Advertisement

Psychosocial and Sensory Factors Contribute to Self-Reported Pain and Quality of Life in Young Adults with Irritable Bowel Syndrome

Published:January 21, 2022DOI:https://doi.org/10.1016/j.pmn.2021.12.004

      Abstract

      Aims

      Psychosocial and sensory factors, including anxiety, depression, and pressure pain threshold have been used to cluster chronic symptoms in irritable bowel syndrome (IBS). This study examined the contribution of psychosocial sensory factors on pain interference and quality of life (QOL) in this population.

      Design

      We performed a cross-sectional analysis of baseline data from a randomized controlled trial.

      Settings

      Two gastrointestinal clinics, general communities, and two large campuses of a public university in the Northeastern United States.

      Participants/Subjects

      Eighty young adults with IBS aged 21 ± 2.57 years (76.25% female).

      Methods

      Demographic and psychosocial factors including anxiety, depression, fatigue, cognition or general concerns, sleep disturbance, self-efficacy, coping, and food intake were measured as independent variables. Quantitative sensory testing was conducted to measure mechanical, thermal, and pressure pain thresholds. Self-reported pain measured by the brief pain inventory (BPI) and IBS-QOL were assessed as the outcome variables. Regression analysis and mediation analysis were conducted to determine the associated factors of IBS pain and QOL.

      Results

      Age, sex, and psychosocial factors including coping, self-efficacy, alcohol intake, mechanical pain sensitivity, and cold pain threshold were significantly associated with pain interference (all p < 0.05). Coping, and self-efficacy were significantly associated with IBS-QOL (all p < 0.05). In the mediation analysis, coping catastrophizing and self-efficacy were indirectly associated with IBS-QOL mediated by fatigue.

      Conclusions

      Psychosocial factors including coping and self-efficacy, and quantitative sensory testing factors significantly correlate with self-reported pain and QOL among young adults with IBS. This preliminary research calls for further interventional studies that target personalized psychosocial and quantitative sensory factors to improve pain management and quality of life in IBS patients.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pain Management Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Achenbach J.
        • Tran A.
        • Jaeger B.
        • Kapitza K.
        • Bernateck M.
        • Karst M.
        Quantitative sensory testing in patients with multisomatoform disorder with chronic pain as the leading bodily symptom-a matched case-control study.
        Pain Medicine (Malden, Mass.). 2020; 21: e54-e61
        • Adeyemo M.A.
        • Spiegel B.M.R.
        • Chang L.
        Meta-analysis: Do irritable bowel syndrome symptoms vary between men and women?.
        Alimentary Pharmacology & Therapeutics. 2010; 32: 738-755
        • Ames N.J.
        • Barb J.J.
        • Schuebel K.
        • Mudra S.
        • Meeks B.K.
        • Tuason R.T.S.
        • Brooks A.T.
        • Kazmi N.
        • Yang S.
        • Ratteree K.
        • Diazgranados N.
        • Krumlauf M.
        • Wallen G.R.
        • Goldman D.
        Longitudinal gut microbiome changes in alcohol use disorder are influenced by abstinence and drinking quantity.
        Gut Microbes. 2020; 11: 1608-1631
        • Barandouzi Z.A.
        • Lee J.
        • Maas K.
        • Starkweather A.R.
        • Cong X.S.
        Altered gut microbiota in irritable bowel syndrome and its association with food components.
        Journal of Personalized Medicine. 2021; 11: 35
        • Böhn L.
        • Störsrud S.
        • Törnblom H.
        • Bengtsson U.
        • Simrén M.
        Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life.
        The American Journal of Gastroenterology. 2013; 108: 634-641
        • Borren N.Z.
        • van der Woude C.J.
        • Ananthakrishnan A.N.
        Fatigue in IBD: Epidemiology, pathophysiology and management.
        Nature Reviews Gastroenterology & Hepatology. 2019; 16: 247-259
        • Camilleri M.
        • Lasch K.
        • Zhou W.
        Irritable bowel syndrome: Methods, mechanisms, and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome.
        American Journal of Physiology. Gastrointestinal and Liver Physiology. 2012; 303: G775-G785
        • Canavan C.
        • West J.
        • Card T.
        The epidemiology of irritable bowel syndrome.
        Clinical Epidemiology. 2014; 6: 71-80
        • Chang L.
        • Heitkemper M.M.
        Gender differences in irritable bowel syndrome.
        Gastroenterology. 2002; 123: 1686-1701
        • Cho H.S.
        • Park J.M.
        • Lim C.H.
        • Cho Y.K.
        • Lee I.S.
        • Kim S.W.
        • Choi M.-G.
        • Chung I.-S.
        • Chung Y.K.
        Anxiety, depression and quality of life in patients with irritable bowel syndrome.
        Gut and Liver. 2011; 5: 29-36
        • Choghakhori R.
        • Abbasnezhad A.
        • Amani R.
        • Alipour M.
        Sex-related differences in clinical symptoms, quality of life, and biochemical factors in irritable bowel syndrome.
        Digestive Diseases and Sciences. 2017; 62: 1550-1560
        • Cong X.
        • Ramesh D.
        • Perry M.
        • Xu W.
        • Bernier K.M.
        • Young E.E.
        • Walsh S.
        • Starkweather A.
        Pain self-management plus nurse-led support in young adults with irritable bowel syndrome: Study protocol for a pilot randomized control trial.
        Research in Nursing & Health. 2018; 41: 121-130
        • Dąbek-Drobny A.
        • Mach T.
        • Zwolińska-Wcisło M.
        Effect of selected personality traits and stress on symptoms of irritable bowel syndrome.
        Folia Medica Cracoviensia. 2020; 60: 29-41
        • Enck P.
        • Aziz Q.
        • Barbara G.
        • Farmer A.D.
        • Fukudo S.
        • Mayer E.A.
        • Niesler B.
        • Quigley E.M.M.
        • Rajilić-Stojanović M.
        • Schemann M.
        • Schwille-Kiuntke J.
        • Simren M.
        • Zipfel S.
        • Spiller R.C.
        Irritable bowel syndrome.
        Nature Reviews. Disease Primers. 2016; 2: 16014
        • Endo Y.
        • Shoji T.
        • Fukudo S.
        • Machida T.
        • Machida T.
        • Noda S.
        • Hongo M.
        The features of adolescent irritable bowel syndrome in Japan.
        Journal of Gastroenterology and Hepatology. 2011; 26: 106-109
        • Farup P.G.
        • Hestad K.
        Cognitive functions and depression in patients with irritable bowel syndrome.
        Gastroenterology Research and Practice. 2015; 2015438329
        • Farzaei M.H.
        • Bahramsoltani R.
        • Abdollahi M.
        • Rahimi R.
        The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.
        Journal of Neurogastroenterology and Motility. 2016; 22: 558-574
        • Ford A.C.
        • Sperber A.D.
        • Corsetti M.
        • Camilleri M.
        Irritable bowel syndrome.
        Lancet (London, England). 2020; 396: 1675-1688
        • Ford D.E.
        • Cooper-Patrick L.
        Sleep disturbances and mood disorders: An epidemiologic perspective.
        Depression and Anxiety. 2001; 14: 3-6
        • Frissora C.L.
        • Koch K.L.
        Symptom overlap and comorbidity of irritable bowel syndrome with other conditions.
        Current Gastroenterology Reports. 2005; 7: 264-271
        • Gaynor S.M.
        • Bortsov A.
        • Bair E.
        • Fillingim R.B.
        • Greenspan J.D.
        • Ohrbach R.
        • Diatchenko L.
        • Nackley A.
        • Tchivileva I.E.
        • Whitehead W.
        • Alonso A.A.
        • Buchheit T.E.
        • Boortz-Marx R.L.
        • Liedtke W.
        • Park J.J.
        • Maixner W.
        • Smith S.B.
        Phenotypic profile clustering pragmatically identifies diagnostically and mechanistically informative subgroups of chronic pain patients.
        Pain. 2021; 162: 1528-1538
        • Hahn B.A.
        • Kirchdoerfer L.J.
        • Fullerton S.
        • Mayer E.
        Evaluation of a new quality of life questionnaire for patients with irritable bowel syndrome.
        Alimentary Pharmacology & Therapeutics. 1997; 11: 547-552
        • Hastie B.A.
        • Riley J.L.
        • Fillingim R.B.
        Ethnic differences in pain coping: Factor structure of the coping strategies questionnaire and coping strategies questionnaire-revised.
        The Journal of Pain. 2004; 5: 304-316
        • Heitkemper M.
        • Jarrett M.
        • Bond E.F.
        • Chang L.
        Impact of sex and gender on irritable bowel syndrome.
        Biological Research for Nursing. 2003; 5: 56-65
        • Hu F.B.
        • Rimm E.
        • Smith-Warner S.A.
        • Feskanich D.
        • Stampfer M.J.
        • Ascherio A.
        • Sampson L.
        • Willett W.C.
        Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire.
        The American Journal of Clinical Nutrition. 1999; 69: 243-249
        • Ikechi R.
        • Fischer B.D.
        • DeSipio J.
        • Phadtare S.
        Irritable bowel syndrome: Clinical manifestations, dietary influences, and management.
        Healthcare (Basel, Switzerland). 2017; 5
        • Jarrett M.E.
        • Shulman R.J.
        • Cain K.C.
        • Deechakawan W.
        • Smith L.T.
        • Richebé P.
        • Eugenio M.
        • Heitkemper M.M.
        Conditioned pain modulation in women with irritable bowel syndrome.
        Biological Research For Nursing. 2014; 16: 368-377
        • Kanazawa M.
        • Hongo M.
        • Fukudo S.
        Visceral hypersensitivity in irritable bowel syndrome.
        Journal of Gastroenterology and Hepatology. 2011; 26: 119-121
        • Keller S.
        • Bann C.M.
        • Dodd S.L.
        • Schein J.
        • Mendoza T.R.
        • Cleeland C.S.
        Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain.
        The Clinical Journal of Pain. 2004; 20: 309-318
        • Kim H.J.
        • Greenspan J.D.
        • Ohrbach R.
        • Fillingim R.B.
        • Maixner W.
        • Renn C.L.
        • Johantgen M.
        • Zhu S.
        • Dorsey S.G.
        Racial/ethnic differences in experimental pain sensitivity and associated factors: Cardiovascular responsiveness and psychological status.
        PloS One. 2019; 14e0215534
        • Kim Y.S.
        • Kim N.
        Sex-gender differences in irritable bowel syndrome.
        Journal of Neurogastroenterology and Motility. 2018; 24: 544-558
        • Knowles S.R.
        • Austin D.W.
        • Sivanesan S.
        • Tye-Din J.
        • Leung C.
        • Wilson J.
        • Castle D.
        • Kamm M.A.
        • Macrae F.
        • Hebbard G.
        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.
        Psychology, Health & Medicine. 2017; 22: 524-534
        • Kosako M.
        • Akiho H.
        • Miwa H.
        • Kanazawa M.
        • Fukudo S.
        Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): A large population-based internet survey.
        BioPsychoSocial Medicine. 2018; 12: 12
        • Kristal A.R.
        • Feng Z.
        • Coates R.J.
        • Oberman A.
        • George V.
        Associations of race/ethnicity, education, and dietary intervention with the validity and reliability of a food frequency questionnaire: The Women's Health Trial Feasibility Study in Minority Populations.
        American Journal of Epidemiology. 1997; 146: 856-869
        • Lackner J.M.
        • Quigley B.M.
        • Blanchard E.B.
        Depression and abdominal pain in IBS patients: The mediating role of catastrophizing.
        Psychosomatic Medicine. 2004; 66: 435-441
        • Lacy B.E.
        • Chey W.D.
        • Lembo A.J.
        New and emerging treatment options for irritable bowel syndrome.
        Gastroenterology & Hepatology. 2015; 11: 1-19
        • Lee O.Y.
        • Mayer E.A.
        • Schmulson M.
        • Chang L.
        • Naliboff B.
        Gender-related differences in IBS symptoms.
        The American Journal of Gastroenterology. 2001; 96: 2184-2193
        • Lorig K.R.
        • Sobel D.S.
        • Ritter P.L.
        • Laurent D.
        • Hobbs M.
        Effect of a self-management program on patients with chronic disease.
        Effective Clinical Practice. 2001; 4: 256-262
        • Mars R.A.T.
        • Yang Y.
        • Ward T.
        • Houtti M.
        • Priya S.
        • Lekatz H.R.
        • Tang X.
        • Sun Z.
        • Kalari K.R.
        • Korem T.
        • Bhattarai Y.
        • Zheng T.
        • Bar N.
        • Frost G.
        • Johnson A.J.
        • van Treuren W.
        • Han S.
        • Ordog T.
        • Grover M.
        • Kashyap P.C.
        Longitudinal multi-omics reveals subset-specific mechanisms underlying irritable bowel syndrome.
        Cell. 2020; 182 (1460-1473.e17)
        • Mönnikes H.
        Quality of life in patients with irritable bowel syndrome.
        Journal of Clinical Gastroenterology. 2011; 45: S98-S101
        • Ohman L.
        • Stridsberg M.
        • Isaksson S.
        • Jerlstad P.
        • Simrén M.
        Altered levels of fecal chromogranins and secretogranins in IBS: Relevance for pathophysiology and symptoms?.
        The American Journal of Gastroenterology. 2012; 107: 440-447
        • Patel A.
        • Hasak S.
        • Cassell B.
        • Ciorba M.A.
        • Vivio E.E.
        • Kumar M.
        • Gyawali C.P.
        • Sayuk G.S.
        Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in irritable bowel syndrome.
        Alimentary Pharmacology & Therapeutics. 2016; 44: 246-258
        • Patterson R.E.
        • Kristal A.R.
        • Tinker L.F.
        • Carter R.A.
        • Bolton M.P.
        • Agurs-Collins T.
        Measurement characteristics of the Women's Health Initiative food frequency questionnaire.
        Annals of Epidemiology. 1999; 9: 178-187
        • Piche T.
        • Ducrotté P.
        • Sabate J.M.
        • Coffin B.
        • Zerbib F.
        • Dapoigny M.
        • Hua M.
        • Marine-Barjoan E.
        • Dainese R.
        • Hébuterne X.
        Impact of functional bowel symptoms on quality of life and fatigue in quiescent Crohn disease and irritable bowel syndrome.
        Neurogastroenterology and Motility. 2010; 22: 626-e174
        • Pittayanon R.
        • Lau J.T.
        • Yuan Y.
        • Leontiadis G.I.
        • Tse F.
        • Surette M.
        • Moayyedi P.
        Gut microbiota in patients with irritable bowel syndrome: A systematic review.
        Gastroenterology. 2019; 157: 97-108
        • Riley J.L.
        • Robinson M.E.
        CSQ: Five factors or fiction?.
        The Clinical Journal of Pain. 1997; 13: 156-162
        • Robinson M.E.
        • Riley J.L.
        • Myers C.D.
        • Sadler I.J.
        • Kvaal S.A.
        • Geisser M.E.
        • Keefe F.J.
        The coping strategies questionnaire: A large sample, item level factor analysis.
        The Clinical Journal of Pain. 1997; 13: 43-49
        • Rolke R.
        • Magerl W.
        • Campbell K.A.
        • Schalber C.
        • Caspari S.
        • Birklein F.
        • Treede R.-D.
        Quantitative sensory testing: A comprehensive protocol for clinical trials.
        European Journal of Pain (London, England). 2006; 10: 77-88
        • Rosseel Y.
        lavaan: An R package for structural equation modeling.
        Journal of Statistical Software. 2012; 48
        • Starkweather A.R.
        • Heineman A.
        • Storey S.
        • Rubia G.
        • Lyon D.E.
        • Greenspan J.
        • Dorsey S.G.
        Methods to measure peripheral and central sensitization using quantitative sensory testing: A focus on individuals with low back pain.
        Applied Nursing Research. 2016; 29: 237-241
        • Tang Y.-R.
        • Yang W.-W.
        • Liang M.-L.
        • Xu X.-Y.
        • Wang M.-F.
        • Lin L.
        Age-related symptom and life quality changes in women with irritable bowel syndrome.
        World Journal of Gastroenterology. 2012; 18: 7175-7183
        • Tang Y.
        • Yang W.
        • Wang Y.-L.
        • Lin L.
        Sex differences in the symptoms and psychological factors that influence quality of life in patients with irritable bowel syndrome.
        European Journal of Gastroenterology & Hepatology. 2012; 24: 702-707
        • Ten Brink M.
        • Lee H.Y.
        • Manber R.
        • Yeager D.S.
        • Gross J.J
        Stress, sleep, and coping self-efficacy in adolescents.
        Journal of Youth and Adolescence. 2021; 50: 485-505
        • Tibshirani R.
        Regression shrinkage and selection via the lasso.
        Series B (Methodological). 1996; 58: 267-288
        • Torkzadeh F.
        • Danesh M.
        • Mirbagher L.
        • Daghaghzadeh H.
        • Emami M.H.
        Relations between coping skills, symptom severity, psychological symptoms, and quality of life in patients with irritable bowel syndrome.
        International Journal of Preventive Medicine. 2019; 10: 72
        • Uddin Z.
        • MacDermid J.C.
        Quantitative sensory testing in chronic musculoskeletal pain.
        Pain Medicine (Malden, Mass.). 2016; 17: 1694-1703
        • van Tilburg M.A.L.
        • Palsson O.S.
        • Whitehead W.E.
        Which psychological factors exacerbate irritable bowel syndrome? Development of a comprehensive model.
        Journal of Psychosomatic Research. 2013; 74: 486-492
        • Verdugo R.
        • Ochoa J.L.
        Quantitative somatosensory thermotest. A key method for functional evaluation of small calibre afferent channels.
        Brain: A Journal of Neurology. 1992; 115: 893-913
        • Voreades N.
        • Kozil A.
        • Weir T.L.
        Diet and the development of the human intestinal microbiome.
        Frontiers in Microbiology. 2014; 5: 494
        • Whitehead W.E.
        • Palsson O.
        • Jones K.R.
        Systematic review of the comorbidity of irritable bowel syndrome with other disorders: What are the causes and implications?.
        Gastroenterology. 2002; 122: 1140-1156
        • Wong R.K.
        • Van Oudenhove L.
        • Li X.
        • Cao Y.
        • Ho K.Y.
        • Wilder-Smith C.H.
        Visceral pain perception in patients with irritable bowel syndrome and healthy volunteers is affected by the MRI scanner environment.
        United European Gastroenterology Journal. 2016; 4: 132-141
        • Yeom H.-A.
        • Choi M.
        • Belyea M.
        • Fleury J.
        Psychometric evaluation of the index of self-regulation.
        Western Journal of Nursing Research. 2011; 33: 268-285
        • Zhou Q.
        • Fillingim R.B.
        • Riley J.L.
        • Malarkey W.B.
        • Verne N.G.
        Central and peripheral hypersensitivity in the irritable bowel syndrome.
        Pain. 2010; 148: 454-461