Negative coping strategies can worsen gastrointestinal symptoms

May 21, 2000

Certain ways of coping with gastrointestinal disorders can negatively affect health, according to a recent study of women.

"The findings add to our growing knowledge of the contribution of psychosocial factors to health status among patients with gastrointestinal disorders," said lead author Douglas A. Drossman, MD, of the University of North Carolina, Chapel Hill.

For one year, Drossman and colleagues followed the progress of 174 female study participants suffering from varying functional gastrointestinal disorders including irritable bowel syndrome, constipation, dyspepsia, and chest and abdominal pain, as well as other gastrointestinal diseases such as gastroesophageal reflux, liver disease, ulcerative colitis, and Crohn's disease.

Study participants who tended to catastrophize, or hold deeply negative and pessimistic views of their illness, as well as participants who felt they had little power to decrease their symptoms were likely to have poorer health outcomes, the researchers found. The study findings appear in the May/June issue of Psychosomatic Medicine.

A participant's tendency to catastrophize was measured by the degree to which she identified with statements such as "I feel it's never going to get any better," "I worry all the time about whether it will end," and "I feel my life isn't worth living."

In addition to the maladaptive coping strategies of catastrophizing and having a low perception of power over symptoms, the researchers also found that a history of sexual abuse was a predictor of negative health results.

"A history of sexual abuse may indeed set in motion or enhance the effects of these maladaptive coping strategies, since sexual abuse is associated both with a perceived inability to effect positive consequences in the environment and with hypervigilance to bodily sensations with an overinterpretation of their significance," said Drossman.

The researchers' findings suggest that treatments like cognitive behavioral therapy, which helps patients replace maladaptive perceptions with more realistic ones, may help those whose negative coping strategies interfere with their recovery from gastrointestinal illness.

The researchers, however, note that more research is needed to determine if cognitive behavioral treatments truly improve gastrointestinal symptoms, as well as to gain a more exact understanding of the relationship between coping strategies and gastrointestinal disorders.

This study was funded by the National Institutes of Health.
Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468.

Posted by the Center for the Advancement of Health < >. For information about the Center, call Petrina Chong, < > (202) 387-2829.

Center for Advancing Health

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