Examining the Role of Biopsychosocial Factors in Disability Among Individuals with Inflammatory Bowel Disease

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Fretz, Katherine
inflammatory bowel disease , disability , depression , pain catastrophizing , social support , pain
IBD is an inflammatory disease that affects the gastrointestinal tract, encompassing two conditions (Crohn’s disease and ulcerative colitis). IBD negatively affects patients in a physical and psychosocial manner, which significantly impacts their quality of life. Related to quality of life is disability, which is an under-researched topic in the IBD literature. Models theorize that disability is the result of a disease and its related impairments, limitations, and restrictions it causes to an individual and their life. Environmental and psychosocial factors are also theorized to affect this process of disablement. Biopsychosocial factors such pain, depression, pain catastrophizing, and social support have all been linked to IBD disability-related outcomes, but no multivariate research has examined all of these factors simultaneously. This study aimed to elucidate the role of psychosocial factors in the process of disablement in an outpatient tertiary care IBD sample. Depressive symptoms, pain catastrophizing, and perceived social support were examined as mediators in the relationship between pain and pain-related disability cross-sectionally and longitudinally. Alternate models exploring feedback effects amongst disability and pain, and potential moderators (gender, disease type) of the mediation relationships were also tested. Cross-sectionally, depressive symptoms and pain catastrophizing, but not perceived social support, were significant mediators in the relationship between pain and pain-related disability. Support was found for feedback effects, such that disability predicted pain both cross-sectionally (through depressive symptoms as a mediator) and longitudinally (directly). These findings augment the research supporting a biopsychosocial model of IBD disability. Further, these results highlight the importance of targeting psychological factors such as depressive symptoms and pain catastrophizing in the treatment of individuals with IBD.
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