Gastrointestinal Therapeutics

Biography

Biography: Ines A. Trindade

Abstract

The negative impact of inflammatory bowel disease-related symptomatology on patients’ quality of life and level of psychopathology has been reported by several studies. Indeed, IBD is known to hold detrimental effects on the physical and psychosocial functioning of the patients, even when the disease is inactive. Nevertheless, the analysis of the psychological mechanisms that may underlie these effects is yet scarcely developed, even though it has been considered an especially relevant field. We have therefore explored the role of maladaptive psychological processes in IBD using samples of Portuguese patients with Crohn’s Disease and Ulcerative Colitis. Our findings have demonstrated that experiential avoidance, i.e. one’s unavailability to accept internal events such as sensations, thoughts or emotions while trying to control them, mediates the relationship between IBD symptomatology and physical and psychological quality of life. That is, it seems that when patients try to control or avoid sensations like pain or discomfort, or thoughts related to the illness or its symptoms, this strategy holds a paradoxical nature and heightens the effect of those internal experiences on patients’ well-being. Furthermore, we have also recently found that cognitive fusion (the excessive attachment to the content of one’s thoughts) and brooding (a form of rumination defined as the repetitive focused attention on one\\\\\\\'s distress and on its possible causes and consequences) act as significant exacerbators of the association between symptomatology and depression. In fact, for the same level of IBD symptomatology, patients who presented higher levels of those maladaptive processes revealed a significantly higher incidence of depressive symptomatology. These findings suggest that rather than focusing solely on a physical and objective evaluation and approach of patients’ IBD symptomatology, clinicians should also focus on the way patients deal with their symptoms, in order to be able to identify maladaptive emotion regulation processes (e.g., persistent patterns of inflexible thoughts relating to the limitations and consequences of the disease and/or its symptoms; inflexible efforts to avoid or control inner experiences). Furthermore, our results also highlight that psychological interventions that focus on the promotion of adaptive emotion regulation processes to deal with adverse and stressful events should be developed and implemented in IBD patients’ health care.