Towards A Better Understanding of Anxiety in Irritable Bowel Syndrome: A Preliminary Look at Worry and Intolerance of Uncertainty

Abstract

Although it has been fairly well established that symptoms of anxiety are often present in patients with irritable bowel syndrome (IBS), less is known about the role of worry and intolerance of uncertainty in this population. This study investigates the relations among these variables in a sample of treatment-seeking IBS patients. Although the results are preliminary, worry does seem to predict gastrointestinal symptom severity and, when combined with a measure of current anxiety, accounts for almost 30% of the variance. Intolerance of uncertainty differentiated diarrhea-predominant IBS patients from constipation-predominant IBS patients. Earlier research has taken a psychiatric perspective on anxiety in IBS patients-the current study may provide some support for shifting our focus to the cognitive biases that may be operating in IBS patients, regardless of the presence of an anxiety disorder. Implications for a cognitive therapy approach to IBS treatment are discussed.

Relationship between Irritable Bowel Syndrome, Worry and Stress in Adolescent Girls

“…Keefer et al (30) said that although patients diagnosed with IBS were found not to be highly anxious, they reported high levels of intolerance of uncertainty, which is a construct found to be highly related to worry. In addition, they also showed that worry and state anxiety were proved to be good predictors of GI symptom severity, accounting for almost 30% of the variance.…”

Irritable bowel syndrome is strongly associated with generalized anxiety disorder: a community study

“…As individuals with GAD were cognitively predisposed to catastrophize the potential consequences of their worries, such visceral anxiety in IBS could be greatly magnified and become even more impairing when the two illnesses co‐occurred. Furthermore, given the hypochondriacal tendency of people with GAD, the physical symptoms of IBS could reinforce their anxious inability to tolerate and cope with these discomforts, thereby forming a vicious spiral between physical and psychological symptoms 36 . These interactive pathological processes might intensify avoidance and other maladaptive behaviours that in turn compromised comorbid individuals’ functional capacity and quality of life.…”

Interpersonal communication apprehension, topic avoidance, and the experience of irritable bowel syndrome

“…Because previous research (Keefer et al, 2005; Lackner & Gurtman, 2005) has found that psychological and interpersonal variables significantly differed according to predominant IBS symptom and length of time with IBS, data analyses examined these two items in association with CA, overall topic avoidance, and reasons for topic avoidance to ensure that they did not exert any unexpected influence upon the hypothesized relationships. A series of univariate analyses of variance (ANOVAs) revealed that none of the dependent variables significantly differed according to either IBS item (see Table 2 for F values, means, and standard deviations for each preliminary analysis).…”