Relationship Between Abuse History and Gastrointestinal and Extraintestinal Symptom Severity in Irritable Bowel Syndrome

• Objective This study aimed to investigate the associations between the different abuse types, and gastrointestinal (GI) and extraintestinal symptom severity in irritable bowel syndrome (IBS), and possible mediators of these relationships. Methods We assessed sexual and physical abuse in childhood and adulthood with the Drossman and Leserman abuse questionnaire, whereas GI and extraintestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale and the Symptom Check List-90 Revised. General linear models with bootstrapping tested the mediating role of depressive symptoms, anxiety symptoms, and GI-specific anxiety and rectal pain threshold. A path model analysis testing all relationships simultaneously was also performed. Results Among our 186 patients with IBS, an overall history of abuse (i.e., at least one type) was found in 37%. The effects of child and adult sexual abuse on GI symptom severity were fully mediated by GI-specific anxiety and rectal pain threshold (F = 21.540, R-2 = 0.43, and F = 22.330, R-2 = 0.44, respectively; p < .001 for both). The effect of adult sexual abuse and child physical abuse on extraintestinal symptom severity was fully mediated by GI-specific anxiety, depressive symptoms, and rectal pain threshold, whereas the effect of child sexual abuse was partially mediated (F = 14.992, R-2 = 0.28; F = 15.065, R-2 = 0.30; and F = 18.037, R-2 = 0.32, respectively; p < .001 for all). When analyzed in a single path model, child sexual abuse and adult physical abuse only had a direct effect on extraintestinal symptom severity, whereas child physical abuse had an indirect effect through depressive symptoms. Conclusions Abuse is associated with increased GI and extraintestinal symptom severity in IBS. These associations are mediated by levels of GI-specific anxiety, depressive symptoms, and rectal sensitivity.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Keyword

irritable bowel syndrome

abuse history

gastrointestinal symptom

severity

extraintestinal symptom severity

AIC = Akaike information

criterion

CFI = Comparative Fit Index

DGBI = disorder of gut-brain

interaction

GI = gastrointestinal

GLM = general linear model

GSRS

Gastrointestinal Symptom Rating Scale

IBS = irritable bowel syndrome

RMSEA = Root Mean Squared Error of Approximation

SCL-90-R = Symptom

Check List-90 Revised

SRMR = Standardized Root Mean Residual

quality-of-life

physical abuse

childhood trauma

female-patients

sexual-abuse

validation

anxiety

sensitivity

impact

women

Psychiatry

Psychology

Publication and Content Type

ref (subject category)

art (subject category)