Defense mechanisms and alexithymia in Inflammatory bowel disease and Irritable bowel disease
Abstract
Objectives: This study aimed to examine the differential contribution of demographic and medical characteristics on severity of gastrointestinal symptoms in a sample of patients with IBS or IBD. In a sample of outpatients with gastrointestinal disorders. In addition this study aimed to explore the role of alexithymia and defense style on gastrointestinal symptoms. Methods: The participants consisted of 65 outpatients with an IBS or IBD diagnosis who completed a demographic questionnaire, the Toronto Alexithymia Scale – 20 (TAS-20), the Defense Style Questionnaire (DSQ), and the Gastrointestinal Symptom Rating Scale (GSR). Results: ANOVA showed no significant effect of specific diagnosis on the severity of gastrointestinal symptoms. Results of MANCOVA showed that there was a significant multivariate effect of gender with female scoring significantly higher than males on severity of intestinal symptoms. Other variables such as age, level of education, years since diagnosis did not reach a significance on the dependent variables. In addition the defense style defined “maladaptive” had a significant effect on dyspeptic symptoms. Conclusions: Our results have shown the influence of the maladaptive defense style on the severity of symptoms with no differences for the three considered diagnosis. Moreover they are coherent with past studies highlighting the risk for the female gender to develop a somatic disease.
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Agostini, A., Rizzello, F., Ravegnani, G., Gionchetti, P., Tambasco, R., Straforini, G., … Campieri, M. (2010). Adult Attachment and Early Parental Experiences in Patients With Crohn’s Disease. Psychosomatics, 51(3), 208–215. https://doi.org/10.1016/s0033-3182(10)70687-3
Ballou, S., & Keefer, L. (2017). Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases. Clinical and Translational Gastroenterology, 8(1), e214-e214. https://doi.org/10.1038/ctg.2016.69
Bagby, R.M., Parker, J.D.A., & Taylor, G.J. (1994). The Twenty-Item Toronto Alexithymia Scale – I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23-32
Bond, M.P. (1986). Defense Style Questionnaire. In: Vaillant, G.E. (ed). Empirical Studies of Ego Mechanisms of Defense. Washington, DC: American Psychiatric Press.
Bressi, C., Taylor, G.J., Parker, J.D.A., Bressi, S., Brambilla, V., Aguglia, E., Allegranti, I., Bongiorno, A., Giberti, F., Bucca, M., Todarello, O., Callegari, C., Vender, S., Gala, C., & Invernizzi, G. (1996). Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: An Italian multicenter study. Journal of Psychosomatic Research, 41(6), 551-559.
Chan, W., Shim, H. H., Lim, M. S., Bahjin, S. F. L., Poongunam, S. I., Chuah, S. W., Kong, C. (2017). Symptoms of Anxiety and Depression are Independently associated with Inflammatory Bowel Disease-related Disability. Digestive and Liver Disease. https://doi.org/10.1016/j.dld.2017.08.020
Edman, J. S., Greeson, J. M., Roberts, R. S., Kaufman, A. B., Abrams, D. I., Dolor, R. J., & Wolever, R. Q. (2017). Perceived Stress in Patients with Common Gastrointestinal Disorders: Associations with Quality of Life, Symptoms and Disease Management. Explore, 13(2), 124–128. https://doi.org/10.1016/j.explore.2016.12.005
Gick, M. L., & Sirois, F. M. (2010). Insecure attachment moderates women’s adjustment to inflammatory bowel disease severity. Rehabilitation Psychology, 55(2), 170-179. https://doi.org/10.1037/a0019358
Graff, L. A., Walker, J. R., & Bernstein, C. N. (2009). Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management. Inflammatory Bowel Diseases, 15(7), 1105-1118. https://doi.org/10.1002/ibd.20873
Gralnek, I. M., Hays, R. D., Kilbourne, A., Naliboff, B., & Mayer, E. A. (2000). The impact of irritable syndrome on health-related quality of life. Journal of Gastroenterology, 119(3), 654-660. https://doi.org/10.1053/gast.2000.16484
Hyphantis, T. N., Tomenson, B., Bai, M., Tsianos, E., Mavreas, V., & Creed, F. (2009). Psychological Distress, Somatization, and Defense Mechanisms Associated with Quality of Life in Inflammatory Bowel Disease Patients. Digestive Diseases and Sciences, 55(3), 724–732. https://doi.org/10.1007/s10620-009-0762-z
Hyphantis, T. N., Triantafillidis, J. K., Pappa, S., Mantas, C., Kaltsouda, A., Cherakakis, P., … Mavreas, V. G. (2005). Defense mechanisms in inflammatory bowel disease. Journal of Gastroenterology, 40(1), 24–30. https://doi.org/10.1007/s00535-004-1491-x
Janmohamed, N., & Steinhart, A. H. (2017). Measuring Severity of Anxiety and Depression in Patients with Inflammatory Bowel Disease. Inflammatory Bowel Diseases, 23(7), 1168-1173. https://doi.org/10.1097/mib.0000000000001107
Jordan, C., Sin, J., Fear, N. T., & Chalder, T. (2016). A systematic review of the psychological correlates of adjustment outcomes in adults with inflammatory bowel disease. Clinical Psychology Review, 47, 28–40. https://doi.org/10.1016/j.cpr.2016.06.001
Kulich, K.R., Calabrese, C., Pacini, F., Vigneri, S., Carlsson, J., & Wiklund, I.K. (2004). Psychometric Validation of the Italian Translation of the Gastrointestinal Symptom-Rating Scale and Quality of Life in Reflux and Dyspepsia Questionnaire in Patients with Gastro-Oesophageal Reflux Disease. Clinical Drug Investigation, 24(4), 205-215. https://doi.org/10.2165/00044011-200424040-00002
La Barbera, D., Bonanno, B., Rumeo, M. V., Alabastro, V., Frenda, M., Massihnia, E., … Nastri, L. (2017). Alexithymia and personality traits of patients with inflammatory bowel disease. Scientific Reports, 7(1). https://doi.org/10.1038/srep41786
Porcelli, P., Michael Bagby, R., Taylor, G. J., De Carne, M., Leandro, G., & Todarello, O. (2003). Alexithymia as Predictor of Treatment Outcome in Patients with Functional Gastrointestinal Disorders. Psychosomatic Medicine, 65(5), 911–918. https://doi.org/10.1097/01.psy.0000089064.13681.3b
Porcelli, P., De Carne, M., & Leandro, G. (2017). The role of alexithymia and gastrointestinal-specific anxiety as predictors of treatment outcome in irritable bowel syndrome. Comprehensive Psychiatry, 73, 127–135. https://doi.org/10.1016/j.comppsych.2016.11.010
Porcelli, P., Leoci, C., Guerra, V., Taylor, G. J., & Bagby, R. M. (1996). A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease. Journal of Psychosomatic Research, 41(6), 569–573. https://doi.org/10.1016/s0022-3999(96)00221-8
Portincasa, P., Moschetta, A., Baldassarre, G., Altomare, D. F., & Palasciano, G. (2003). Pan-enteric dysmotility, impaired quality of life and alexithymia in a large group of patients meeting ROME II criteria for irritable bowel syndrome. World Journal of Gastroenterology, 9(10), 2293. https://doi.org/10.3748/wjg.v9.i10.2293
San Martini, P., Roma, P., Sarti, S., Lingiardi, V., & Bond, M. (2004). Italian Version of the Defense Style Questionnaire. Comprensive Psychiatry, 45(6), 483-494.
Schmulson, M. J., & Drossman, D. A. (2017). What Is New in Rome IV. Journal of Neurogastroenterology and Motility, 23(2), 151-163. https://doi.org/10.5056/jnm16214
Sibelli, A., Chalder, T., Everitt, H., Workman, P., Windgassen, S., & Moss-Morris, R. (2016). A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychological Medicine, 46(15), 3065-3080. https://doi.org/10.1017/s0033291716001987
Svedlund, J., Sjödin, I., & Dotevall, G. (1988). GSRS? A clinical rating scale for gastrointestinal sympotms in patients with irritable bowel syndrome and peptic ulcer disease. Digestive Diseases and Sciences, 33(2), 129-134. https://doi.org/10.1007/bf01535722
Verissimo, R., Mota-Cardoso, R., & Taylor, G. (1998). Relationships between Alexithymia, Emotional Control, and Quality of Life in Patients with Inflammatory Bowel Disease. Psychotherapy and Psychosomatics, 67(2), 75–80. https://doi.org/10.1159/000012263
Wiklund, I. (1995). Aspects of Quality of Life in Gastrointestinal Disease: Some Methodological Issues. Scandinavian Journal of Gastroenterology, 30(s208), 129-132. https://doi.org/10.1002/(sici)1099-0879(199905)6:2<71::aid-cpp1863.3.co;2-7
Wouters, M. M., & Boeckxstaens, G. E. (2015). Is there a causal link between psychological disorders and functional gastrointestinal disorders? Expert Review of Gastroenterology & Hepatology, 10(1), 5-8. https://doi.org/10.1586/17474124.2016.1109446
DOI: https://doi.org/10.6092/2612-4033/0110-2041
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