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The role of high expectations of self and social desirability in emotional processing in IBS

Dolphin

Senior Member
Messages
17,567
(Looks like it might be annoying but I don't have time to look into it)

Free full text: http://onlinelibrary.wiley.com/doi/10.1111/bjhp.12264/full

Original Article
The role of high expectations of self and social desirability in emotional processing in individuals with irritable bowel syndrome: A qualitative study
Authors
  • Alice Sibelli,
  • Trudie Chalder,
  • Hazel Everitt,
  • Paul Workman,
  • Felicity L. Bishop,
  • Rona Moss-Morris
Abstract
Objectives
Although high levels of distress are associated with the onset and severity of Irritable bowel syndrome (IBS), it is unclear how this relates to emotional processing, particularly in relation to maintenance of symptoms and treatment outcome. This qualitative study embedded within a randomized controlled trial aimed to explore how individuals with refractory IBS experience, express, and manage their emotions after either therapist-delivered cognitive behavioural therapy (TCBT) or Web-based CBT (WBCBT) compared to treatment as usual (TAU).

Design
Cross-sectional qualitative study.

Methods
Fifty-two semi-structured interviews were conducted at post-treatment with 17 TCBT, 17 WBCBT, and 18 TAU participants. The transcripts were analysed using inductive thematic analysis with grounded theory elements. NVivo 11 was used to compare themes across groups.

Results
Across all groups, high expectations of self was a recurring reason for how participants experienced and expressed their emotions. Three themes with subthemes captured how high expectations related to specific aspects of emotional processing: perceived causes of emotions, strategies for coping with emotions (bottling up, avoiding emotions, and active coping strategies), and the perceived interplay between emotions and IBS symptoms.

Conclusions
Patients recognized that their IBS symptoms both triggered and were triggered by negative emotions. However, there was a tendency to bottle up or avoid negative emotions for reasons of social desirability regardless of whether patients had CBT for IBS or not. Future psychological interventions in IBS may benefit from addressing negative beliefs about expressing emotions, promoting assertive emotional expression, and encouraging the experience of positive emotions.

Statement of contribution
What is already known on this subject?

  • High levels of distress are consistently associated with both the onset and maintenance of IBS symptoms.
  • Little is known about how this relates to the concept of emotional processing.
  • Preliminary findings suggest a positive correlation between poor emotional processing and IBS. However, further studies need to confirm its role in relation to aetiology, maintenance of symptoms, and response to treatment.
What does this study add?

  • High expectations of self and social desirability seem to be important aspects shaping the way individuals with IBS experience, express, and manage their emotions.
  • Emotional avoidance and bottling up were reported as key strategies to cope with negative emotions.
  • The study revealed that bottling up is not perceived as an all-or-nothing strategy but can be applied selectively depending on the context.
  • Psychological interventions in IBS may benefit from addressing not only illness-related causes of negative emotions but also personal and social triggers of distress.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
The role of stupidity, selfishness and sociopathy in ignoring facts amongst psychiatrists/psychologists with Irritating Bastard Syndrome: A qualitative study

There, fixed the title for the assholes!
;)

never-argue-with-stupid-people-mark-twain.jpg
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
*#@&$€¥!
What this study really shows...
People with IBS have emotions too - no really, it's true, they do......
IBS is unpleasant, and might make you feel a bit more emotional, which you might cope with in a variety of ways....no sh*t Sherlock :bang-head:
Most researchers are quite stuck in their ways and will hold onto irrational beliefs, trying to present ongoing evidence as to why their beliefs are in fact 'the truth'!
 

Hutan

Senior Member
Messages
1,099
Location
New Zealand
Have they got some form of template/paper generator? Coz apart from the subject and a few numbers that obviously no one ever checks, all these papers look the same, at least to me.

Yes, I had exactly the same thought as I realised that my response to this is the same as others I have written for other papers.

i.e.
What type of person with <IBS> would be in a position to, and willing to, participate in a research study? And not just any research study but one likely to suggest that the illness is related to a person's personality?

Answer:
* most likely women (more women diagnosed with <IBS> than men)
* well-educated people (have the resources to seek treatment, want to contribute to science)
* people motivated to work hard to get better
* people open to the idea of psychosomatic illness and self-blame (more skeptical self-asured people, more certain that their personality isn't a significant factor in their illness, would tell the researchers what they could do with their patient-blaming survey)

It's therefore not surprising that the participants were found to tend to have the following characteristics:
* High expectations of self
* Bottling up negative emotions for social desirability reasons

So, this study may possibly say something accurate about the personalities of the particular participants in this study. But it doesn't move the understanding of <IBS> forward at all.
 

A.B.

Senior Member
Messages
3,780
This might just show the evil genius of Freud: make vague statements about emotions being the cause of the illness, and how "opening up" will bring relief, and the patients will go along with this, dutifully talking about all their repressed emotions and conflicts and how they are surely related to the illness. The patients have been told this cleansing ritual will cure them and they go along with it. Since this can lead to self blame and feelings of hopelessness when the promised improvement doesn't materialize, this is actually not harmless. Concrete proof of any such emotional causes in IBS will of course never be obtained. More indirect harm can result from biological investigation being neglected as consequence of these psychological models being promoted.

There is nothing wrong with opening up, just don't expect it to treat your illness.
 
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Skycloud

Senior Member
Messages
508
Location
UK
I don't have experience with IBS, but I have an older sister who has expressed to me that her IBS is brought on by exactly what they are referring to in that article.

I wouldn't disagree with your sister actually. She has her experience. In my case certain foods have been a factor. Going gluten free was like magic. I do have a problem with this study; perhaps I'll explain why when I have more energy.
 
Messages
32
During my childhood I had something which, if I would have pursued treatment for it, probably would have been diagnosed as IBS.
These days I rarely notice it anymore. But if I notice it, it's usually at the same time as when I'm feeling uncomfortable. Physically (e.g. when I'm cold) but sometimes also mentally/emotionally (e.g. when doing hard math or watching a violent video). It's kind of strange. I'm not sure if this is because emotions are causing the pain, or if the pain is simply always present & in these situations I'm paying more attention to it.

On the other hand a family member greatly improved after changing diet like @Skycloud. So I think it really differs from person to person and I don't think my experience is representative for everyone. (Also because I had a mild form.)
 
Messages
32
Preliminary findings suggest a positive correlation between poor emotional processing and IBS.

If they talk about "poor", then can they please clarify what "good" emotional processing looks like?
Because this seems to be one of those subjects where the patient is always wrong. I went to a MUPS center for my CFS and I experienced it all.

Patient expresses much emotion > therapist thinks cause = mass hysteria
Patient expresses little emotion > therapist thinks cause = suppressed emotions
Patient expresses mixed emotions > therapist thinks patient is too normal > cause must be burnout / stress related

No matter how you behave, psychology is the solution.
 
Last edited:
Messages
724
Location
Yorkshire, England
I don't have experience with IBS, but I have an older sister who has expressed to me that her IBS is brought on by exactly what they are referring to in that article.

Some people on the spectrum experience flares from anxiety etc, but the BPS crowd (as usual) are fixated on things that don't seem to have much to do with the underlying condition.

My IBS is made worse by anxiety. My anxiety was made much worse by the hospital consultant insisting that it was a purely psychological. I'm lying in a hospital bed, losing weight rapidly and I'm told I'm doing it to myself, all the terrible pain, cramps, drastic weight loss are my fault, if only subconsciously. (And by the way, would I like to try the curry today? :bang-head:)

I only got better when I discharged myself and went to the GP who had known me since birth. He explained the gastrocolic reflex, prescribed anti-spasmodics and gave me diet advice and where to look for further information.

As usual there was no 'bio' in the BPS, yet amazingly, when prescribed the correct medication and given advice for the suspected physical causes I slowly improved.

Also, in my experience IBS causes distressing emotions, and these can be an early warning sign of a flare.

There might not be many positive tests in patients when patients doing the tests are not tested under the conditions in which the IBS occurs. Much like scanning for lower back pain does not reveal much when the symptoms occur while standing or due to posture.

How do they expect to see the spasms that occur due to certain foods/drinks when a patient is nil by mouth 48 hours before tests? This should not be rocket science, but common sense.

The lack of symptoms during a one off test under abnormal circumstances is taken as proof that the symptoms are caused by thoughts and feelings in normal circumstances, even when a great majority of patients can tell the examiner just what kind of foods/drinks make them worse, and how long it makes them worse in great detail.

Helping patients deal with the anxiety IBS brings? Yes, very important in a supportive way, but ignoring well known biological processes that are most likely the cause and maintaing factor(s) is very damaging.
 

AndyPandy

Making the most of it
Messages
1,928
Location
Australia
My IBS is made worse by certain food sensitivities and alcohol. I also have low digestive enzymes. I deal with this and manage it every day. My gastroenterologist and dietician agree that these are the causes.

Very occasionally life events cause me stress. Sometimes this will aggravate my IBS but not always. Food and alcohol triggers always make my IBS worse.

For me it's nothing to do with suppressed emotions, high expectations of self or social desirability.

I find these studies hard to "digest".