title: Stress reactivity in traditional Chinese medicine-based subgroups of patients with irritable bowel syndrome.
abstract: OBJECTIVE
  This study aimed to examine differences in autonomic responses to stress, pain perception, and the role of negative affect in these responses in individuals with irritable bowel syndrome (IBS) according to Traditional Chinese Medicine (TCM) classifications.
  
  
  METHODS
  Fifty-nine female patients with IBS age 18-65 years diagnosed by TCM practitioners as showing primarily an excess (n=32) or an overlap (n=27) pattern (mixed excess and deficiency) were assessed for symptom differences, heart rate, and skin conductance responses to a psychosocial stressor and pain perception. SETTINGS/LOCATIONS: University of California in Los Angeles, California.
  
  
  RESULTS
  Compared with the excess group, the overlap group showed significantly greater overall gastrointestinal symptom severity, abdominal pain, and negative affect. The excess group with higher levels of negative affect showed greater reactivity to stress, whereas the overlap group showed an opposite response pattern. The overlap group showed increased cold sensitivity.
  
  
  CONCLUSIONS
  IBS patients with the overlap pattern have greater disease severity and comorbidity than those with excess alone. Those with excess showed a pattern of increased stress response with greater negative affect, whereas the overlap group with greater deficiency showed lower physiologic arousal with greater negative affect, consistent with depletion resulting from allostatic load.
authors.affiliation: 1 Department of Occupational Therapy, San Jose State University , San Jose, CA.
authors.forename: Megan C
authors.initials: MC
authors.lastname: Chang
authors.forename: David
authors.initials: D
authors.lastname: Shapiro
authors.forename: Aditi
authors.initials: A
authors.lastname: Joshi
authors.forename: Leila
authors.initials: L
authors.lastname: Shahabi
authors.forename: Steven
authors.initials: S
authors.lastname: Tan
authors.forename: Suzanne
authors.initials: S
authors.lastname: Smith
authors.forename: Ka Kit
authors.initials: KK
authors.lastname: Hui
authors.forename: Kirsten
authors.initials: K
authors.lastname: Tillisch
authors.forename: Emeran A
authors.initials: EA
authors.lastname: Mayer
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Naliboff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000145:classification / Q000503:physiopathology* / Q000523:psychology*; D015141:Los Angeles; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D013312:Stress, Physiological / Q000502:physiology*; D013315:Stress, Psychological / Q000503:physiopathology*; D055815:Young Adult