Self-consciousness, psychological distress, coping and negative cognitions in irritable bowel syndrome

Objectives. To investigate differences between Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disorder (IBD) patients and controls on measures of self-consciousness, psychological distress, coping in stressful situations and negative bowel cognitions. Relationships between these measures in the IBS group were also examined.;Design. Cross-sectional between-groups design.;Method. IBS and IBD patients were recruited from a gastroenterology clinic. Thirty-three IBS patients, and 35 IBD patients and 35 controls completed the Self-Consciousness Scale (SCS), Hospital Anxiety and Depression Scale (HADS), Coping Inventory for Stressful Situations (CISS) and Cognitive Scale for Functional Bowel Disorders (CSFBD).;Results. IBS patients were significantly more anxious and had greater negative bowel cognitions than controls. There were no significant differences between IBS and IBD patients on any of the measures. There were several significant positive relationships between the four measures in the IBS group. For example, private self-consciousness (on the SCS) was related to all negative bowel cognitions on the CSFBD (except for disease conviction), anxiety and depression (on the HADS) and emotion- and task-focused coping (on the CISS). Coping (social diversion, emotion- and task-focused) was also related with various negative bowel cognitions. Finally, when IBS patients were subdivided into anxious and non-anxious groups, anxious IBS patients used significantly greater emotion-focused coping and had greater worries in relation to embarrassment/shame, anger/frustration, social approval and self-nurturance. The results are discussed in relation to previous literature and the Self-Regulatory Executive Functioning model. An alternative model based on the findings is also proposed.;Conclusion. IBS patients who are psychologically distressed may benefit from psychological intervention that consists of cognitive and attentional training.