Moderating effect of IBS acceptance on psychosocial mediators of Irritable Bowel Syndrome

Abstract

Background/Objective: In this study a theoretically driven model is presented of how gastrointestinal anxiety, behavioural response, symptom severity, quality of life and IBS acceptance interact to determine how people cope and respond in IBS. Method: Crosssectional data from 166 outpatients attending a motility disorders clinic was used to test a model of moderated serial mediation. Results: Gastrointestinal anxiety and behavioural response were found to serially mediate the relationship between symptom severity and quality of life; each step of this 'indirect effect' was significant at the p<.001 level. The strength of the mediatory effect was linearly related to IBS acceptance; a significant interaction was found between IBS acceptance as a moderator at the level of the indirect effect (-.0091, 95%CI =-.0163 to .0019). Conclusions: Findings suggest that the effect of multiple psychosocial variables in IBS experience and outcomes may be conditional on levels of IBS Acceptance. The theoretical and clinical implications of these findings are discussed.

Investigating the Role of Gastrointestinal-Specific Anxiety and Perceived Disability in the Adjustment to Inflammatory Bowel Disease

“…In light of these notes, it is possible to say that the current study might be more representative of the experience of patients with IBD and more robust in its findings given that it accounts for more related variables. It is, however, encouraging that as a process variable, GSA seems to have a similar role in the development of problems with QoL as observed in IBS populations [35]; it can be specifically targeted through several types of psychological interventions (e.g., [36]).…”

Acceptance and commitment therapy for the treatment of irritable bowel syndrome and inflammatory bowel disease: a narrative review

“…The mechanism by which ACT may help patients with IBS may be due to acceptance of symptoms. Bowers and colleagues ( 41 ) conducted a secondary data analysis of Gillanders and colleagues ( 39 ) and Ferreira and colleagues ( 38 ) studies and concluded that IBS acceptance may mediate and moderate IBS QOL. The authors hypothesize that participants with IBS who have more IBS acceptance engage in less avoidant behaviors (i.e., more values-based behavior) and thus see less of an impact on their QOL ( 41 ).…”

“…Bowers and colleagues ( 41 ) conducted a secondary data analysis of Gillanders and colleagues ( 39 ) and Ferreira and colleagues ( 38 ) studies and concluded that IBS acceptance may mediate and moderate IBS QOL. The authors hypothesize that participants with IBS who have more IBS acceptance engage in less avoidant behaviors (i.e., more values-based behavior) and thus see less of an impact on their QOL ( 41 ). IBS acceptance may be protective even if symptom severity is high, which is consistent with literature on ACT in other chronic health conditions ( 41 ).…”

“…The authors hypothesize that participants with IBS who have more IBS acceptance engage in less avoidant behaviors (i.e., more values-based behavior) and thus see less of an impact on their QOL ( 41 ). IBS acceptance may be protective even if symptom severity is high, which is consistent with literature on ACT in other chronic health conditions ( 41 ).…”

“…One such process metric to consider for consistency across future ACT interventions in these patient populations is the Acceptance and Action Questionnaire (AAQ-II), which specifically measures psychological flexibility and experiential avoidance ( 58 ). The IBS AAQ-II, which has acceptable validity and reliability ( 59 ) was used in IBS specific ACT studies ( 38 , 39 , 41 , 60 ) and some ACT studies for IBD ( 42 - 44 , 48 ).…”