The longitudinal effects of emotion regulation on physical and psychological health: a latent growth analysis exploring the role of cognitive fusion in inflammatory bowel disease
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OBJECTIVE: This study thus aims to test differences between patients with inflammatory bowel disease (IBD) regarding IBD symptomatology, cognitive fusion, and psychological and physical health, as well as to explore whether the maladaptive emotion regulation process of cognitive fusion longitudinally impacts on the baseline and evolution of these outcomes over a period of 18 months. DESIGN AND METHODS: Participants include 116 IBD patients with a mean age of 36.76 (SD = 11.39) of both genders (69.83% females) that completed the self-report measures of interest in three different times, equally spaced 9 months apart, over a period of 18 months. Latent growth curve models were conducted using structural equation modelling to estimate the growth trajectory of the variables in study. RESULTS: Inflammatory bowel disease symptomatology and cognitive fusion's levels were negatively associated with psychological health and physical health's baseline levels. Furthermore, IBD symptomatology did not influence the growth of psychological health, while cognitive fusion did (β = .30, p = .007). The same result was found for physical health (β = .26, p = .024). These findings indicate that individuals with higher levels of cognitive fusion present lower levels of psychological health and physical health that tend to further decrease over the time through the effects of this maladaptive emotion regulation process. CONCLUSIONS: This study implies that it is of crucial importance to include psychotherapeutic interventions in the health care of patients with IBD. If successful, these interventions could represent decreases in the cost of IBD treatment and in the use of drugs with adverse side effects, in addition to improving patients' mental health and quality of life. Further implications for clinical and research work are discussed. Statement of contribution What is already known on this subject? Research has demonstrated the impact of emotion regulation on both physical and mental health. Nevertheless, the longitudinal effects of the specific emotion regulation process of cognitive fusion on physical and psychological health have never been explored. Additionally, no study has yet examined the causal role of emotion regulation in evolution of physical health in inflammatory bowel disease (IBD). What does this study add? Cognitive fusion longitudinally impacted on IBD patients' physical and mental health. These variables were measured over a period of 18 months. Treatment for IBD should include interventions aiming to diminish maladaptive emotion regulation.
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Third-wave cognitive and behavioural therapies have been suggested as particularly pertinent in populations with illness.
“Third-wave cognitive and behavioural therapies (CBT) (e.g., Mindfulness-Based Interventions, Acceptance and Commitment Therapy [ACT], and Compassion Focused Therapy [CFT]). have been suggested as particularly pertinent in populations with illness (Graham et al., 2016; Ferreira et al., 2018; Trindade et al., 2018).”
From Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease: the LIFEwithIBD intervention (2024) · cites this paper as Trindade et al., 2018
The Discussion (page not provided) suggests that ACT-based interventions would probably help patients with inflammatory bowel disease if the study’s findings are corroborated. That supports the claim for one therapy and one illness population, but the paper does not extend the suggestion to mindfulness-based or compassion-focused therapies, or to illness populations generally. (LLM, conf=0.85)
Experimental — accuracy not yet measuredCognitive fusion is negatively associated with psychological and physical health in IBD and mediates the relationship between chronic-illness-related stigma and psychological quality of life.
“For example, the ACT process of cognitive fusion—the tendency to perceive and act on thoughts through a context of literality—has been observed to be negatively associated with psychological and physical health in IBD and mediates the relationship between chronic-illness-related stigma and psychological QoL [31,32].”
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 [31]
The Predicting change and Physical health sections report that higher cognitive fusion was associated with lower psychological and physical health in patients with IBD. The paper does not report that cognitive fusion mediates a relationship between chronic-illness-related stigma and psychological quality of life; its models examine IBD symptomatology and cognitive fusion instead. The indexed passages provide section labels but no page numbers. (LLM, conf=0.88)
Experimental — accuracy not yet measuredChanges in cognitive fusion, rather than IBD symptomatology, predicted improvements in psychological health.
“Moreover, changes in cognitive fusion rather than IBD symptomatology predicted improvements in psychological health.”
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 [31]
The ‘Predicting change’ section reports that cognitive fusion predicted the rate of change in psychological health, whereas IBD symptomatology did not. But the study tested cognitive-fusion levels as a predictor, not changes in cognitive fusion; the ‘Discussion’ describes higher fusion as predicting further decline in psychological health, not improvement. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredInitial evidence suggests ACT may be an appropriate intervention to target psychological suffering in people with an IBD diagnosis.
“Initial evidence suggests ACT may be an appropriate intervention to target psychological suffering in people with an IBD diagnosis.”
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- Authors
- Trindade, I. A., Ferreira, C., & Pinto‐Gouveia, J.
- Affiliations
- University of Coimbra (PT)
- Corresponding author
- Trindade, Inês A.
- Venue
- British Journal of Health Psychology
- Publisher
- Wiley
- Published
- 2017-10-04
- Volume
- 23
- Issue
- 1
- Pages
- 171-185
- ISSN
- 1359-107X (ISSN-L)
- 2044-8287
- OpenAlex
- W2763310251
- Cited by
- 35
- References
- 44
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 4
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- British Journal of Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
- Funders
- Fundação para a Ciência e a Tecnologia (SFRH/BD/101906/2014)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- cognitive fusion, emotion regulation, inflammatory bowel disease, mental health, physical health, maladaptive emotion regulation, longitudinal trajectories, psychotherapeutic interventions, quality of life
- MeSH terms
- Adolescent, Adult, Aged, Cognition, Emotions, Female, Health Status, Humans, Internal-External Control, Male, Middle Aged, Quality of Life, Inflammatory Bowel Diseases, Young Adult, Self Report
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