Reynolds Darren P, Chalder Trudie, Henderson Claire
King's College London, Institute of Psychiatry Psychology & Neuroscience, Department of Psychology, London, United Kingdom.
King's College London, School of Population Health and Environmental Sciences, London, United Kingdom.
J Crohns Colitis. 2025 May 8;19(5). doi: 10.1093/ecco-jcc/jjaf055.
This study examined the relationship between psychological inflexibility, internalized stigma, and patient outcomes in adults with inflammatory bowel disease (IBD). It aimed to explore if psychological inflexibility mediated the relationship between internalized stigma and patient outcomes.
Three hundred and eighty-two participants with IBD took part in a cross-sectional quantitative study conducted via an online survey from May to December 2020. Participants completed questionnaires that assessed psychological inflexibility, committed action, internalized stigma related to IBD, psychological distress, IBD self-efficacy, self-concealment, beliefs about emotions, and fatigue. Participants also completed a sociodemographic and clinical questionnaire in addition to a bespoke Covid-19 questionnaire. Pearson's correlations and exploratory simple mediation analyses were used to examine relationships between variables and the mediating effect of psychological inflexibility.
40.5% of participants experienced internalized stigma. Higher psychological inflexibility was associated with higher internalized stigma, lower committed action, poorer health-related quality of life, lower IBD self-efficacy, higher self-concealment, higher fatigue, and more negative beliefs about emotions. Psychological inflexibility partially mediated the relationship between internalized stigma and several patient outcomes (psychological distress, IBD health-related quality of life, IBD self-efficacy, and self-concealment) and completely mediated the relationship between internalized stigma and fatigue.
Psychological inflexibility significantly impacts the quality of life in individuals with internalized stigma related to IBD and mediates the relationship between internalized stigma and patient outcomes. Increasing psychological flexibility in adults with IBD may reduce distress and enhance quality of life. Longitudinal studies and trials of psychological interventions targeting psychological flexibility warrant exploration.
本研究探讨了炎症性肠病（IBD）成年患者的心理僵化、内化耻辱感与患者结局之间的关系。其目的是探究心理僵化是否介导了内化耻辱感与患者结局之间的关系。
382名IBD患者参与了一项于2020年5月至12月通过在线调查进行的横断面定量研究。参与者完成了评估心理僵化、坚定行动、与IBD相关的内化耻辱感、心理困扰、IBD自我效能感、自我隐瞒、情绪信念和疲劳的问卷。除了一份定制的新冠病毒问卷外，参与者还完成了一份社会人口学和临床问卷。使用Pearson相关性分析和探索性简单中介分析来检验变量之间的关系以及心理僵化的中介作用。
40.5%的参与者经历了内化耻辱感。更高的心理僵化与更高的内化耻辱感、更低的坚定行动、更差的健康相关生活质量、更低的IBD自我效能感、更高的自我隐瞒、更高的疲劳以及对情绪的更消极信念相关。心理僵化部分介导了内化耻辱感与几个患者结局（心理困扰、IBD健康相关生活质量、IBD自我效能感和自我隐瞒）之间的关系，并完全介导了内化耻辱感与疲劳之间的关系。
心理僵化显著影响与IBD相关的内化耻辱感个体的生活质量，并介导内化耻辱感与患者结局之间的关系。提高IBD成年患者的心理灵活性可能会减少困扰并提高生活质量。针对心理灵活性的纵向研究和心理干预试验值得探索。
