Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-26T04:53:14.969Z Has data issue: false hasContentIssue false
  • English
  • Français

Changing Beliefs About Emotions in IBS: A Single Case Design

Published online by Cambridge University Press:  08 November 2018

H.M. Bowers Open the ORCID record for H.M. Bowers [Opens in a new window]  and
A.L. Wroe
H.M. Bowers*
Affiliation:
Royal Holloway University of London
A.L. Wroe
Affiliation:
Royal Holloway University of London
*
Correspondence to Hannah Bowers, Psychology Department, Royal Holloway University of London, Egham Hill, Egham TW20 0EX, UK. E-mail: Hannah.Bowers.2010@live.rhul.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Previous research suggests benefits of targeting beliefs about the unacceptability of emotions in treatment for irritable bowel syndrome (IBS). Aims: The current study developed and tested an intervention focusing on beliefs and behaviours around emotional expression. Method: Four participants with IBS attended five group sessions using cognitive behavioural techniques focusing on beliefs about the unacceptability of expressing emotions. Bi-weekly questionnaires were completed and a group interview was conducted. This study used an AB design with four participants. Results: Averages indicate that participants showed decreases in beliefs about unacceptability of emotions and emotional suppression during the intervention, although this was not reflected in any of the individual trends in Beliefs about Emotions Scale scores and was significant in only one individual case for Courtauld Emotional Control Scale scores. Affective distress and quality of life improved during follow-up, with only one participant not improving with regard to distress. Qualitative data suggest that participants felt that the intervention was beneficial, referencing the value in sharing their emotions. Conclusions: This study suggests the potential for beliefs about emotions and emotional suppression to be addressed in cognitive behavioural interventions in IBS. That beliefs and behaviours improved before outcomes suggests they may be important processes to investigate in treatment for IBS.

Keywords

beliefs about emotionsemotional suppressioncognitive behavioural therapyirritable bowel syndromesingle case design
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 3 , May 2019 , pp. 303 - 317
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altayar, O., Sharma, V., Prokop, L. J., Sood, A. and Murad, M. H. (2015). Psychological therapies in patients with irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials. Gastroenterology Research and Practice, 2015. https://www.hindawi.com/journals/grp/2015/549308/Google Scholar
Bowers, H. and Wroe, A. (2016). Beliefs about emotions mediate the relationship between emotional suppression and quality of life in irritable bowel syndrome. Journal of Mental Health, 25, 154–158. https://doi.org/10.3109/09638237.2015.1101414Google Scholar
Bowers, H., Wroe, A. and Pincus, T. (2017a). ‘Isn't it ironic?’ Beliefs about the unacceptability of emotions and emotional suppression relate to worse outcomes in fibromyalgia. Clinical Rheumatology, 1–8. https://doi.org/10.1007/s10067-017-3590-0Google Scholar
Bowers, H., Wroe, A. and Pincus, T. (2017b). The relationship between beliefs about emotions and quality of life in irritable bowel syndrome. Psychology Health and Medicine. https://doi.org/10.1080/13548506.2017.1307996Google Scholar
Bradford, K., Shih, W., Videlock, E. J., Presson, A. P., Naliboff, B. D., Mayer, E. A. and Chang, L. (2012). Association between early adverse life events and irritable bowel syndrome. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 10, 385–90. https://doi.org/10.1016/j.cgh.2011.12.018Google Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. https://doi.org/10.1191/1478088706qp063oaGoogle Scholar
Canavan, C., West, J. and Card, T. (2014). The epidemiology of irritable bowel syndrome. Clinical Epidemiology, 6, 71–80. https://doi.org/10.2147/CLEP.S40245Google Scholar
Elsenbruch, S. (2011). Abdominal pain in irritable bowel syndrome: a review of putative psychological, neural and neuro-immune mechanisms. Brain, Behavior, and Immunity, 25, 386–394. https://doi.org/10.1016/j.bbi.2010.11.010Google Scholar
Elsenbruch, S. and Enck, P. (2016). Psychobiologische Mechanismen bei der Pathophysiologie chronischer viszeraler Schmerzen. Der Schmerz, 30, 407–411. https://doi.org/10.1007/s00482-016-0130-9Google Scholar
Endo, Y., Shoji, T. and Fukudo, S. (2015). Epidemiology of irritable bowel syndrome. Annals of Gastroenterology, 28, 158–159. Retrieved from: www.annalsgastro.grGoogle Scholar
Ford, A. C., Quigley, E. M. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R. et al. (2014). Effect of antidepressants and psychological therapies, including hypnotherapy, in irritable bowel syndrome: systematic rview and meta-analysis. American Journal of Gastroenterology, 109, 1350–1365. https://doi.org/10.1038/ajg.2014.148Google Scholar
Gilbert, P. (2010). Compassion focused therapy: distinctive features (CBT Distinctive Features), 248. Retrieved from: http://www.amazon.com/Compassion-Focused-Therapy-Distinctive-Features/dp/0415448077Google Scholar
Gillis, M. E., Lumley, M. A., Mosley-Williams, A., Leisen, J. C. C. and Roehrs, T. (2006). The health effects of at-home written emotional disclosure in fibromyalgia: a randomized trial. Annals of Behavioral Medicine, 32, 135–146. https://doi.org/10.1207/s15324796abm3202Google Scholar
Greenhalgh, T., Annandale, E., Ashcroft, R., Barlow, J., Black, N., Bleakley, A. et al. (2016). An open letter to The BMJ editors on qualitative research. British Medical Journal, 352. Retrieved from: http://www.bmj.com/content/352/bmj.i563Google Scholar
Haynes, S. N., Mumma, G. H. and Pinson, C. (2009). Idiographic assessment: conceptual and psychometric foundations of individualized behavioral assessment. Clinical Psychology Review, 29, 179–191. https://doi.org/10.1016/j.cpr.2008.12.003Google Scholar
Lackner, J. M., Mesmer, C., Morley, S., Dowzer, C. and Hamilton, S. (2004). Psychological treatments for irritable bowel syndrome: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 72, 1100–13. https://doi.org/10.1037/0022-006X.72.6.1100Google Scholar
Laird, K. T., Tanner-Smith, E. E., Russell, A. C., Hollon, S. D. and Walker, L. S. (2017). Comparative efficacy of psychological therapies for improving mental health and daily functioning in irritable bowel syndrome: a systematic review and meta-analysis. Clinical Psychology Review, 51, 142–152. https://doi.org/10.1016/j.cpr.2016.11.001Google Scholar
Manning, A. P., Thompson, W. G., Heaton, K. W. and Morris, A. F. (1978). Towards positive diagnosis of the irritable bowel. British Medical Journal, 2 (6138), 653–654. Retrieved from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1607467andtool=pmcentrezandrendertype=abstractGoogle Scholar
Mayer, E. A., Savidge, T. and Shulman, R. J. (2014). Brain-gut microbiome interactions and functional bowel disorders. Gastroenterology, 146, 1500–1512. https://doi.org/10.1053/j.gastro.2014.02.037Google Scholar
McInnis, O. A., McQuaid, R. J., Bombay, A., Matheson, K. and Anisman, H. (2015). Finding benefit in stressful uncertain circumstances: relations to social support and stigma among women with unexplained illnesses. Stress, 18, 169–177.Google Scholar
Patrick, D. L., Drossman, D. a, Frederick, I. O., DiCesare, J. and Puder, K. L. (1998). Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Digestive Diseases and Sciences, 43, 400–11. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/9512138Google Scholar
Rennie, D. L. and Frommer, J. (2015). Applications of qualitative and mixed-methods counseling and psychotherapy research. In Psychotherapy Research (pp. 429–454). Vienna: Springer Vienna. https://doi.org/10.1007/978-3-7091-1382-0_21Google Scholar
Rimes, K. A. and Chalder, T. (2010). The Beliefs about Emotions Scale: validity, reliability and sensitivity to change. Journal of Psychosomatic Research, 68, 285–92. https://doi.org/10.1016/j.jpsychores.2009.09.014Google Scholar
Rimes, K. A., Ashcroft, J., Bryan, L. and Chalder, T. (2016). Emotional suppression in chronic fatigue syndrome: experimental study. Health Psychology, 35, 979–986. https://doi.org/10.1037/hea0000341Google Scholar
Sibelli, A., Chalder, T., Everitt, H., Workman, P., Windgassen, S. and Moss-Morris, R. (2017). A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychological Medicine, 46, 3065–3080. https://doi.org/10.1017/S0033291716001987Google Scholar
Spence, M. J. and Moss-Morris, R. (2007). The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis. Gut, 56, 1066–1071. https://doi.org/10.1136/gut.2006.108811Google Scholar
Sperber, A. D., Dumitrascu, D., Fukudo, S., Gerson, C., Ghoshal, U. C., Gwee, K. A. et al. (2016). The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut, 1–8. https://doi.org/10.1136/gutjnl-2015-311240Google Scholar
Spiegal, B. M. R., Khanna, D., Bolus, R., Agarwal, N., Khanna, P. and Chang, L. (2011). Understanding gastrointestinal distress: a framework for clinical practice. American Journal of Gastroenterology, 106, 308–385. https://doi.org/10.1097/MPG.0b013e3181a15ae8.ScreeningGoogle Scholar
Sydenham, M., Beardwood, J. and Rimes, K. A. (2016). Beliefs about emotions, depression, anxiety and fatigue: a mediational analysis. Behavioural and Cognitive Psychotherapy, 1–6. https://doi.org/10.1017/S1352465816000199Google Scholar
Thakur, E. R., Holmes, H. J., Lockhart, N. A., Carty, J. N., Ziadni, M. S., Dohert, H.K., Lackner, J. M., Schubiner, H. and Lumley, M. A. (2017). Emotional awareness and expression training improves irritable bowel syndrome: a randomized controlled trial. Neurogastroenterology and Motility, 29, 1–9. https://doi.org/10.1111/nmo.13143Google Scholar
Watson, M. and Greer, S. (1983). Development of a questionnaire measure of emotional control. Journal of Psychosomatic Research, 27, 299–305.Google Scholar
Williams, M., Barclay, Y., Benneyworth, R., Gore, S., Hamilton, Z., Matull, R. et al. (2016). Using best practice to create a pathway to improve management of irritable bowel syndrome: aiming for timely diagnosis, effective treatment and equitable care. Frontline Gastroenterology, 7, 323–330. https://doi.org/10.1136/flgastro-2016-100727Google Scholar
Willson, R., Veale, D. and Freeston, M. (2016). Imagery rescripting for body dysmorphic disorder: a multiple-baseline single-case experimental design. Behavior Therapy, 47, 248–261. https://doi.org/10.1016/j.beth.2015.08.006Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scaninavica, 67, 361–370.Google Scholar
Supplementary material: File

Bowers and Wroe supplementary material

Bowers and Wroe supplementary material 1

Download Bowers and Wroe supplementary material(File)
File 311.7 KB
Submit a response

Comments

No Comments have been published for this article.