Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that can cause decrements in the quality of life. This study examined the mediational role of illness perceptions in the relationship between personality traits and health-related quality of life (HRQOL) in IBS patients. One hundred seventy-eight patients completed a set of measurements including the HRQOL, illness perceptions, and personality traits. The results of the study showed that only neuroticism as a personality trait was directly related to the HRQOL and negative illness perceptions statistically mediated the relationship between neuroticism and HRQOL. More clearly, the higher score in neuroticism was associated with the perceptions including more negative effects on the lives of the patients, more emotional reactions, more incoherent understanding of IBS, and more psychological attributions to IBS. These perceptions were, in turn, linked to poor HRQOL. In light of the findings of the present study, it was suggested that identifying and screening illness perceptions are important for health outcomes. Intervention approaches should be designed to modify negative illness perceptions based on personality traits to improve the HRQOL of IBS patients.
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Abbreviations
- IBS:
-
Irritable bowel syndrome
- HRQOL:
-
Health-related quality of life
- CSM:
-
Common Sense Model
- BPTI:
-
The Basic Personality Traits Inventory
- IPQ-R:
-
The Revised Illness Perception Questionnaire
- IBS-QOL:
-
The Irritable Bowel Syndrome Quality of Life Scale
- RMSEA:
-
Root mean square error of approximation
- GFI:
-
Goodness of fit index
- AGFI:
-
Adjusted GFI
- CFI:
-
Comparative fit index
- IPQ:
-
Illness Perception Questionnaire
- IPQ-I:
-
Illness Perception Questionnaire Identity
- IPQ-C:
-
Illness Perception Questionnaire consequences
- IPQ-T:
-
Illness Perception Questionnaire Timeline
- IPQ-PC:
-
Illness Perception Questionnaire Personal Control
- IPQ-TC:
-
Illness Perception Questionnaire Treatment Control
- IPQ-CO:
-
Illness Perception Questionnaire Illness Coherence
- IPQ-ER:
-
Illness Perception Questionnaire Emotional Representation
- IPQ-PA:
-
Illness Perception Questionnaire Psychological Attribution
- IPQ-CT:
-
Illness Perception Questionnaire Cyclical Timeline
References
Arbuckle, J. L. (2014). IBM SPSS Amos 23.0 User's Guide. Retrieved from http://amosdevelopment.com/download/User_Guide_23.pdf.
Axelsson, M., Cliffordson, C., Lundbäck, B., & Lötvall, J. (2013). The function of medication beliefs as mediators between personality traits and adherence behavior in people with asthma. Patient Preference and Adherence, 7, 1101–1109. https://doi.org/10.2147/PPA.S49725
Blanchard, E. B. (2001). Diagnosis: What is Irritable Bowel Syndrome? In Irritable Bowel Syndrome Psychosocial Assessment and Treatment (p.6). Washington, DC: American Psychological Association. https://doi.org/10.1037/10393-000
Broadbent, E., Ellis, C. J., Thomas, J., Gamble, G., & Petrie, K. J. (2009). Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. Journal of Psychosomatic Research, 67(1), 17–23. https://doi.org/10.1016/j.jpsychores.2008.12.001
Cartwright, T., Endean, N., & Porter, A. (2009). Illness perceptions, coping and quality of life in patients with alopecia. British Journal of Dermatology, 160(5), 1034–1039. https://doi.org/10.1111/j.1365-2133.2008.09014.x
Caspi, A., Roberts, B. W., & Shiner, R. L. (2005). Personality development: Stability and change. Annual Review of Psychology, 56, 453–484. https://doi.org/10.1146/annurev.psych.55.090902.141913
Cho, H. S., Park, J. M., Lim, C. H., Cho, Y. K., Lee, I. S., Kim, S. W., & Chung, Y. K. (2011). Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut and Liver, 5(1), 29–36. https://doi.org/10.5009/gnl.2011.5.1.29
Costa, P. T., & McCrae, R. R. (1985). Hypochondriasis, neuroticism, and aging: When are somatic complaints unfounded? American Psychologist, 40(1), 19–28. https://doi.org/10.1037/0003-066X.40.1.19
Costa, P. T., Jr., & McCrae, R. R. (1987). Neuroticism, somatic complaints, and disease: Is the bark worse than the bite? Journal of Personality, 55(2), 299–316. https://doi.org/10.1111/j.1467-6494.1987.tb00438.x
Costa, P. T., Jr., & McCrae, R. R. (1997). Stability and change in personality assessment: The revised NEO Personality Inventory in the year 2000. Journal of Personality Assessment, 68(1), 86–94. https://doi.org/10.1207/s15327752jpa6801_7
Dancey, C. P., Hutton-Young, S. A., Moye, S., & Devins, G. M. (2002). Perceived stigma, illness intrusiveness and quality of life in men and women with irritable bowel syndrome. Psychology, Health & Medicine, 7(4), 381–395. https://doi.org/10.1080/1354850021000015203
De Gucht, V. (2015). Illness perceptions mediate the relationship between bowel symptom severity and health-related quality of life in IBS patients. Quality of Life Research, 24(8), 1845–1856. https://doi.org/10.1007/s11136-015-0932-8
Diefenbach, M. A., & Leventhal, H. (1996). The common-sense model of illness representation: Theoretical and practical considerations. Journal of Social Distress and the Homeless, 5(1), 11–38. https://doi.org/10.1007/BF02090456
Drossman, D. A. (1999). Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome? The American Journal of Medicine, 107(5), 41–50. https://doi.org/10.1016/S0002-9343(99)00081-9
Drossman, D. A. (2006). The functional gastrointestinal disorders and the Rome III process. Gastroenterology, 130(5), 1377–1390. https://doi.org/10.1053/j.gastro.2006.03.008
El-Serag, H. B., Olden, K., & Bjorkman, D. (2002). Health-related quality of life among persons with irritable bowel syndrome: A systematic review. Alimentary Pharmacology & Therapeutics, 16(6), 1171–1185. https://doi.org/10.1046/j.1365-2036.2002.01290.x
Ferguson, E. (2013). Personality is of central concern to understand health: Towards a theoretical model for health psychology. Health Psychology Review, 7(sup1), S32–S70. https://doi.org/10.1080/17437199.2010.547985
Frank, L., Kleinman, L., Rentz, A., Ciesla, G., Kim, J. J., & Zacker, C. (2002). Health-related quality of life associated with irritable bowel syndrome: Comparison with other chronic diseases. Clinical Therapeutics, 24(4), 675–689. https://doi.org/10.1016/S0149-2918(02)85143-8
Gençöz, T., & Öncül, Ö. (2012). Examination of personality characteristics in a Turkish sample: Development of basic personality traits inventory. The Journal of General Psychology, 139(3), 194–216. https://doi.org/10.1080/00221309.2012.686932
Gibson, L. M., & Cook, M. J. (1996). Neuroticism and sense of coherence. Psychological Reports, 79(1), 343–349. https://doi.org/10.2466/pr0.1996.79.1.343
Gralnek, I. M., Hays, R. D., Kilbourne, A., Naliboff, B., & Mayer, E. A. (2000). The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology, 119(3), 654–660. https://doi.org/10.1053/gast.2000.16484
Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and Health, 18(2), 141–184. https://doi.org/10.1080/088704403100081321
Hahn, B. A., Kirchdoerfer, L. J., Fullerton, S., & Mayer, E. (1997). Patient-perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life. Alimentary Pharmacology & Therapeutics, 11(3), 553–559. https://doi.org/10.1046/j.1365-2036.1997.00160.x
Hansel, S. L., Umar, S. B., Lunsford, T. N., Harris, L. A., Dibaise, J. K., & Crowell, M. D. (2010). Personality traits and impaired health-related quality of life in patients with functional gastrointestinal disorders. Clinical Gastroenterology and Hepatology, 8(2), 220–222. https://doi.org/10.1016/j.cgh.2009.10.008
Hausteiner-Wiehle, C., & Henningsen, P. (2014). Irritable bowel syndrome: Relations with functional, mental, and somatoform disorders. World Journal of Gastroenterology: WJG, 20(20), 6024–6030. https://doi.org/10.3748/wjg.v20.i20.6024
Hoyle, R. H., & Panter, A. T. (1995). Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modeling Concepts, issues, and applications (pp. 158–176). Sage.
Hudson, N. W., & Fraley, R. C. (2015). Volitional personality trait change: Can people choose to change their personality traits? Journal of Personality and Social Psychology, 109(3), 490–507. https://doi.org/10.1037/pspp0000021
Jamali, R., Jamali, A., Poorrahnama, M., Omidi, A., Jamali, B., Moslemi, N., ... & Daryani, N. E.(2012). Evaluation of health related quality of life in irritable bowel syndrome patients. Health and Quality of Life Outcomes, 10(1), 12. https://doi.org/10.1186/1477-7525-10-12
Kaplan, R. M. (2003). The significance of quality of life in health care. Quality of Life Research, 12(1), 3–16. https://doi.org/10.1023/A:1023547632545
Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.), New York: Guilford
Kocaman, N., Özkan, M., Armay, Z. & Özkan, S. (2007). Hastalık Algısı Ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirlik çalışması. Anatolian Journal of Psychiatry, 8, 271–280.
Lawson, V. L., Bundy, C., Belcher, J., & Harvey, J. N. (2010). Mediation by illness perceptions of the effect of personality and health threat communication on coping with the diagnosis of diabetes. British Journal of Health Psychology, 15(3), 623–642. https://doi.org/10.1348/135910709X478664
Lea, R., & Whorwell, P. J. (2001). Quality of life in irritable bowel syndrome. PharmacoEconomics, 19(6), 643–653. https://doi.org/10.2165/00019053-200119060-00003
Lehto, R. H. (2007). Causal attributions in individuals with suspected lung cancer: Relationships to illness oherence and emotional responses. Journal of the American Psychiatric Nurses Association, 13(2), 109–115. https://doi.org/10.1177/1078390307303112
Leventhal, H., Nerenz, D.R. & Steele, D.J. (1984). Illness representations and coping with health threats. In: A. Baum, S. E. Taylor & J. E. Singer (Eds.), Handbook of psychology and health: social psychological aspects of health (pp. 219–252). Earlbaum: Hillsdale, NJ.
Magidson, J. F., Roberts, B. W., Collado-Rodriguez, A. & Lejuez, C. W. (2014). Theory-driven intervention for changing personality: Expectancy value theory, behavioral activation, and conscientiousness. Developmental Psychology, 50(5), 1442–1450..https://doi.org/10.1037/a0030583
Mayer, E. A. (2008). Irritable bowel syndrome. New England Journal of Medicine, 358(16), 1692–1699
McCrae, R. R., & Costa, P. T. (2003). Personality in adulthood. A five-factor theory perspective (2nd ed.). The Guilford Press.
McKinnon, A. C., Van Oudenhove, L., Tack, J., & Jones, M. (2015). The association of personality, ppraisal, catastrophising and vigilance with gastrointestinal symptom-specific anxiety. Journal of Health Psychology, 20(4), 456–465. https://doi.org/10.1177/1359105313503027
Millar, K., Purushotham, A. D., McLatchie, E., George, W. D., & Murray, G. D. (2005). A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for reast cancer. Journal of Psychosomatic Research, 58(4), 335–342. https://doi.org/10.1016/j.jpsychores.2004.10.005
Moreno-Jiménez, B., Blanco, B. L., Rodríguez-Muñoz, A., & Hernández, E. G. (2007). The influence of personality factors on health-related quality of life of patients with inflammatory bowel disease. Journal of Psychosomatic Research, 62(1), 39–46. https://doi.org/10.1016/j.jpsychores.2006.07.026
Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology and Health, 17(1), 1–16. https://doi.org/10.1080/08870440290001494
Muris, P., Roelofs, J., Rassin, E., Franken, I., & Mayer, B. (2005). Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Personality and Individual Differences, 39(6), 1105–1111. https://doi.org/10.1016/j.paid.2005.04.005
Muscatello, M. R. A., Bruno, A., Mento, C., Pandolfo, G., & Zoccali, R. A. (2016). Personality traits and emotional patterns in irritable bowel syndrome. World Journal of Gastroenterology, 22(28), 6402. https://doi.org/10.3748/wjg.v22.i28.6402
Owens, D. M., Nelson, D. K., & Talley, N. J. (1995). The irritable bowel syndrome: Long-term prognosis and the physician-patient interaction. Annals of Internal Medicine, 122(2), 107–112. https://doi.org/10.7326/0003-4819-122-2-199501150-00005
Özgürsoy, B. N. (2010). İrritabl Barsak Sendromu Yaşam Kalitesi Ölçeği geçerlik güvenirlik çalışması (Unpublished master’s thesis). Ege University.
Patrick, D. L., Drossman, D. A., Frederick, I. O., Dicesare, J., & Puder, K. L. (1998). Quality of life in persons with irritable bowel syndrome (development and validation of a new measure). Digestive Diseases and Sciences, 43(2), 400–411. https://doi.org/10.1023/A:1018831127942
Rassart, J., Luyckx, K., Klimstra, T. A., Moons, P., Groven, C., & Weets, I. (2014). Personality and illness adaptation in adults with Type 1 diabetes: The intervening role of illness coping and perceptions. Journal of Clinical Psychology in Medical Settings, 21(1), 41–55. https://doi.org/10.1007/s10880-014-9387-2
Robins, P. M., Smith, S. M., & Proujansky, R. (2002). Children with recurrent abdominal pain: Comparison of community and tertiary care samples. Children’s Health Care, 31(2), 93–106. https://doi.org/10.1207/S15326888CHC3102_1
Rose, M., Köhler, K., Köhler, F., Sawitzky, B., Fliege, H., & Klapp, B. F. (2005). Determinants of the quality of life of patients with congenital heart disease. Quality of Life Research, 14(1), 35–43. https://doi.org/10.1007/s11136-004-0611-7
Rutter, C. L., & Rutter, D. R. (2002). Illness representation, coping and outcome in irritable bowel syndrome (IBS). British Journal of Health Psychology, 7(4), 377–391. https://doi.org/10.1348/135910702320645372
Sararoudi, R. B., Afshar, H., Adibi, P., Daghaghzadeh, H., Fallah, J., & Abotalebian, F. (2011). Type D personality and quality of life in patients with irritable bowel syndrome. Journal of Research in Medical Sciences: THe Official Journal of Isfahan University of Medical Sciences, 16(8), 985.
Scharloo, M., Baatenburg de Jong, R. J., Langeveld, T. P. M., van Velzen-Verkaik, E., Doorn-op den Akker, M. M., & Kaptein, A. A. (2005). Quality of life and illness perceptions in patients with recently diagnosed head and neck cancer. Head & Neck, 27(10), 857–863. https://doi.org/10.1002/hed.20251
Schiaffino, K. M., Shawaryn, M. A., & Blum, D. (1998). Examining the impact of illness representations on psychological adjustment to chronic illnesses. Health Psychology, 17(3), 262–268. https://doi.org/10.1037/0278-6133.17.3.262
Seres, G., Kovács, Z., Kovács, Á., Kerékgyártó, O., Sárdi, K., Demeter, P., & Túry, F. (2008). Different associations of health related quality of life with pain, psychological distress and coping strategies in patients with irritable bowel syndrome and inflammatory bowel disorder. Journal of Clinical Psychology in Medical Settings, 15(4), 287–295. https://doi.org/10.1007/s10880-008-9132-9
Sherwin, L. B., Leary, E., & Henderson, W. A. (2016). Effect of illness representations and catastrophizing on quality of life in adults with irritable bowel syndrome. Journal of Psychosocial Nursing and Mental Health Services, 54(9), 44–53. https://doi.org/10.3928/02793695-20160803-01
Singh, P., Agnihotri, A., Pathak, M. K., Shirazi, A., Tiwari, R. P., Sreenivas, V., & Makharia, G. K. (2012). Psychiatric, somatic and other functional gastrointestinal disorders in patients with irritable bowel syndrome at a tertiary care center. Journal of Neurogastroenterology and Motility, 18(3), 324–331. https://doi.org/10.5056/jnm.2012.18.3.324
Smith, T. W., & Williams, P. G. (1992). Personality and health: Advantages and limitations of the five-factor model. Journal of Personality, 60(2), 395–425. https://doi.org/10.1111/j.1467-6494.1992.tb00978.x
Spain, L. A., Tubridy, N., Kilpatrick, T. J., Adams, S. J., & Holmes, A. C. N. (2007). Illness perception and health-related quality of life in multiple sclerosis. Acta Neurologica Scandinavica, 116(5), 293–299. https://doi.org/10.1111/j.1600-0404.2007.00895.x
Spiegel, B. M. (2009). The burden of IBS: Looking at metrics. Current Gastroenterology Reports, 11(4), 265–269. https://doi.org/10.1007/s11894-009-0039-x
Surdea-Blaga, T., Baban, A., Nedelcu, L. & Dumitrascu, D. L. (2016). Psychological Interventions for Irritable Bowel Syndrome. Journal of Gastrointestinal & Liver Diseases, 25(3): 359–366. https://doi.org/10.15403/jgld.2014.1121.253.ibs
Talley, N. J., Boyce, P. M., & Jones, M. (1998). Is the association between irritable bowel syndrome and abuse explained by neuroticism? A population based study. Gut, 42(1), 47–53. https://doi.org/10.1136/gut.42.1.47
Tkalcic, M., Hauser, G., & Štimac, D. (2010). Differences in the health-related quality of life, affective status, and personality between irritable bowel syndrome and inflammatory bowel disease patients. European Journal of Gastroenterology & Hepatology, 22(7), 862–867. https://doi.org/10.1097/MEG.0b013e3283307c75
Turnquist, D. C., Harvey, J. H., & Andersen, B. L. (1988). Attributions and adjustment to life-threatening illness. British Journal of Clinical Psychology, 27(1), 55–65. https://doi.org/10.1111/j.2044-8260.1988.tb00753.x
Van De Ven, M. O., & Engels, R. C. (2011). Quality of life of adolescents with asthma: The role of personality, coping strategies, and symptom reporting. Journal of Psychosomatic Research, 71(3), 166–173. https://doi.org/10.1016/j.jpsychores.2011.03.002
Weinman, J., Petrie, K. J., Sharpe, N., & Walker, S. (2000). Causal attributions in patients and spouses following first-time myocardial infarction and subsequent lifestyle changes. British Journal of Health Psychology, 5(3), 263–273. https://doi.org/10.1348/135910700168900
Whitehead, W. E., Burnett, C. K., Cook, E. W., & Taub, E. (1996). Impact of irritable bowel syndrome on quality of life. Digestive Diseases and Sciences, 41(11), 2248–2253.
Yıldırım, O., Alçelik, A., Canan, F., Aktaş, G., Sit, M., İşçi, A., & Yilmaz, E. E. (2013). Impaired subjective sleep quality in irritable bowel syndrome patients with a T ype D personality. Sleep and Biological Rhythms, 11(2), 135–138. https://doi.org/10.1111/sbr.12005
Zweig, A., Schindler, V., Becker, A. S., van Maren, A., & Pohl, D. (2018). Higher prevalence of joint hypermobility in constipation predominant irritable bowel syndrome. Neurogastroenterology & Motility, 30(9), e13353.
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Yastibaş, C., dirik, G. & Akpinar, Z. Personality Traits and Health-Related Quality of Life in Irritable Bowel Syndrome (IBS) Patients: The Mediating Role of Illness Perceptions. Psychol Stud 66, 200–211 (2021). https://doi.org/10.1007/s12646-021-00618-7
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DOI: https://doi.org/10.1007/s12646-021-00618-7