Gerson M J, Schonholtz J, Grega C H, Barr D R
Graduate Program in Clinical Psychology, New York University, NY, USA.
Mt Sinai J Med. 1998 Oct-Nov;65(5-6):398-403.
This study examines psychological correlates of inflammatory bowel disease (IBD) to answer these questions: What is the association between individual and family stress levels and the patient's coping ability and severity of illness? How does the level of family functioning correlate with individual coping and illness severity? To what extent are patient and family beliefs about IBD related to symptomatology?
Seventeen patients and 44 of their family members were studied intensively in an exploration of the psychological response to IBD. They completed a comprehensive battery of self-report questionnaires assessing stressful life events, coping related to the illness, and beliefs regarding IBD. Ratings of family functioning were made from videotaped family discussions about IBD. Treating physicians made independent ratings of past and current disease severity.
Surprisingly, recent disease activity was negatively correlated with family stress level (r = -0.794), but was not associated with patient stress level. However, impaired coping with IBD by affected individuals was directly correlated with both individual (r = 0.595) and family-wide (r = 0.724) reported stress levels. Disease severity was also found to be responsive to family communication style (r = 0.431) and to level of family agreement (r = 0.531) regarding the etiology and management of IBD.
These findings suggest that individual stress affects coping with IBD, whereas family-wide stress, communication style, and agreement about disease etiology and management are related to disease activity. The interrelationship of family and patient as well as individual coping with IBD should be evaluated in future studies.
本研究探讨炎症性肠病（IBD）的心理关联，以回答以下问题：个体和家庭压力水平与患者的应对能力及疾病严重程度之间有何关联？家庭功能水平与个体应对及疾病严重程度如何相关？患者及家庭对IBD的信念在多大程度上与症状学相关？
对17名患者及其44名家庭成员进行深入研究，以探究对IBD的心理反应。他们完成了一系列全面的自我报告问卷，评估应激性生活事件、与疾病相关的应对方式以及对IBD的信念。通过录制的关于IBD的家庭讨论对家庭功能进行评分。主治医生对过去和当前的疾病严重程度进行独立评分。
令人惊讶的是，近期疾病活动与家庭压力水平呈负相关（r = -0.794），但与患者压力水平无关。然而，受影响个体应对IBD的能力受损与个体报告的压力水平（r = 0.595）和全家庭报告的压力水平（r = 0.724）均直接相关。还发现疾病严重程度对应于家庭沟通方式（r = 0.431）以及关于IBD病因和管理的家庭共识水平（r = 0.531）。
这些发现表明，个体压力影响对IBD的应对，而全家庭压力、沟通方式以及关于疾病病因和管理的共识与疾病活动相关。未来研究应评估家庭与患者以及个体应对IBD之间的相互关系。
