Increased Acoustic Startle Responses in IBS Patients During Abdominal and Nonabdominal Threat
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Background and Aims: Visceral hypersensitivity and symptom severity in Irritable Bowel Syndrome (IBS) are both exacerbated by stress. The eye-blink startle response represents a noninvasive measure of central defensive responding. Evidence for central hyperexcitability was studied in IBS patients by examining potentiation of the startle reflex to a nociceptive threat. Methods: Acoustic startle responses were examined in female IBS patients (n = 42) and healthy controls (n = 22) during cued periods in which an aversive abdominal or biceps stimulation was impossible (safe), possible (imminent threat) or anticipated (period just before the imminent threat), and during a threatening context (muscle stimulation pads attached but no cues for stimulation). Results: Both groups showed potentiation of startle responses during the imminent threat condition compared with both the anticipation and safe conditions. Compared with controls, IBS subjects showed significantly larger startle responses during anticipation and imminent threat conditions after receiving an initial aversive stimulation. There were no group differences during the context threat manipulation. Moreover, in IBS patients but not controls, higher neuroticism was associated with larger startle responses during safe and anticipation conditions but not imminent threat, whereas anxiety symptoms were negatively associated with startle magnitude during imminent threat. Conclusions: Female IBS patients show increased startle responses to threat of aversive stimulation at both abdominal and nonabdominal sites compared with controls. The data represent the first demonstration of altered threat potentiated startle in a functional pain condition and provide support for the use of these paradigms in further evaluation of affective mechanisms in these disorders. ASR = acoustic startle response; IBS = irritable bowel syndrome; GI = gastrointestinal; HADS = Hospital Anxiety and Depression Scales; EPQ-N = Neuroticism scale from the Eysenck Personality Questionnaire; EMG = electromyogram; EOG = electrooculogram; SS = startle stimulus; IGCM = individual growth curve modeling; ANOVA = analysis of variance; ANCOVA = analysis of covariance.
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Selective attention to visceral sensations and heightened threat appraisals may maintain IBS symptoms even without present stressors.
“Furthermore, selective attention to visceral sensations and heightened threat appraisals may maintain IBS symptoms in lieu of present stressors (Naliboff et al., 2008).”
From Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. (2012) · cites this paper as Naliboff et al., 2008
The Introduction links hypervigilance to GI sensations and symptom-specific fears with visceral hypersensitivity, which it says may underlie IBS discomfort. The Discussion links hypersensitivity to symptom generation, but does not establish that these processes maintain symptoms without present stressors; the heightened response observed in this study occurred in a threat context after aversive stimulation. (LLM, conf=0.84)
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- Authors
- Naliboff, B. D., Waters, A. M., Labus, J. S., Kilpatrick, L., Craske, M. G., Chang, L., Negoro, H., Ibrahimovic, H., Mayer, E. A., & Ornitz, E.
- Affiliations
- University of California, Los Angeles (US)
- Griffith University (AU)
- Corresponding author
- Naliboff, Bruce D.
- ORCID
- Venue
- Psychosomatic Medicine
- Published
- 2008-10
- Volume
- 70
- Issue
- 8
- Pages
- 920-927
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC4104120
- OpenAlex
- W1992385330
- Cited by
- 45
- References
- 33
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 4
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- National Institute of Nursing Research (R01NR007768, NR007768)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK085133, K08DK071626, R01DK048351, P50DK064539)
- National Center for Complementary and Integrative Health (R24AT002681)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- irritable bowel syndrome, acoustic startle response, visceral hypersensitivity, central hyperexcitability, stress, neuroticism, anxiety, abdominal pain, functional pain, blink reflex
- MeSH terms
- Abdominal Muscles, Acoustic Stimulation, Adult, Anxiety, Arousal, Blinking, Cues, Electric Stimulation, Electromyography, Electrooculography, Fear, Female, Humans, Isometric Contraction, Nociceptors, Colon, Sigmoid, Reflex, Startle, Pain Threshold, Irritable Bowel Syndrome, 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 ›
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