Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, ECMC, 462 Grider St., Buffalo, NY, 14215, USA.
Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, ECMC, 462 Grider St., Buffalo, NY, 14215, USA.
Behav Res Ther. 2022 Jul;154:104033. doi: 10.1016/j.brat.2022.104033. Epub 2022 Jan 10.
This study tested the novel hypothesis that CBT-treated IBS patients who learn to self-manage painful GI symptoms by targeting rigid cognitive style show improvement in cognitive flexibility, GI symptoms (e.g., abdominal pain), and quality of life. Participants included 130 Rome-III diagnosed IBS patients (M age = 40.3, F = 83%) with moderate-to-severe symptoms randomly assigned to either cognitive behavioral therapy (CBT; N = 86) or a nonspecific education/support (EDU) comparator (N = 44). Participants completed an assessment battery at baseline and post-treatment 2 weeks after 10-week acute treatment phase. Measures included cognitive flexibility, psychological flexibility, emotion regulation strategies, IBS symptom severity, quality of life (QOL), and distress. CBT but not EDU patients showed significant GI sympton improvement from baseline to post-treatment in cognitive flexibility. For CBT patients, changes in cognitive flexibility were significantly associated with changes in IBS symptom severity, abdominal pain, and IBS QOL. Neither condition showed significant changes in psychological flexibility (Acceptance and Action Questionnaire-II) or use of emotion regulation strategies (Emotion Regulation Questionnaire). The ability to self-manage painful IBS symptoms refractory to conventional medical and dietary treatments is related to the ability to respond flexibly across shifting contexts using cognitive change procedures featured in CBT for IBS.
本研究检验了一个新颖的假设，即接受认知行为疗法（CBT）治疗的肠易激综合征（IBS）患者通过针对僵化认知风格来自我管理疼痛性胃肠道症状，可能会改善认知灵活性、胃肠道症状（例如腹痛）和生活质量。参与者包括 130 名罗马 III 诊断的 IBS 患者（M 年龄=40.3，F=83%），他们具有中度至重度症状，随机分配到认知行为疗法（CBT；N=86）或非特异性教育/支持（EDU）对照组（N=44）。参与者在基线和急性治疗 10 周后 2 周时完成了评估工具包。评估包括认知灵活性、心理灵活性、情绪调节策略、IBS 症状严重程度、生活质量（QOL）和痛苦。与 EDU 患者相比，CBT 患者的认知灵活性从基线到治疗后显著改善，胃肠道症状也得到了显著改善。对于 CBT 患者，认知灵活性的变化与 IBS 症状严重程度、腹痛和 IBS QOL 的变化显著相关。两种治疗方案均未显示心理灵活性（接受与行动问卷-II）或情绪调节策略（情绪调节问卷）有显著变化。自我管理难治性 IBS 疼痛症状的能力与在 CBT 中用于 IBS 的认知改变程序相关，该能力可以在不断变化的情况下灵活应对。
