Skip to main content

Advertisement

SpringerLink
Log in

Examining Psychosocial Mechanisms of Pain-Related Disability in Inflammatory Bowel Disease

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

Disability in inflammatory bowel disease (IBD) is under-investigated. Models theorize that disability is the result of a disease and its related impairments, limitations, and restrictions. This disablement process can be affected by psychosocial factors. Pain, depression, catastrophizing, and social support are associated with IBD-disability outcomes, but no studies have examined these factors concurrently. This study examined the role of psychosocial factors in the process of IBD disablement within the context of pain. Depressive symptoms, pain catastrophizing, and perceived social support were proposed as mediators in the relationship between pain and pain-related disability in cross-sectional and longitudinal models. Cross-sectionally, the mediation effects of depressive symptoms and pain catastrophizing, but not perceived social support, were significant. Longitudinally, depression was a significant mediator. Depressive symptoms and pain catastrophizing have mechanistic roles in the relationship between IBD patients’ pain and pain-related disability and should be targets for intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review,96, 358–372.

    Article  Google Scholar 

  • Blondel-Kucharski, F., Chircop, C., Marquis, P., Cortot, A., Baron, F., Gendre, J. P., … the Groupe d’Etudes de Therapeutique des Affections Inflammatoires Digestives (GETAID). (2001). Health-related quality of life in Crohn’s disease: A prospective longitudinal study in 231 patients. The American Journal of Gastroenterology,96, 2915–2920.

    Article  CAS  PubMed  Google Scholar 

  • Büsch, K., da Silva, S. A., Holton, M., Rabacow, F. M., Khalili, H., & Ludvigsson, J. F. (2014a). Sick leave and disability pension in inflammatory bowel disease: A systematic review. Journal of Crohn’s and Colitis,8, 1362–1377.

    Article  PubMed  Google Scholar 

  • Büsch, K., Sonnenberg, A., & Bansback, N. (2014b). Impact of inflammatory bowel disease on disability. Current Gastroenterology Reports,16, 414.

    Article  PubMed  Google Scholar 

  • Conrad, K., Roggenbuck, D., & Laass, M. W. (2014). Diagnosis and classification of ulcerative colitis. Autoimmunity Reviews,13, 463–466.

    Article  CAS  PubMed  Google Scholar 

  • Devlen, J., Beusterien, K., Yen, L., Ahmed, A., Cheifetz, A. S., & Moss, A. C. (2014). The burden of inflammatory bowel disease: A patient-reported qualitative analysis and development of a conceptual model. Inflammatory Bowel Diseases,20, 545–552.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dibley, L., & Norton, C. (2013). Experiences of fecal incontinence in people with inflammatory bowel disease: Self-reported experiences among a community sample. Inflammatory Bowel Diseases,19, 1450–1462.

    Article  PubMed  Google Scholar 

  • Fuller-Thomson, E., & Sulman, J. (2006). Depression and inflammatory bowel disease: Findings from two nationally representative Canadian surveys. Inflammatory Bowel Diseases,12, 697–707.

    Article  PubMed  Google Scholar 

  • Graff, L. A., Walker, J. R., & Bernstein, C. N. (2009). Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management. Inflammatory Bowel Diseases,15, 1105–1118.

    Article  PubMed  Google Scholar 

  • Greenley, R. N., Hommel, K. A., Nebel, J., Raboin, T., Li, S. H., Simpson, P., & Mackner, L. (2010). A meta-analytic review of the psychosocial adjustment of youth with inflammatory bowel disease. Journal of Pediatric Psychology,35, 857–869.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York, NY: Guilford Press.

    Google Scholar 

  • Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.). New York, NY: Guilford Press.

    Google Scholar 

  • Henkel, V., Bussfeld, P., Möller, H. J., & Hegerl, U. (2002). Cognitive-behavioural theories of helplessness/hopelessness: Valid models of depression? European Archives of Psychiatry and Clinical Neuroscience,252, 240–249.

    Article  CAS  PubMed  Google Scholar 

  • Hunt, M. G., Ertel, E., Coello, J. A., & Rodriguez, L. (2014). Development and validation of the GI-Cognitions Questionnaire. Cognitive Therapy and Research,38, 472–482.

    Article  Google Scholar 

  • Israeli, E., Graff, L. A., Clara, I., Walker, J. R., Lix, L. M., Targownik, L. E., & Bernstein, C. N. (2014). Low prevalence of disability among patients with inflammatory bowel diseases a decade after diagnosis. Clinical Gastroenterology and Hepatology,12, 1330–1337.

    Article  PubMed  Google Scholar 

  • Katz, L., Tripp, D. A., Nickel, J. C., Mayer, R., Reimann, M., & van Ophoven, A. (2013). Disability in women suffering from interstitial cystitis/bladder pain syndrome. BJU International,111, 114–121.

    Article  PubMed  Google Scholar 

  • Katz, L., Tripp, D. A., Ropeleski, M., Depew, W., Nickel, J. C., Vanner, S., & Beyak, M. J. (2016). Mechanisms of quality of life and social support in inflammatory bowel disease. Journal of Clinical Psychology in Medical Settings,23, 88–98.

    Article  PubMed  Google Scholar 

  • Kiebles, J. L., Doerfler, B., & Keefer, L. (2010). Preliminary evidence supporting a framework of psychological adjustment to inflammatory bowel disease. Inflammatory Bowel Diseases,16, 1685–1695.

    Article  PubMed  PubMed Central  Google Scholar 

  • Knowles, S. R., Graff, L. A., Wilding, H., Hewitt, C., Keefer, L., & Mikocka-Walus, A. (2018a). Quality of life in inflammatory bowel disease: A systematic review and meta-analyses—Part I. Inflammatory Bowel Diseases,24, 742–751.

    Article  PubMed  Google Scholar 

  • Knowles, S. R., Graff, L. A., Wilding, H., Hewitt, C., Keefer, L., & Mikocka-Walus, A. (2018b). Quality of life in inflammatory bowel disease: A systematic review and meta-analyses—Part II. Inflammatory Bowel Diseases,24, 966–976.

    Article  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine,16, 606–613.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Laass, M. W., Roggenbuck, D., & Conrad, K. (2014). Diagnosis and classification of Crohn’s disease. Autoimmunity Reviews,13, 467–471.

    Article  PubMed  Google Scholar 

  • Lix, L. M., Graff, L. A., Walker, J. R., Clara, I., Rawsthorne, P., Rogala, L., … Bernstein, C. N. (2008). Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease. Inflammatory Bowel Diseases,14, 1575–1584.

    Article  PubMed  Google Scholar 

  • Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain,30, 191–197.

    Article  CAS  PubMed  Google Scholar 

  • Mikocka-Walus, A., Knowles, S. R., Keefer, L., & Graff, L. (2016). Controversies revisited: A systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases. Inflammatory Bowel Diseases,22, 752–762.

    Article  PubMed  Google Scholar 

  • Morrison, G., Van Langenberg, D. R., Gibson, S. J., & Gibson, P. R. (2013). Chronic pain in inflammatory bowel disease: Characteristics and associations of a hospital-based cohort. Inflammatory Bowel Diseases,19, 1210–1217.

    Article  PubMed  Google Scholar 

  • Moskovitz, D. N., Maunder, R. G., Cohen, Z., McLeod, R. S., & MacRae, H. (2000). Coping behavior and social support contribute independently to quality of life after surgery for inflammatory bowel disease. Diseases of the Colon and Rectum,43, 517–521.

    Article  CAS  PubMed  Google Scholar 

  • Mowat, C., Cole, A., Windsor, A., Ahmad, T., Arnott, I., Driscoll, R., … Bloom, S. (2011). Guidelines for the management of inflammatory bowel disease in adults. Gut,60, 571–607.

    Article  PubMed  Google Scholar 

  • Peyrin-Biroulet, L., Cieza, A., Sandborn, W. J., Kostanjsek, N., Kamm, M. A., Hibi, T., … Colombel, J. F. (2010). Disability in inflammatory bowel diseases: Developing ICF core sets for patients with inflammatory bowel diseases based on the International Classification of Functioning. Inflammatory Bowel Diseases,16, 15–22.

    Article  PubMed  Google Scholar 

  • Phillips, L. J., & Stuifbergen, A. K. (2009). Structural equation modeling of disability in women with fibromyalgia or multiple sclerosis. Western Journal of Nursing Research,31, 89–109.

    Article  PubMed  Google Scholar 

  • Pollard, C. A. (1984). Preliminary validity study of the Pain Disability Index. Perceptual and Motor Skills,59, 974.

    Article  CAS  PubMed  Google Scholar 

  • Rouquette, A., Badley, E. M., Falissard, B., Dub, T., Leplege, A., & Coste, J. (2015). Moderators, mediators, and bidirectional relationships in the International Classification of Functioning, Disability and Health (ICF) framework: An empirical investigation using a longitudinal design and structural equation modeling (SEM). Social Science and Medicine,135, 133–142.

    Article  PubMed  Google Scholar 

  • Sajadinejad, M. S., Asgari, K., Molavi, H., Kalantari, M., & Adibi, P. (2012). Psychological issues in inflammatory bowel disease: An overview. Gastroenterology Research and Practice,2012, 1–11.

    Article  Google Scholar 

  • Siebert, U., Wurm, J., Gothe, R. M., Arvandi, M., Vavricka, S. R., von Känel, R., … the Swiss IBD Cohort Study Group. (2013). Predictors of temporary and permanent work disability in patients with inflammatory bowel disease: Results of the swiss inflammatory bowel disease cohort study. Inflammatory Bowel Diseases,19, 847–855.

    Article  PubMed  Google Scholar 

  • Sirois, F. M., & Wood, A. M. (2017). Gratitude uniquely predicts lower depression in chronic illness populations: A longitudinal study of inflammatory bowel disease and arthritis. Health Psychology,36, 122–132.

    Article  PubMed  Google Scholar 

  • Slonim-Nevo, V., Sarid, O., Friger, M., Schwartz, D., Sergienko, R., Pereg, A., … Israeli IBD Research Nucleus (IIRN). (2018). Effect of social support on psychological distress and disease activity in inflammatory bowel disease patients. Inflammatory Bowel Diseases,24, 1389–1400.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment,7, 524–532.

    Article  Google Scholar 

  • Sweeney, L., Moss-Morris, R., Czuber-Dochan, W., Meade, L., Chumbley, G., & Norton, C. (2018). Systematic review: Psychosocial factors associated with pain in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics,47, 715–729.

    Article  CAS  Google Scholar 

  • Turk, D. C., Wilson, H., & Swanson, K. S. (2011). The biopsychosocial model of pain and pain management. In M. Ebert & R. Kerns (Eds.), Behavioral and psychopharmacologic pain management (pp. 16–43). Cambridge: Cambridge University Press.

    Google Scholar 

  • van der Have, M., Fidder, H. H., Leenders, M., Kaptein, A. A., van der Valk, M. E., van Bodegraven, A. A., … Oldenburg, B. (2015). Self-reported disability in patients with inflammatory bowel disease largely determined by disease activity and illness perceptions. Inflammatory Bowel Diseases,21, 369–377.

    Article  PubMed  Google Scholar 

  • Verbrugge, L. M., & Jette, A. M. (1994). The disablement process. Social Science and Medicine,38, 1–14.

    Article  CAS  PubMed  Google Scholar 

  • Weinert, C., & Brandt, P. A. (1987). Measuring social support with the personal resource questionnaire. Western Journal of Nursing Research,9, 589–602.

    Article  CAS  PubMed  Google Scholar 

  • WHO. (2001). International classification of functioning, disability and health: ICF. Geneva: World Health Organization.

    Google Scholar 

  • WHOQOL Group. (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine,41, 1403–1409.

    Article  Google Scholar 

  • Wojtowicz, A. A., Greenley, R. N., Gumidyala, A. P., Rosen, A., & Williams, S. E. (2014). Pain severity and pain catastrophizing predict functional disability in youth with inflammatory bowel disease. Journal of Crohn’s and Colitis,8, 1118–1124.

    Article  PubMed  Google Scholar 

  • Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment,52, 30–41.

    Article  Google Scholar 

Download references

Funding

This research was funded by Crohn’s and Colitis Canada.

Author information

Authors and Affiliations

  1. Department of Psychology, Queen’s University, Kingston, ON, Canada

    Katherine M. Fretz

  2. Departments of Psychology, Anesthesiology and Urology, Queen’s University, Kingston, ON, Canada

    Dean A. Tripp

  3. Michael G. DeGroote Pain Clinic, McMaster University Medical Centre, Hamilton, ON, Canada

    Laura Katz

  4. Department of Medicine, Gastrointestinal Diseases Research Unit, Queen’s University, Kingston, ON, Canada

    Mark Ropeleski & Michael J. Beyak

Authors
  1. Katherine M. Fretz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dean A. Tripp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Katz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Ropeleski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael J. Beyak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katherine M. Fretz.

Ethics declarations

Conflict of interest

Authors Katherine M. Fretz, Dean A. Tripp, Laura Katz, Mark Ropeleski, and Michael J. Beyak declare that they have no conflict of interest to disclose.

Research Involving Human Participants

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research ethics board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fretz, K.M., Tripp, D.A., Katz, L. et al. Examining Psychosocial Mechanisms of Pain-Related Disability in Inflammatory Bowel Disease. J Clin Psychol Med Settings 27, 107–114 (2020). https://doi.org/10.1007/s10880-019-09627-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-019-09627-1

Keywords

Search

Navigation