The Stressometer: A Simple, Valid, and Responsive Measure of Psychological Stress in Inflammatory Bowel Disease Patients

Keegan, Denise; Byrne, Kathryn; Cullen, Garret; Doherty, Glen A.; Dooley, Barbara; Mulcahy, Hugh E.

doi:10.1093/ecco-jcc/jjv120

Cited by 19Inflammatory Bowel DiseaseAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and Testing

The Stressometer: A Simple, Valid, and Responsive Measure of Psychological Stress in Inflammatory Bowel Disease Patients

Keegan, Denise, Byrne, Kathryn, Cullen, Garret, Doherty, Glen A., Dooley, Barbara, Mulcahy, Hugh E.·2015·Journal of Crohn s and Colitis

DOI 10.1093/ecco-jcc/jjv120

Open this paper in CoChat — free account

Abstract

BACKGROUND AND AIMS: Psychological stress is associated with inflammatory bowel disease [IBD], but the nature of this relationship is complex. At present, there is no simple tool to screen for stress in IBD clinical practice or assess stress repeatedly in longitudinal studies. Our aim was to design a single-question 'stressometer' to rapidly measure stress and validate this in IBD patients. METHODS: In all, 304 IBD patients completed a single-question 'stressometer'. This was correlated with stress as measured by the Depression Anxiety Stress Scales [DASS-21], quality of life, and disease activity. Test-retest reliability was assessed in 31 patients who completed the stressometer and the DASS-21 on two occasions 4 weeks apart. RESULTS: Stressometer levels correlated with the DASS-21 stress dimension in both Crohn's disease [CD] (Spearman's rank correlation coefficient [rs] 0.54; p < 0.001) and ulcerative colitis [UC] [rs 0.59; p < 0.001]. Stressometer levels were less closely associated with depression and anxiety [rs range 0.36 to 0.49; all p-values < 0.001]. Stressometer scores correlated with all four Short Health Scale quality of life dimensions in both CD and UC [rs range 0.35 to 0.48; all p-values < 0.001] and with disease activity in Crohn's disease [rs 0.46; p < 0.001] and ulcerative colitis [rs 0.20; p = 0.02]. Responsiveness was confirmed with a test-retest correlation of 0.43 [p = 0.02]. CONCLUSIONS: The stressometer is a simple, valid, and responsive measure of psychological stress in IBD patients and may be a useful patient-reported outcome measure in future IBD clinical and research assessments.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1093/ecco-jcc/jjv120

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

The Stressometer is a validated and responsive measure of stress in people with IBD.
“The “Stressometer” is a validated and responsive measure of stress in people with IBD [66].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [66]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample
Henry, J. D., & Crawford, J. R. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466505x29657 · Cited by 5,801 · see citing works
Use of the noninvasive components of the mayo score to assess clinical response in Ulcerative Colitis
Lewis, J. D., Chuai, S., Nessel, L. A., Lichtenstein, G. R., Aberra, F. N., & Ellenberg, J. H. (2008) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20520 · Cited by 965 · see citing works
Response Burden and Questionnaire Length: Is Shorter Better? A Review and Meta-analysis
Rolstad, S., Adler, J., & Rydén, A. (2011) · Value in Health · doi:10.1016/j.jval.2011.06.003 · Cited by 958 · see citing works
The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial.
Irvine, E. J., Zhou, Q., & Thompson, A. K. (1996) · PubMed · Cited by 632 · see citing works
The Science of Asking Questions
Schaeffer, N. C., & Presser, S. (2003) · Annual Review of Sociology · doi:10.1146/annurev.soc.29.110702.110112 · Cited by 625 · see citing works
Psychological stress in IBD: new insights into pathogenic and therapeutic implications
Mawdsley, J. E., & Rampton, D. S. (2005) · Gut · doi:10.1136/gut.2005.064261 · Cited by 622 · see citing works
The stress appraisal measure (SAM): A multidimensional approach to cognitive appraisal
Peacock, E. J., & Wong, P. T. P. (1990) · Stress Medicine · doi:10.1002/smi.2460060308 · Cited by 565 · see citing works
Validation of the Distress Thermometer worldwide: state of the science
Donovan, K. A., Grassi, L. G., McGinty, H. L., & Jacobsen, P. B. (2013) · Psycho-Oncology · doi:10.1002/pon.3430 · Cited by 449 · see citing works
Reliability and Validity of 2 Single-Item Measures of Psychosocial Stress
Littman, A. J., White, E., Satia, J. A., Bowen, D. J., & Kristal, A. R. (2006) · Epidemiology · doi:10.1097/01.ede.0000219721.89552.51 · Cited by 266 · see citing works
Patient-reported outcomes as primary end points in clinical trials of inflammatory bowel disease
Williet, N., Sandborn, W. J., & Peyrin–Biroulet, L. (2014) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2014.02.016 · Cited by 260 · see citing works
Encyclopedia of Survey Research Methods
Jarvis, M. (2010) · Reference Reviews · doi:10.1108/09504121011011879 · Cited by 241 · see citing works
Psychosocial determinants of relapse in ulcerative colitis: A longitudinal study
Bitton, A., Sewitch, M. J., Peppercorn, M. A., de B Edwardes, M. D., Shah, S., Ransil, B., & Locke, S. E. (2003) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07717.x · Cited by 226 · see citing works
Short CDAI: Development and validation of a shortened and simplified Crohnʼs disease activity index
Thia, K., Faubion, W. A., Loftus, E. V., Persson, T., Persson, A., & Sandborn, W. J. (2011) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21400 · Cited by 134 · see citing works
Stressful life events and the onset of chronic diseases among Australian adults: findings from a longitudinal survey
Renzaho, A. M. N., Houng, B., Oldroyd, J. C., Nicholson, J. M., D’Esposito, F., & Oldenburg, B. F. (2013) · European Journal of Public Health · doi:10.1093/eurpub/ckt007 · Cited by 130 · see citing works
The Short Health Scale: A valid measure of subjective health in ulcerative colitis
Hjortswang, H., Järnerot, G., Curman, B., Sandberg–Gertzén, H., Tysk, C., Blomberg, B., Almer, S. H., & Ström, M. (2006) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520600610618 · Cited by 128 · see citing works
Clinical status, psychosocial impairments, medical treatment and health care costs for patients with inflammatory bowel disease (IBD) in Germany: an online IBD registry
Bokemeyer, B., Hardt, J., Hüppe, D., Prenzler, A., Conrad, S., Düffelmeyer, M., Hartmann, P., Hoffstadt, M., Klugmann, T., Schmidt, C., et al. (2013) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2012.02.014 · Cited by 87 · see citing works
Interview Measurement of Stressful Life Events
Wethington, E., Brown, G. W., & Kessler, R. C. (1995) · doi:10.1093/oso/9780195086416.003.0003 · Cited by 85 · see citing works
Life Events and Inflammatory Bowel Disease Relapse: A Prospective Study of Patients Enrolled in Remission
Vidal, A., Gómez-Gil, E., Sans, M., Portella, M. J., Salamero, M., Piqué, J. M., & Panés, J. (2006) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00476.x · Cited by 81 · see citing works
Stressful life events and the onset of asthma
Lietzén, R., Virtanen, P., Mika Kivimaki, B., Sillanmäki, L. H., Vahtera, J., & Koskenvuo, M. (2010) · European Respiratory Journal · doi:10.1183/09031936.00164609 · Cited by 81 · see citing works
IBD patients need in health quality of care ECCO consensus
Elkjær, M., Moser, G., Reinisch, W., Durovicova, D., Lukáš, M., Vucelic, B. N., Wewer, V., Colombel, J., Shuhaibar, M., O'Morain, C. A., et al. (2008) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2008.02.001 · Cited by 68 · see citing works
FDA and EMA end points: which outcome end points should we use in clinical trials in patients with irritable bowel syndrome?
Corsetti, M., & Tack, J. F. (2013) · Neurogastroenterology & Motility · doi:10.1111/nmo.12151 · Cited by 56 · see citing works
The Short Health Scale: A valid and reliable measure of health related quality of life in English speaking inflammatory bowel disease patients
McDermott, E., Keegan, D., Byrne, K., Doherty, G. A., & Mulcahy, H. E. (2012) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2012.07.030 · Cited by 40 · see citing works
Life-event stress induced by the Great East Japan Earthquake was associated with relapse in ulcerative colitis but not Crohn’s disease: A retrospective cohort study
Shiga, H., Miyazawa, T., Kinouchi, Y., Takahashi, S., Tominaga, G., Takahashi, H., Takagi, S., Obana, N., Kikuchi, T., Oomori, S., et al. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002294 · Cited by 31 · see citing works
The relationship between a short measure of health status and physical activity in a workplace population
Bize, R., & Plotnikoff, R. C. (2008) · Psychology Health & Medicine · doi:10.1080/13548500802032699 · Cited by 28 · see citing works
ON001 An investigation of the manifestations of perceived psychological stress in patients with inflammatory bowel disease
Sugrue, K., Landers, M., McCarthy, J., & Buckley, M. (2013) · Journal of Crohn s and Colitis · doi:10.1016/s1873-9946(13)60727-8 · Cited by 1 · see citing works
Rapid screening for psychologic distress in men with prostate carcinoma
Roth, A. J., Kornblith, A. B., Batel-Copel, L., Peabody, E., Scher, H. I., & Holland, J. C. (1998) · Cancer · doi:10.1002/(sici)1097-0142(19980515)82:10

Flagged first, then by citations

Research works printed but not linked: 2

Keegan D, Byrne K, McDermott E, et al. Simple question, simple answer, complex implications: What does a distress thermometer tell us about disease activity and quality of life in IBD patients? J Crohns Colitis 2013;7:S295.
Irvine EJ, Zhou Q, Thompson AK. The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians manag- ing inflammatory bowel disease. Am J Gastroenterol 1996;91:1571-8.

Sorted by citations

Acceptance and Commitment Therapy Reduces Psychological Stress in Patients With Inflammatory Bowel Diseases
Wynne, B., McHugh, L., Gao, W., Keegan, D., Byrne, K., Rowan, C., Hartery, K., Kirschbaum, C., Doherty, G., Cullen, G., et al. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.11.030 · Cited by 188 · see citing works
Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease
Zhang, M., Hong, L., Zhang, T., Lin, Y., Zheng, S., Zhou, X., Fan, R., Wang, Z., Zhang, C.-L., & Zhong, J. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s118413 · Cited by 76 · see citing works
Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies
Lavelle, J., Storan, D., Eswara Murthy, V., De Dominicis, N., Mulcahy, H. E., & McHugh, L. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11102757 · Cited by 23 · see citing works
“The “Stressometer” is a validated and responsive measure of stress in people with IBD [66].”
Background
Trajectories of Acute Diabetes-Specific Stress in Adolescents With Type 1 Diabetes and Their Caregivers Within the First Year of Diagnosis
Yi‐Frazier, J. P., Cochrane, K., Whitlock, K. B., Rosenberg, A. R., Pascual, M., Beauregard, N., Mitrovich, C., Panlasigui, N., & Pihoker, C. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsy003 · Cited by 20 · see citing works
Resilience and Diabetes Distress at 3 Months Following Diagnosis Predict A1C Trajectories in Youth With Type 1 Diabetes: An Argument for Early Intervention
Scott, S., O’Donnell, M., Manczak, E. M., Fladeboe, K., ELLISOR, B. M., Rosenberg, A. R., Malik, F. S., & Yi‐Frazier, J. P. (2022) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsac046 · Cited by 20 · see citing works
Pain neuroscience education improves post-traumatic stress disorder, disability, and pain self-efficacy in veterans and service members with chronic low back pain: Preliminary results from a randomized controlled trial with 12-month follow-up
Benedict, T., Nitz, A. J., Gambrel, M. K., & Louw, A. (2023) · Military Psychology · doi:10.1080/08995605.2023.2188046 · Cited by 18 · see citing works
Disordered Eating Attitudes and Their Association with Age, BMI, Stress, and Diet in College Students
Sifre, N., Deringer, R., Prapkree, L., & Palacios, C. S. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21060766 · Cited by 13 · see citing works
The influence of self‐criticism on depression symptoms among ambulatory patients with inflammatory bowel disease
Trindade, I. A., Irons, C., Ferreira, C., Portela, F., & Pinto‐Gouveia, J. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2398 · Cited by 13 · see citing works
The Role of Monitoring and Acceptance in Daily Affective Stress Reactivity: An Ambulatory Assessment Study
Hoffmann, C. F. A., Schröder–Abé, M., & Ewert, C. (2024) · Mindfulness · doi:10.1007/s12671-024-02443-1 · Cited by 7 · see citing works
Stress
Oriot, D., Trigolet, M., Kessler, D. O., Auerbach, M. A., & Ghazali, D. A. (2020) · Pediatric Emergency Care · doi:10.1097/pec.0000000000001962 · Cited by 6 · see citing works
Coping with Stress in Patients with Inflammatory Bowel Disease and Its Relationship with Disease Activity, Psychological Disorders, and Quality of Life
Danesh, M., Gholamrezaei, A., Torkzadeh, F., Mirbagher, L., Soluki, R., & Emami, M. H. (2015) · International journal of body, mind and culture · doi:10.22122/ijbmc.v2i2.29 · Cited by 6 · see citing works
Lifestyle and psychosocial factors in inflammatory bowel disease: Prevalence, impact, motivation, and support needs
Demers, K., Hendrix, E. M. B., Ardabili, A. R., Bredero, Q. M., Bodegraven, A. A. V., van der Horst, D., Jonkers, D. M. A. E., Kimman, M., Mujagic, Z., Romberg-Camps, M. J. L., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0331092 · Cited by 6 · see citing works
Cross-Sectional Survey of Opinions, Professional Changes, and Personal Hardships of COVID-19 on Chiropractors in the United States
Neff, S. M., Deyo, R. L., Auley, A. L. M., & Lawrence, D. J. (2022) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2022.04.002 · Cited by 5 · see citing works
Effect of using the snackability app on snack quality among US college students with overweight and obesity: A randomized controlled trial
Prapkree, L., Deringer, R., Coccia, C. C., Huffman, F. G., & Palacios, C. S. (2024) · Journal of American College Health · doi:10.1080/07448481.2024.2337008 · Cited by 2 · see citing works
Empowered listening: Self-selected music’s role in uplifting emotions during stress
Fountain, C., Klibert, J., Stambaugh, L. A., Bountress, K. E., Bansal, S., & Locker, L. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1757012 · Cited by 1 · see citing works
The Impact of Stress on Resilience: Examining the Moderated Effects of a Savoring Intervention
Newman, H. L. (2019)
Snack intake among college students with overweight/obesity and its association with gender, income, stress, and availability of snacks during the COVID-19 pandemic
Baghdadi, M., Prapkree, L., Uddin, R., Jaafar, J. A. A., Sifre, N., Corea, G., Faith, J., Hernández, J., & Palacios, C. S. (2022) · American Journal of Non-Communicable Diseases · doi:10.25148/ajncd.1.1.010175
Oral and intestinal histopathological alterations in inflammatory bowel disease: correlation with clinical activity and psychosocial factors–pilot study
Lopes, D. N., de Oliveira, N. P., Marques, L. C., Augusto, K. C. D. C., Vieira, J. S. P., Dias, I. D. S. X., Pereira, B. A. S., Miguez, A. L., Magalhães, M. H., da Silva, A. K. F., et al. (2025) · Oral Surgery Oral Medicine Oral Pathology and Oral Radiology · doi:10.1016/j.oooo.2025.08.019
IBstressD: The effect of Acceptance and Commitment Therapy (ACT) on stress reduction in Inflammatory Bowel Disease (A pilot study)
Nicholenas, A., Lavelle, J., Mellotte, G. S., Harpur, L. L., Mulcahy, H. E., & McHugh, L. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100951

N001 Development of a simple stressometer to assess stress in inflammatory bowel disease patients
Keegan, D., Byrne, K., Cullen, G., Doherty, G. A., & Mulcahy, H. E. (2014) · Journal of Crohn s and Colitis · doi:10.1016/s1873-9946(14)60799-6
Fragebogen zur Messung der psychosozialen Belastungen bei chronisch-entzündlichen Darmerkrankungen (FBCED): Konstruktion und Evaluation
Petrak, F., Börner, N., Clement, T., Neurath, M. F., Wanitschke, R., Hautzinger, M., & Hoffmann, S. O. (2002) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/s-2002-34284 · Cited by 5 · see citing works
Psychosocial impairments in patients with inflammatory bowel diseases (IBD): Construction and validation of an indicator scale of perceived stress based on item response theory
Hardt, J., Conrad, S., Muche‐Borowski, C., & Raspe, H. (2011) · German Medical Science (German Research Foundation) · doi:10.3205/11gmds317
Defining the Relationship Between Clinical and Biochemical Disease Activity Indices and Perceived Stress in Inflammatory Bowel Disease
Gracie, D. J., & Ford, A. C. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.09.024 · Cited by 2 · see citing works
Epidemiology of depression and distress in patients with inflammatory bowel disease (IBD) and validation of an indicator scale of perceived stress for psychosocial impairments
Hardt, J., Conrad, S., Muche‐Borowski, C., & Raspe, H. H. (2011) · European Psychiatry · doi:10.1016/s0924-9338(11)73920-7 · Cited by 6 · see citing works

Authors: Keegan, D., Byrne, K., Cullen, G., Doherty, G. A., Dooley, B., & Mulcahy, H. E.
Affiliations: University College Dublin (IE)
ORCID: Doherty, Glen A.
Dooley, Barbara
Mulcahy, Hugh E.
Venue: Journal of Crohn s and Colitis
Publisher: Oxford University Press (OUP)
Published: 2015-07-27
Volume: 9
Issue: 10
Pages: 881-885
ISSN: 1873-9946 (ISSN-L)
1876-4479
DOI: 10.1093/ecco-jcc/jjv120
OpenAlex: W2098949784
Cited by: 19
References: 28
Citations by year: 2026: 1 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 4 · 2020: 1 · 2019: 2 · 2018: 2 · 2016: 1 · 2015: 1
FWCI: 0.91
Type: journal article
Language: en
Open access: closed
Locations: Journal of Crohn s and Colitis (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: psychological stress, inflammatory bowel disease
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Colitis, Ulcerative, Crohn Disease, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Stress, Psychological, Reproducibility of Results, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

The Stressometer: A Simple, Valid, and Responsive Measure of Psychological Stress in Inflammatory Bowel Disease Patients

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks