Visceral sensitivity as a mediator of outcome in the treatment of irritable bowel syndrome

• Published in: Behaviour research and therapy 2012-10, Vol.50 (10), p.647-650
• Main Authors: Wolitzky-Taylor, Kate, Craske, Michelle G., Labus, Jennifer S., Mayer, Emeran A., Naliboff, Bruce D.
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Anxiety - prevention & control; Attention; Attitude to Health; Avoidance behaviour; Behavior therapy. Cognitive therapy; Biological and medical sciences; Clinical outcomes; Cognitive Therapy; Feeding Behavior; Female; Humans; Indexing in process; Interoceptive exposure; Irritable bowel syndrome; Irritable Bowel Syndrome - physiopathology; Irritable Bowel Syndrome - psychology; Irritable Bowel Syndrome - therapy; Male; Medical sciences; Medical treatment; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; Sensitivity; Stress, Psychological - etiology; Symptoms; Treatment mediation; Treatment Outcome; Treatments; Viscera - physiology; Visceral sensitivity
• ISSN: 0005-7967; 1873-622X
• DOI: 10.1016/j.brat.2012.05.010

Patients with irritable bowel syndrome (IBS) experience anxiety about visceral sensations, leading to avoidance behaviors and hypervigilance that maintain IBS symptoms. The current study used data from a clinical trial that compared a treatment aimed at reducing anxiety about visceral sensations (interoceptive exposure; IE) to an attention control (AC) and a CBT-based stress-management treatment (SM) to examine whether changes in visceral sensitivity mediated IBS symptom and quality of life outcomes. Data from participants who completed one of the three treatments (N = 76) were subjected to mediation analyses. Visceral sensitivity mediated treatment outcomes across all outcome measures and across all treatment groups, with no differences between IE and the other treatment groups. This finding suggests that psychosocial treatments for IBS may work by decreasing visceral sensitivity, and the degree to which visceral sensitivity is decreased is related to outcome, suggesting IE may be the preferable treatment option. ► Visceral sensitivity mediated bowel symptom severity. ► Visceral sensitivity mediated quality of life outcomes. ► No between-group differences in the effect of the mediator were found.