title: Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations.
abstract: Irritable bowel syndrome (IBS) is a prevalent functional disorder characterized by abdominal pain and hypervigilance to gastrointestinal sensations. We hypothesized that mindfulness training (MT), which promotes nonreactive awareness of emotional and sensory experience, may target underlying mechanisms of IBS including affective pain processing and catastrophic appraisals of gastrointestinal sensations. Seventy five female IBS patients were randomly assigned to participate in either 8 weeks of MT or a social support group. A theoretically grounded, multivariate path model tested therapeutic mediators of the effect of MT on IBS severity and quality of life. Results suggest that MT exerts significant therapeutic effects on IBS symptoms by promoting nonreactivity to gut-focused anxiety and catastrophic appraisals of the significance of abdominal sensations coupled with a refocusing of attention onto interoceptive data with less emotional interference. Hence, MT appears to target and ameliorate the underlying pathogenic mechanisms of IBS.
authors.affiliation: College of Social Work, Trinity Institute for the Addictions, Florida State University, 296 Champions Way, PO Box 3062570, Tallahassee, FL, 32306-2570, USA, egarland@fsu.edu.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Garland
authors.forename: Susan A
authors.initials: SA
authors.lastname: Gaylord
authors.forename: Olafur
authors.initials: O
authors.lastname: Palsson
authors.forename: Keturah
authors.initials: K
authors.lastname: Faurot
authors.forename: J
authors.initials: J
authors.lastname: Douglas Mann
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000628:therapy*; D001288:Attention; D058443:Catastrophization / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D064866:Mindfulness; D059408:Pain Management / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D055815:Young Adult