Is There a Link between Irritable Bowel Syndrome and Left-Handedness?: An Exploratory Study

Recent research has found that people with Irritable Bowel Syndrome (IBS) and those with Inflammatory Bowel Disease (IBD) show a relative deficit in verbal IQ, compared to their own performance IQ, and the IQ of a healthy comparison group. It has been suggested that the elevated prevalence of left-handedness shown in previous studies investigating people with IBD is due to compromised left-hemisphere development. This may be associated with a decrement in certain cognitive functions such as verbal IQ. A shift in brain dominance from left to right has been found in many atopic and immunological diseases as well as in autonomic dysfunctions. It was uncertain whether this would apply to people with IBS, a functional disorder in which the cause or causes remain unclear. Therefore, the aim of this preliminary study was to investigate whether people with IBS have an increased prevalence of left-handedness. It was found that there was an association between IBS and left-handedness, showing that further research on this association both in IBS and other functional disorders (as well as on the similarities between IBS and IBD) is warranted.     

Is there a link between irritable bowel syndrome and left-handedness?: An exploratory study

Recent research has found that people with Irritable Bowel Syndrome (IBS) and those with Inflammatory Bowel Disease (IBD) show a relative deficit in verbal IQ, compared to their own performance IQ, and the IQ of a healthy comparison group. It has been suggested that the elevated prevalence of left-handedness shown in previous studies investigating people with IBD is due to compromised left-hemisphere development. This may be associated with a decrement in certain cognitive functions such as verbal IQ. A shift in brain dominance from left to right has been found in many atopic and immunological diseases as well as in autonomic dysfunctions. It was uncertain whether this would apply to people with IBS, a functional disorder in which the cause or causes remain unclear. Therefore, the aim of this preliminary study was to investigate whether people with IBS have an increased prevalence of left-handedness. It was found that there was an association between IBS and left-handedness, showing that further research on this association both in IBS and other functional disorders (as well as on the similarities between IBS and IBD) is warranted.     

The role of anxiety and depression in the irritable bowel syndrome

Using a reliable and valid structured diagnostic interview scale (ADIS-R), and patients with careful medical characterization, we found significantly more diagnosable psychopathology, particularly anxiety disorders, among treatment seeking patients with irritable bowel syndrome than among comparable age and sex samples of treatment seeking patients with Inflammatory Bowel Disease. Significant differences were also found on the Hamilton Anxiety Rating Scale and Hamilton Rating Scale for Depression between IBS patients and the IBD patients and controls, who did not differ. Comparable levels of psychiatric disorder among parents of probands were found in all three groups. The results are consistent with Latimer's (1983) notion of IBS patients being a subclass of 'neurotics'.     

Arousal and physiological toughness: implications for mental and physical health

From W.B. Cannon's identification of adrenaline with "fight or flight" to modern views of stress, negative views of peripheral physiological arousal predominate. Sympathetic nervous system (SNS) arousal is associated with anxiety, neuroticism, the Type A personality, cardiovascular disease, and immune system suppression; illness susceptibility is associated with life events requiring adjustments. "Stress control" has become almost synonymous with arousal reduction. A contrary positive view of peripheral arousal follows from studies of subjects exposed to intermittent stressors. Such exposure leads to low SNS arousal base rates, but to strong and responsive challenge- or stress-induced SNS-adrenal-medullary arousal, with resistance to brain catecholamine depletion and with suppression of pituitary adrenal-cortical responses. That pattern of arousal defines physiological toughness and, in interaction with psychological coping, corresponds with positive performance in even complex tasks, with emotional stability, and with immune system enhancement. The toughness concept suggests an opposition between effective short- and long-term coping, with implications for effective therapies and stress-inoculating life-styles.     

Behaviorally treated irritable bowel syndrome patients: a four-year follow-up

Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had completed a multicomponent treatment involving progressive muscle relaxation, thermal biofeedback, cognitive therapy and IBS education were located and evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original sample) rated themselves as more than 50% improved. Six of the 12 patients (50%) who submitted symptom monitoring diaries met our criteria for clinical improvement, i.e. achieving at least a 50% reduction in primary IBS symptom scores. The means on all measures at long-term follow-up were lower than those obtained prior to treatment. When follow-up symptom means were compared with pretreatment means, significant (P less than 0.05) reductions were obtained on abdominal pain/tenderness, diarrhea, nausea, and flatulence.     

Behavioral interventions may prolong remission in patients with inflammatory bowel disease

Inflammatory Bowel Diseases (IBDs) are chronic, relapsing and remitting gastrointestinal conditions with no known cure. Previous studies have linked behavioral factors, including stress and medication adherence, to relapse.

Purpose

We sought to determine the effect of participation in a behavioral self-management program on incidence of flare within 12 months following behavioral intervention when compared to the natural history of flare incidence prior to program participation.

Results

Results from a 2-level regression model indicated that those participants in the treatment group were 57% less likely to flare in the following 12 months (compared to 18% in the control group). The decline in “flare odds” was about 2 times greater in treatment versus controls (OR = 0.52, t(34) = 2.07, p < 0.05). Office visits, ER visits, and disease severity (all p < 0.05) were identified as moderators of flare risk.

Conclusions

We have demonstrated 1) a statistical model estimating the likelihood of flare rates in the 12 months following a behavioral intervention for IBD (compared to a control condition), and 2) that the introduction of a behavioral intervention can alter the natural course of a chronic, relapsing and remitting gastrointestinal condition such as IBD.     

The relationship between cardiac reactivity in the laboratory and in real life.

OBJECTIVE: An excessive cardiovascular response to acute stress is a probable risk factor for cardiovascular (CV) disease. Such reactivity is usually assessed from the CV response to laboratory stressors. However, if it is a risk factor, correlated responses must occur in real life. DESIGN: In the present study, we investigated the relationship between the heart rate (HR) response to five laboratory stressors and HR reactivity in the field. MEASURES: HR variation, the response to a real life stressor (public speaking), and the increase in HR with periods of self-reported tense arousal. Ambulatory HR, activity and posture were measured continuously over a 7-hr period. RESULTS: The HR increase to laboratory stressors did not relate to HR variation consistently, but it did relate to the other two field measures. CONCLUSION: The results suggested that a tendency to increased HR reactivity may be a risk factor for cardiovascular disease when combined with exposure to stress.     

The impact of anxiety on sexual arousal in women

This study examined the impact of state anxiety, trait anxiety, and anxiety sensitivity on physiological and self-report measures of sexual arousal and sexual function in a non-clinical sample of women. Physiological sexual responses to an erotic stimulus were assessed using vaginal photoplethysmography, and subjective reactions were measured using questionnaires. Results suggested a curvilinear relationship between state anxiety and physiological sexual arousal (vaginal pulse amplitude; VPA). Trait anxiety and anxiety sensitivity were correlated with self-reported sexual arousal outside the laboratory. The findings may be interpreted in light of sympathetic nervous system (SNS) influences on sexual arousal and potential cognitive interference mechanisms associated with anxiety.     

Women with diarrhoea-predominant irritable bowel syndrome show an increased pressure response to 35% carbon dioxide stress challenge

The responses to inhalation of 35% carbon dioxide (CO(2)) as a stressor were compared in female irritable bowel syndrome (IBS) patients and healthy controls to assess potential differences in cardiovascular, neuroendocrine and behavioural responses to stress. A total of 22 women (12 patients with ROME II defined diarrhoea-predominant IBS and 10 aged-matched controls) were challenged with a single vital capacity breath of 35% CO(2) (with 65% oxygen). Beat-to-beat blood pressure and heart rate were recorded prior to, during and after the inhalation. Serum cortisol concentration and behavioural ratings were measured pre- and post-inhalation. A typical pattern of responses to CO(2) was observed, characterised by a reduction in heart rate and increases in serum cortisol and anxiogenic symptoms; however, these responses did not differ between groups. Both groups also demonstrated an increase in systolic blood pressure; however, this response was significantly enhanced in IBS patients compared to healthy controls (P < 0.05). These findings demonstrate that females with diarrhoea-predominant IBS have an exaggerated pressor response to 35% CO(2) stress challenge, suggesting a more stress-responsive sympathetic nervous system.     

Impact of Social Networking Sites on Children in Military Families

Youth in military families experience a relatively unique set of stressors that can put them at risk for numerous psychological and behavior problems. Thus, there is a need to identify potential mechanisms by which children can gain resiliency against these stressors. One potential mechanism that has yet to be empirically studied with military youth is social networking sites (SNSs). SNSs have gained significant popularity among society, especially youth. Given the significance of these communication tools in youths’ lives, it is important to analyze how SNS use may affect military youth and their ability to cope with common military life stressors. The current review examines the potential positive and negative consequences associated with SNS use in coping with three common stressors of youth in military families: parent deployment, frequent relocation, and having a family member with a psychological or physical disability. By drawing from SNS and military literature, we predict that SNS use can be a positive tool for helping children in military families to cope with stressors. However, certain SNS behaviors can potentially result in more negative outcomes. Recommendations for future research are also discussed.     

Aroused at Home: Basic Autonomic Regulation during Orthostatic and Physical Activation is Altered in Children with Social Anxiety Disorder

Previous research has documented altered autonomic nervous system (ANS) reactivity to laboratory-based social stress tasks in children with social anxiety disorder (SAD). It is unclear, however, whether these alterations are caused by the unfamiliar and possibly threatening lab environment or whether they generalize to other, more representative contexts. Sympathetic and parasympathetic autonomic functioning was assessed in the home (minimizing environmental threat) during a supine baseline phase and two physical activation phases (orthostatic stress, stair stepping) in children (9–13 years) with SAD (n?=?27) and healthy control children (n?=?27). Relative to controls, children with SAD showed tonic autonomic hyperarousal as indicated by higher heart rate and electrodermal activity during the supine baseline phase. Further, there was evidence for stronger cardiac and vascular sympathetic reactivity (T-wave amplitude, pulse wave transit time) to moderate physical activation in children with SAD. Higher autonomic arousal during rest was related to measures of trait social anxiety and general psychopathology. Groups did not differ on parasympathetic parameters. Our results extend previous laboratory findings and provide the first evidence for alterations in children with SAD during basal autonomic regulation and in the absence of explicit social evaluative threat. They may further help to clarify conflicting study results from previous laboratory studies. The findings underline the importance of psychophysiological assessment using different environments and tasks to elucidate the physiological bases of SAD.     

Prediction of treatment outcome among patients with irritable bowel syndrome treated with group cognitive therapy

Using a sample of over 125 patients with irritable bowel syndrome (IBS) who were treated with cognitive therapy administered in small groups, we sought to predict end of treatment and 3-month follow-up improvement in two changes indices of gastrointestinal (GI) symptoms (Pain/Discomfort Index which assessed change in abdominal pain, abdominal tenderness and bloating and Bowel Regularity Index which assessed change in diarrhea and constipation). We also sought to predict scores on IBS specific quality of life (QOL) and overall level of psychological distress using the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI). Significant, but modest, levels of prediction were found for prediction of improvement in GI symptoms (4-15% of variance). Stronger significant prediction was obtained for the QOL and global psychological distress measure with R(2)'s ranging from 0.36 to 0.50. A wide variety of demographic, GI symptom, psychological status and psychiatric status variables entered the final prediction equations.     

Emotional, cognitive and physiological correlates of abuse-related stress in borderline and antisocial personality disorder

Childhood abuse is an important precursor of borderline personality disorder (BPD) and antisocial personality disorder (ASPD). The current study compared the emotional reactivity to abuse-related stress of these patients on a direct and an indirect level. Changes in self-reported affect and schema modes, psychophysiology and reaction time based cognitive associations were assessed following confrontation with an abuse-related film fragment in patients with BPD (n = 45), ASPD (n = 21), Cluster C personality disorder (n = 46) and non-patient controls (n = 36). Results indicated a hyperresponsivity of BPD-patients on self-reported negative affect and schema modes, on some psychophysiological indices and on implicit cognitive associations. The ASPD-group was comparable to the BPD group on implicit cognitions but did not show self-reported and physiological hyper-reactivity. These findings suggest that BPD and ASPD-patients are alike in their implicit cognitive abuse-related stress reactivity, but can be differentiated in their self-reported and physiological response patterns.     

Mental and physical stress as moderators of the postural response in insulin-dependent diabetic patients

Two simple stressors, mental arithmetic and isometric handgrip, were studied as moderators of the physiological response to standing in insulin-dependent diabetic patients and in healthy controls. Continuous (beat-to-beat) measures were taken of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and skin conductance (SC) during postural change under baseline and stressor conditions. Diabetic patients without symptoms of neuropathy and healthy controls showed generally similar responses to postural change and to the stressor conditions. SBP and DBP were more responsive to the mental and physical stressors than were HR or SC, especially after standing. Two diabetic patients with postural hypotension showed significant increases in overall BP levels and less of a fall in BP during postural change under the stressor conditions, despite minimal HR or SC responses. Results indicate that these strategies are effective in increasing BP during postural change in both diabetic and nondiabetic individuals and may be useful in the management of orthostatic hypotension.     

Gastroesophageal reflux disease (GERD) and inflammatory bowel disease (IBD): attachment styles and parental bonding

The attachment styles and parental bonding by 64 patients (M age = 43.2 yr., SD = 13.3) with Gastroesophageal Reflux Disease (GERD) were compared with those of 64 patients (M age = 42.2 yr., SD = 13.5) with Inflammatory Bowel Disease (IBD) and 126 Healthy participants (M age = 42.2 yr., SD = 12.1). Analysis of scores on the Attachment Style Questionnaire indicated insecure attachment in both the patient and control groups. The Parental Bonding scores indicated perceptions of Affectionless Control by parents in both patient groups. In particular, the mean Father-Protection subscale scores were significantly higher for in the GERD group than in the Healthy and IBD groups.     

Cardiovascular dysfunction related to threat, avoidance, and vigilant work: Application of event-related potential and critique

An integrative approach is suggested to track symbolically simulated work environment stressors, as an act to burden higher cortical function in the exposed groups. ERP would be made together with measurement of end organ stress responses as well as measurements of perceived conditions. Field studies would be the necessary complement. The following conclusions are culled from the reviewed literature: among the pilots, cardiovascular problems are the most important cause of loss of license in Europe and North America. Interactions with coworkers for air traffic controllers have been associated with cardiovascular disability. Comparing various degrees of heart disease severity among professional drivers, the IHD drivers showed the smallest N2 amplitudes and the greatest diastolic blood pressure reactivity. P300 target amplitude showed an inverse correlation with number of work hours behind the wheel. The IHD drivers were envisioned in a phase of disturbance of the selective attentional process. An interrelation has been found between Event-Related Slow Potential ERSP and midinterval heart rate acceleration associated with displeasure and arousal. A positive correlation has been found between the amplitude of the ERSP and ventricular arrhythmia rate in cardiac patients. Lowering of arrhythmia rate in response to antiarhythmic agents was associated with a significant attenuation of the ERSP. Either acceleration or deceleration is associated with the appearance of the late CNV to the aversive noise burst. There might be a “common generator behind both anticipatory heart rate responses and cortical events.” CNV might be related to frontally mediated stress mechanisms.     

A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome

Ten of thirteen original participants with Irritable Bowel Syndrome (IBS) participated in a one year follow-up study to determine whether the effects of Relaxation Response Meditation (RRM) on IBS symptom reduction were maintained over the long-term. From pre-treatment to one-year follow-up, significant reductions were noted for the symptoms of abdominal pain (p = 0.017), diarrhea (p = 0.045), flatulence (p = 0.030), and bloating (p = 0.018). When we examined changes from the original three month follow-up point to the one year follow-up, we noted significant additional reductions in pain (p = 0.03) and bloating (p = 0.04), which tended to be the most distressing symptoms of IBS. It appears that: (1) continued use of meditation is particularly effective in reducing the symptoms of pain and bloating; and (2) RRM is a beneficial treatment for IBS in the both short- and the long-term.     

Cardiovascular responses to agency and communion stressors in young women

Theory and research (Helgeson, 1994) suggest that women are particularly responsive to communion stressors (i.e., social relationship concerns) as opposed to agency (i.e., achievement and dominance concerns) and that women low in the trait of agency are vulnerable to stress. To test these hypotheses, 60 undergraduate women interacted with a pre-recorded partner; one-third provided support to an interaction partner (i.e., communion stressor), debated current events (i.e., agency stressor), or described a typical day (i.e., control task). Compared to controls, the debate task evoked greater systolic blood pressure and heart rate reactivity and related autonomic changes. Compared to controls, providing support evoked larger increases in cardiac sympathetic activation and reduced vascular resistance. Low levels of trait agency were associated with greater CVR overall. Hence, agency and communion stressors had distinct psychophysiologic effects. Although both tasks heightened reactivity, the agency task evoked cognitive and physiological responses consistent with threat, whereas the communion task evoked a pattern consistent with challenge.     

Effects of guided imagery with relaxation training on anxiety and quality of life among patients with inflammatory bowel disease

Background: Inflammatory Bowel Disease (IBD) impacts quality of life (QoL). Psychological factors influence the course of the disease and should be targeted for intervention.

Methods: Our study was a prospective, randomised control trial. Fifty-six outpatients were randomly chosen and allocated to a treatment group or a waiting-list control group. Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice. Evaluations performed pre and post-treatment: state anxiety was assessed with the State-Trait Anxiety Inventory, QoL with the IBD Questionnaire. The Visual Analogue Scale assessed pain, depression, stress and mood. Patients completed a symptom monitoring diary. The control group's symptoms were monitored without study-related treatment.

Results: Thirty-nine subjects completed the study and were included in the data analysis. Following the relaxation-training intervention, the treatment group's (n?=?18) measured results showed a statistically significant improvement as compared to the control group (n?=?21) (time by treatment interaction): anxiety levels decreased (p?<?0.01), QoL and mood improved (p?<?0.05), while levels of pain and stress decreased (p?<?0.01).

Conclusions: Findings indicate IBD patients may benefit from relaxation training in their holistic care. New studies as well as further investigation of the subject are warranted.