Development and Validation of the Gastrointestinal Unhelpful Thinking Scale (GUTs)

Abstract

This article describes the development and validation of the Gastrointestinal Unhelpful Thinking scale. The purpose of the research was to develop the Gastrointestinal Unhelpful Thinking scale to assess in tandem the primary cognitiveaffective drivers of brain-gut dysregulation, gastrointestinal-specific visceral anxiety, and pain catastrophizing. The research involved 3 phases which included undergraduate and community samples. In the first phase, an exploratory factor analysis revealed a 15-item 2-factor (visceral sensitivity and pain catastrophizing) scale (N = 323), which then was confirmed in the second phase: N = 399, χ²(26) = 2.08, p = .001, Tucker-Lewis Index = 0.94, comparative fit index = 0.96, standardized root mean square residual = 0.05, and root mean square error of approximation = 0.07. Demonstrating convergent validity, Gastrointestinal Unhelpful Thinking scale total and subscales were strongly correlated with the modified Manitoba Index, Irritable Bowel Syndrome Symptom Severity Scale scores, Visceral Sensitivity Index, and the Pain Catastrophizing Scale. A third phase (N = 16) established test-retest reliability for the Gastrointestinal Unhelpful Thinking scale (total and subscales). The test-retest reliability correlation coefficient for the Gastrointestinal Unhelpful Thinking scale total score was .93 (p < .001) and for the subscales was .86 (p < .001) and .94 (p < .001), respectively. The Gastrointestinal Unhelpful Thinking scale is a brief psychometrically valid measure of visceral anxiety and pain catastrophizing that can be useful for both clinicians and researchers who wish to measure these thinking patterns and relate them to changes in gastrointestinal and psychological symptoms.

Exploring the Impact of Covid-19-Related Perceptions on Psychological Distress and Quality of Life in an International Gastrointestinal Cohort Over Time Guided by the Common Sense Model

“…As with (Möller et al, 2021a ), GI Illness perceptions at Time 2 were strongly predicted by Time 1 GI illness perceptions, and to a lesser extent, T1 GI symptoms. These findings provide longitudinal evidence for the reliable relationship between GI symptoms and illness perceptions seen in cross-sectional CSM-based GI studies (Bree Hayes et al, 2021 ; Hayes et al, 2021 ; Kantidakis et al, 2021 ; Knowles et al, 2017 ; Knowles et al, 2011 ; Möller et al, 2021b ; Woodhouse et al, 2018 ; Zhang et al, 2016 ). However, contrary to hypothesis 2, COVID illness perceptions at Time 2 were only predicted by Time 1 COVID illness perceptions.…”

“…In relation to extending the model, researchers should look to include other well-established health models (e.g., theory of planned behaviour) and how they may influence intentions and actions relating to illness adjustment (Hagger & Orbell, 2021). Researchers should also seek to extend the CSM by exploring the potential role of biological measures (e.g., faecal calprotectin) and relevant illness-specific factors, for example visceral sensitivity and pain catastrophising (e.g., Gastrointestinal Unhelpful Thoughts Scale [GUTS] Knowles et al, 2022) in GI-based studies (B. ).…”

Exploring the Impact of Trauma and Psychosocial Processes on the Quality of Life in Individuals Living with Inflammatory Bowel Disease

“…The 15-item Gastrointestinal Unhelpful Thinking Scale (GUTS) [39] is designed to assess cognitive processes associated with bowel discomfort with two subscales (9 items assessing pain catastrophising and 6 items assessing visceral sensitivity). Each item is scored on a six point rating scale: 0 (strongly agree) -5 (strongly disagree).…”