A Psychosocial Model of Disability in Interstitial Cystitis / Painful Bladder Syndrome
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Interstitial Cystitis / Painful Bladder Syndrome (IC/PBS) is a persistent and refractory medical condition that is characterized by chronic pelvic pain along with abnormal urinary frequency and urgency. There is no widely accepted etiology or efficacious cure for IC/PBS, thus treatment often relies on pain and symptom management. IC/PBS is associated with strong functional disability but theoretical models of disability have yet to be tested with these patients. As well, psychosocial factors associated with various IC/PBS outcomes (i.e., depression, catastrophizing, social support) are also associated with disability in a variety of chronic painful medical conditions but remain untested in disability models for IC/PBS. Thus, this research evaluated psychosocial factors as potential mediators of disability within the Disablement Process Model. Female patients diagnosed with IC/PBS by a urologist in a tertiary care hospitals were recruited (n=196; females). In using structural equation modeling of a final IC/PBS disability model, negative affect and catastrophizing were found to be partial mediators on the relationship between impairments and functional disability and social support was not a significant mediator of disability. Negative affect and catastrophizing may be key psychosocial factors in IC/PBS disability. Research implications for the Disablement Process Model and potential clinical interventions are discussed in light of the current findings.