Publisher: Research Institute for Gastroenterology and Liver Diseases (RIGLD)
  • Register
  • Login

Gastroenterology and Hepatology from Bed to Bench

  • Home
  • Issues
    • Current
    • Archives
  • About
    • About the Journal
    • Aims and Scope
    • Editorial Team
    • Privacy Statement
    • Contact
  • For Authors
    • Submissions
    • Author Guidelines
    • Peer Review Process
  • Indexing & Abstracting
  • Announcements
Advanced Search
  1. Home
  2. Archives
  3. Vol. 17 No. 4 (2024): Vol 17, No 4 (2024): Autumn
  4. Original Article

Vol. 17 No. 4 (2024)

Azar 2024

Exposure-based cognitive behavioral therapy with complementary awareness and emotional expression training for alleviating irritable bowel syndrome (IBS)

  • Elham Saeedinia
  • Hamid Poursharifi
  • Fereshte Momeni
  • Mohsen Vahedi
  • Mansour Abdi
  • Amir Sadeghi
  • Ramin Ghahremani

Gastroenterology and Hepatology from Bed to Bench, Vol. 17 No. 4 (2024), 2 Azar 2024
https://doi.org/10.22037/ghfbb.v17i4.2930 Published: 2024-12-02

  • View Article
  • Download
  • Cite
  • References
  • Statastics
  • Share

Abstract

Aim: The present study presents a new combined approach for the treatment of irritable bowel syndrome (IBS), in which the effect of Cognitive Behavioral Therapy (CBT) based on exposure to awareness and emotional expression on patients' symptoms is examined.

Background: IBS is one of the most common functional gastrointestinal diseases where psychological distress is an integral part of its presentation.

Methods: We performed a clinical trial study on 30 patients with IBS. They were divided into two groups receiving the intervention and waiting list control. All patients were evaluated by IBS quality of life scale, IBS severity score, hospital anxiety and depression scale and visceral sensitivity index in three stages: pre-test, pre-test, and one-month follow-up. Our treatment program for the intervention group (n=15) included 10 group sessions, every week for 90 minutes, based on an exposure-based cognitive behavioral therapy protocol. Also, they underwent three 90-minute sessions of an emotional expression and awareness training program.

Results: The mean age of the participants was 31.0±8.77 years old. No previous history of substance addiction, psychiatric, or neurologic diseases was seen. Twenty participants (66.7%) were single, twenty-three participants (76.7%) had a university degree, and 9 participants were unemployed. No significant difference was seen between the case and control groups regarding education, occupation, and marital status. All pairwise comparisons of pre-test, post-test, and follow-up IBS-QOL scores were significant between the two groups (p<0.001). Similarly, pre- and post-, and pre- and follow-up test differences for IBS-SSS and VSI were significantly different between the two groups.

Conclusion: Exposure-based CBT combined with emotional expression and awareness training could alleviate the IBS symptoms, reduce visceral sensitivity, and improve quality of life.

Keywords:
  • irritable bowel syndrome (IBS)
  • IBS, Anxiety, Depression, IBS subtypes, Psychological factors
  • PDF

How to Cite

Saeedinia, E., Poursharifi, H., Momeni, F., Vahedi, M., Abdi, M., Sadeghi, A., & Ghahremani, R. (2024). Exposure-based cognitive behavioral therapy with complementary awareness and emotional expression training for alleviating irritable bowel syndrome (IBS) . Gastroenterology and Hepatology from Bed to Bench, 17(4). https://doi.org/10.22037/ghfbb.v17i4.2930
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

References

Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. Jama 2015;313:949-58.

Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020;5:908-17.

Kim YS, Kim N. Sex-gender differences in irritable bowel syndrome. J Neurogastroenterol Motil 2018;24:544.

Keefer L, Ko CW, Ford AC. AGA clinical practice update on management of chronic gastrointestinal pain in disorders of gut–brain interaction: expert review. Clin Gastroenterol Hepatol 2021;19:2481-8.

Koloski N, Holtmann G, Talley NJ. Is there a causal link between psychological disorders and functional gastrointestinal disorders? Expert Rev Gastroenterol Hepatol 2020;14:1047-59.

Midenfjord I, Borg A, Törnblom H, Simrén M. Cumulative effect of psychological alterations on gastrointestinal symptom severity in irritable bowel syndrome. ACG. 2021;116:769-79.

Hollier JM, van Tilburg MA, Liu Y, Czyzewski DI, Self MM, Weidler EM, et al. Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome. Neurogastroenterol Motil 2019;31:13509.

Banerjee A, Sarkhel S, Sarkar R, Dhali GK. Anxiety and depression in irritable bowel syndrome. Indian J Psychol Med 2017;39:741-5.

Mayer EA, Nance K, Chen S. The gut–brain axis. Ann Rev Med 2022;73:439-53.

Drossman DA. Gastrointestinal illness and the biopsychosocial model. Psychosom Med 1998;60:258-67.

Mikocka-Walus A, Ford AC, Drossman DA. Antidepressants in inflammatory bowel disease. Nat Rev Gastroenterol Hepatol 2020;17:184-92.

Faraj LJ, Takanti LV, Tavakoli HR. The gut-brain axis: Literature overview and psychiatric applications. Fed Pract 2021;38:356.

Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. sychol Res Behav Manag 2017;10:231.

Lang PJ, Melamed BG, Hart J. A psychophysiological analysis of fear modification using an automated desensitization procedure. J Abnorm Psychol 1970;76:220.

Kennedy T, Jones R, Darnley S, Seed P, Wessely S, Chalder T. Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial. Br Med J 2005;331:435.

Craske MG, Wolitzky-Taylor KB, Labus J, Wu S, Frese M, Mayer EA, et al. A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations. Behav Res Ther 2011;49:413-21.

Mayer EA, Naliboff BD, Chang L, Coutinho SV. V. Stress and irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 2001;280:519-24.

Mann C. Observational research methods. Research design II: cohort, cross sectional, and case-control studies. Emerg Med J 2003;20:54-60.

Patrick DL, Drossman DA, Frederick IO, Dicesare J, Puder KL. Quality of life in persons with irritable bowel syndrome (development and validation of a new measure). Dig Dis Sci 1998;43:400-11.

Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 1997;11:395-402.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70.

Labus J, Bolus R, Chang L, Wiklund I, Naesdal J, Mayer E, et al. The Visceral Sensitivity Index: development and validation of a gastrointestinal symptom‐specific anxiety scale. Aliment Pharmacol Ther 2004;20:89-97.

Luxenberg T, Spinazzola J, Van der Kolk BA. Complex trauma and disorders of extreme stress (DESNOS) diagnosis, part one: Assessment. Directions in psychiatry 2001;21:373-92.

Everitt HA, Landau S, O'Reilly G, Sibelli A, Hughes S, Windgassen S, et al. Cognitive behavioural therapy for irritable bowel syndrome: 24-month follow-up of participants in the ACTIB randomised trial. Lancet Gastroenterol Hepatol 2019;4:863-72.

Toner BB, Stuckless N, Ali A, Downie F, Emmott S, Akman D. The development of a cognitive scale for functional bowel disorders. Psychosom Med 1998;60:492-7.

Sugaya N, Shirotsuki K, Nakao M. Cognitive behavioral treatment for irritable bowel syndrome: a recent literature review. Biopsychosoc Med 2021;15:1-5.

Lackner JM, Coad ML, Mertz HR, Wack DS, Katz LA, Krasner SS, et al. Cognitive therapy for irritable bowel syndrome is associated with reduced limbic activity, GI symptoms, and anxiety. Behav Res Ther 2006;44:621-38.

Lackner JM, Jaccard J, Krasner SS, Katz LA, Gudleski GD, Holroyd K. Self-administered cognitive behavior therapy for moderate to severe irritable bowel syndrome: clinical efficacy, tolerability, feasibility. Clin Gastroenterol Hepatol 2008;6:899-906.

Leibbrand R, Hiller W. Cognitive behavior therapy for functional gastrointestinal disorders: is group treatment effective? Acta Neuropsychiatr 2003;15:242-8.

Radu M, Moldovan R, Pintea S, Băban A, Dumitrașcu D. Predictors of outcome in cognitive and behavioural interventions for irritable bowel syndrome. A meta-analysis. J Gastrointestin Liver Dis 2018;27.

Windgassen S, Moss‐Morris R, Chilcot J, Sibelli A, Goldsmith K, Chalder T. The journey between brain and gut: A systematic review of psychological mechanisms of treatment effect in irritable bowel syndrome. Br J Health Psychol 2017;22:701-36.

Hesser H, Hedman-Lagerlöf E, Lindfors P, Andersson E, Ljótsson B. Behavioral avoidance moderates the effect of exposure therapy for irritable bowel syndrome: a secondary analysis of results from a randomized component trial. Behav Res Ther 2021;141:103862.

Kawanishi H, Sekiguchi A, Funaba M, Fujii Y, Yoshiuchi K, Kikuchi H, et al. Cognitive behavioral therapy with interoceptive exposure and complementary video materials for irritable bowel syndrome (IBS): protocol for a multicenter randomized controlled trial in Japan. Biopsychosoc Med 2019;13:1-11.

Ljótsson B, Hesser H, Andersson E, Lackner JM, El Alaoui S, Falk L, et al. Provoking symptoms to relieve symptoms: a randomized controlled dismantling study of exposure therapy in irritable bowel syndrome. Behav Res Ther 2014;55:27-39.

Walker EA, Katon WJ, Jemelka RP, Roy-Byrne PP. Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study. Am J Med 1992;92:26-30.

Ng QX, Soh AYS, Loke W, Venkatanarayanan N, Lim DY, Yeo WS. Systematic review with meta‐analysis: The association between post‐traumatic stress disorder and irritable bowel syndrome. J Gastroenterol Hepatol 2019;34:68-73.

Bradford K, Shih W, Videlock EJ, Presson AP, Naliboff BD, Mayer EA, et al. Association between early adverse life events and irritable bowel syndrome. Clin Gastroenterol Hepatol 2012;10:385-90.

Thakur ER, Gurtman MB, Keefer L, Brenner DM, Lackner JM, Group RtIOSR. Gender differences in irritable bowel syndrome: the interpersonal connection. Neurogastroenterol Motil 2015;27:1478-86.

Lackner JM, Gurtman MB. Patterns of interpersonal problems in irritable bowel syndrome patients: a circumplex analysis. J Psychosom Res 2005;58:523-32.

Thakur ER, Holmes HJ, Lockhart NA, Carty JN, Ziadni MS, Doherty HK, et al. Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial. Neurogastroenterol Motil 2017;29:13143.

Holmes HJ, Thakur ER, Carty JN, Ziadni MS, Doherty HK, Lockhart NA, et al. Ambivalence over emotional expression and perceived social constraints as moderators of relaxation training and emotional awareness and expression training for irritable bowel syndrome. Gen Hosp Psychiatry 2018;53:38-43.

  • Abstract Viewed: 142 times
  • PDF Downloaded: 7 times

Download Statastics

  • Linkedin
  • Twitter
  • Facebook
  • Google Plus
  • Telegram

Developed By

Open Journal Systems
  • Home
  • Archives
  • Submissions
  • About the Journal
  • Editorial Team
  • Contact

GHFBB journal is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).

Print ISSN: 2008-2258
Online ISSN: 2008-4234

Support Contact: ghfbb.journal@gmail.com

 

GHFBB is an open-access journal and does not charge fees for authors who submit their articles and for readers who access PDF files of published articles.