elements. NVivo 11 was used to compare themes across groups. ResultsAcross all groups, high expectations of self was a recurring reason for how participants experienced and expressed their emotions. Three themes with sub-themes captured how high expectations related to specific aspects of emotional processing: perceived causes of Running head: EMOTIONAL PROCESSING IN IBS 2 emotions, strategies for coping with emotions (bottling up, avoiding emotions and active coping strategies) and the perceived interplay between emotions and IBS symptoms. ConclusionsPatients recognised that their IBS symptoms both triggered and were triggered by negative emotions. However, there was a tendency to bottle up or avoid negative emotions for reasons of social desirability regardless of whether patients had CBT for IBS or not. Future psychological interventions in IBS may benefit from addressing negative beliefs about expressing emotions, promoting assertive emotional expression and encouraging the experience of positive emotions.

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Cognitive behavioral approach to understanding irritable bowel syndrome

Cited by 38 publications

References 141 publications

Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome

Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome

Sex Differences Linking Pain-Related Fear and Interoceptive Hypervigilance: Attentional Biases to Conditioned Threat and Safety Signals in a Visceral Pain Model

The role of high expectations of self and social desirability in emotional processing in individuals with irritable bowel syndrome: A qualitative study

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