Altered attentional control linked to catastrophizing in patients with irritable bowel syndrome

Henrich JF1, Martin M1. Br J Health Psychol. 2018 Mar 23. doi: 10.1111/bjhp.12307. [Epub ahead of print]

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1 Department of Experimental Psychology, University of Oxford, UK.


OBJECTIVES: Our study aimed to investigate differences in attentional control between patients with irritable bowel syndrome (IBS) and healthy participants and to examine the link between attentional control and IBS catastrophizing. Previous research has shown that patients with chronic functional illnesses have lower levels of attentional control. However, no previous study has found altered attentional control in patients with IBS or directly investigated the link between attentional control and catastrophizing. We also aimed to establish whether anxiety is associated with attentional functions in patients with IBS.

DESIGN AND METHODS: In this cross-sectional study, we compared 41 IBS patients with 39 healthy-matched control participants on attentional functions using an attention network task. IBS catastrophizing (Gastrointestinal Cognitions), IBS symptom severity (GSRS-IBS), Depression, Anxiety, and Stress (DASS-21), and Visceral Anxiety Sensitivity were assessed using self-report measures.

RESULTS: Patients with IBS had lower attentional control compared to healthy participants, t (78) = -2.75, p = .007, d = .62. Groups did not differ in alerting or orienting attention. IBS patients with lower attentional control scored higher on IBS catastrophizing than those with higher attention control, t (38.59) = 2.19, p = .032, d = .66. Anxiety was related to orienting attention in the IBS group (ρ = .38, p = .015).

CONCLUSIONS: Patients with IBS displayed reduced attentional control. Crucially, those patients with lower attentional control also had more catastrophizing thoughts than patients with better attentional control. These findings suggest that improving attentional control could be a valid target for psychological interventions for IBS. Statement of contribution What is already known on this subject? It has been hypothesised that psychological processes play a role in the maintenance of irritable bowel syndrome (IBS), and altered levels of attentional control have been found in patients with other functional illnesses but not yet in patients with IBS. Pain catastrophizing, a maladaptive thinking pattern, has been linked with IBS symptom severity, and previous research has shown an association between attentional control and intrusive thoughts. Whether there is an association between catastrophizing thoughts and attentional control in patients with IBS is unknown. What does this study add? Patients with irritable bowel syndrome show reduced levels of attentional control. IBS patients with lower levels of attentional control have more catastrophizing thoughts. Therapies emphasizing attentional control training may help reduce catastrophizing.

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