Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects.
Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.
a Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work (JPS) , Örebro University , Örebro , Sweden.
Katja
K
Boersma
b Deptartment of Clinical Neuroscience , Karolinska Institute , Stockholm , Sweden.
Brjánn
B
Ljótsson
c NGB-I Research Center, School of Health and Medical Sciences , Örebro University , Örebro , Sweden.
Hanna
H
Edebol-Carlman
a Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work (JPS) , Örebro University , Örebro , Sweden.
Martien
M
Schrooten
a Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work (JPS) , Örebro University , Örebro , Sweden.
Steven J
SJ
Linton
c NGB-I Research Center, School of Health and Medical Sciences , Örebro University , Örebro , Sweden.|d Department of Gastroenterology , University Hospital Örebro , Örebro , Sweden.
Robert J
RJ
Brummer
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D058443:Catastrophization / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D020407:Internet; D043183:Irritable Bowel Syndrome / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods; D011788:Quality of Life; D012107:Research Design; D055815:Young Adult
Irritable bowel syndrome; behavioral medicine; exposure treatment; single-case experimental design