title: Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness.
abstract: Irritable Bowel Syndrome (IBS) is a common condition affecting around 10-20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ2(8) = 11.91, p = .16, χ2/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = -.28, p < .001; β = -.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.
authors.affiliation: a Faculty Health, Arts, and Design, Department of Psychology , Swinburne University of Technology , Melbourne , Australia.|b Department of Medicine , The University of Melbourne , Melbourne , Australia.|c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia.|d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Knowles
authors.affiliation: e Department of Psychology , Deakin University , Melbourne , Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Austin
authors.affiliation: d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.
authors.forename: Suresh
authors.initials: S
authors.lastname: Sivanesan
authors.affiliation: d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.|f Walter and Eliza Hall Institute , Melbourne , Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Tye-Din
authors.affiliation: d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.|g The Austin Hospital , Melbourne , Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Leung
authors.affiliation: h Royal Hobart Hospital , Tasmania , Australia.
authors.forename: Jarrad
authors.initials: J
authors.lastname: Wilson
authors.affiliation: b Department of Medicine , The University of Melbourne , Melbourne , Australia.|c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
authors.affiliation: b Department of Medicine , The University of Melbourne , Melbourne , Australia.|i Department of Gastroenterology and Medicine , St Vincent's Hospital , Melbourne , Australia.|j Division of Immunology , Imperial College , London , UK.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
authors.affiliation: d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.
authors.forename: Finlay
authors.initials: F
authors.lastname: Macrae
authors.affiliation: b Department of Medicine , The University of Melbourne , Melbourne , Australia.|d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.
authors.forename: Geoff
authors.initials: G
authors.lastname: Hebbard
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D015331:Cohort Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Irritable Bowel Syndrome; psychological distress; quality of life