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Is the association between irritable bowel syndrome and abuse explained by neuroticism? A population based study
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Background —In outpatients and the community, an association between abuse (particularly sexual abuse) and irritable bowel syndrome (IBS) has been observed, but whether there is a causal link continues to be disputed. Aims —To test the hypothesis that psychological factors explain the apparent association between abuse and IBS. Methods —A sample of residents of Penrith (a Sydney suburb sociodemographically similar to the Australian population) selected randomly from the electoral rolls (that by law include the entire population of age 18 years and above) was mailed a validated self report questionnaire. Measured were gastrointestinal (GI) symptoms including the Rome criteria for IBS, abuse (including the standardised Drossman questions), neuroticism (Eysenck Personality Questionnaire), and psychological morbidity (General Health Questionnaire). Results —The response rate was 64% (n=730); 12% fulfilled the Rome criteria for IBS. Overall abuse in childhood (odds ratio (OR)=2.02, 95% confidence interval (CI) 1.29 to 3.15) but not adulthood (OR=1.39, 95% CI 0.88 to 2.19) was associazted with IBS univariately. Neuroticism and psychological morbidity were also univariately associated with abuse in childhood, abuse in adulthood, and IBS, respectively. However, by logistic regression, abuse in childhood was not associated with IBS after controlling for age, gender, and psychological factors (OR=1.34, 95% CI 0.83 to 2.17). The results were not altered by restricting the analyses to more severe forms of abuse, and were not explained by interactions between abuse and psychological variables. Conclusion —There is an association between abuse and IBS in the community, but this may be explained in part by other psychological factors. Based on a path analysis, we postulate that abuse may induce the expression of neuroticism that in turn leads to IBS.
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“In contrast, more recent population studies (42–45) have suggested that the earlier volunteer non-population-based studies may have been biased, but this view is still controversial (16).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [44]
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“The association between IBS and abuse was largely mediated by psychological factors in a population-based study.(3) A history of sexual or physical abuse is linked to more severe pain, lower quality of life, and higher levels of extraintestinal symptoms in IBS.”
BackgroundGupta, A., Labus, J. S., Kilpatrick, L. A., Bonyadi, M., Ashe-McNalley, C., Heendeniya, N., Bradesi, S., Chang, L., & Mayer, E. A. (2015) · Brain Structure and Function · doi:10.1007/s00429-015-0996-9 · Cited by 36
“More recently, significant structural differences between female IBS patients compared to female HCs have shown significant decrease in sgACC thickness, with positive correlations with IBS symptom severity (Jiang et al. 2013).”
InfluentialLow, E. X. S., Mandhari, M. N. K., Herndon, C. C., Loo, E. X. L., Tham, E. H., & Siah, K. T. H. (2020) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm20109 · Cited by 33
Towards an integrative model of irritable bowel syndrome
Naliboff, B. D., Chang, L., Munakata, J., & Mayer, E. A. (2000) · Progress in brain research · doi:10.1016/s0079-6123(08)62154-8 · Cited by 31
Joshee, S. R., Lim, L., Wybrecht, A., Berriesford, R., & Riddle, M. S. (2022) · Journal of Investigative Medicine · doi:10.1136/jim-2021-002109 · Cited by 32
Sansone, R. A., & Sansone, L. A. (2015) · Europe PMC (PubMed Central) · Cited by 30
The role of childhood trauma in chronic pain and fatigue
Luyten, P. (2008) · Routledge eBooks · doi:10.4324/9780203885017-8 · Cited by 30
Tursz, A. (2013) · Revue française des affaires sociales · doi:10.3917/rfas.125.0032 · Cited by 28
Choudhury, B. K., Shi, X.-Z. P., & Sarna, S. K. (2009) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.90673.2008 · Cited by 28
“Our findings agree with the epidemiological and clinical observations that adverse stressful life experiences, such as sexual abuse and neglect, in early stages of life predispose adult humans to developing IBS after an inflammatory episode (12, 19, 44, 46).”
ResultFitzGerald, L., Kehoe, P., & Sinha, K. (2009) · Western Journal of Nursing Research · doi:10.1177/0193945909339320 · Cited by 27
“Elevated neuroticism values seen in the current IBS-D sample are consistent with reported values in the literature (Talley et al., 1998).”
ResultPathophysiological and Psychosocial Study in Patients With Functional Vomiting
Zhao, Y., Ke, M., Wang, Z., Wei, J., Zhu, L., Sun, X., & Zhang, J. (2010) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2010.16.3.274 · Cited by 26
“Abuse may induce the expression of abnormal personality traits that in turn leads to FGIDs.21 There was also an increased prevalence of abnormal psychological states in clinic patients with FGIDs (in our study, 83.3”
BackgroundInfluentialHypnosis for Irritable Bowel Syndrome:The Quest for the Mechanism of Action
Simrén, M. (2005) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207140500327239 · Cited by 26
“One way of explaining this is that abuse history leads to IBS via neuroticism, rather than being a direct cause ( Talley, Boyce, & Jones, 1998 ).”
BackgroundRecollection of childhood abdominal pain in adults with functional gastrointestinal disorders
Chitkara, D. K., Talley, N. J., Schleck, C. D., Zinsmeister, A. R., Shah, N. D., & Locke, G. R. (2008) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520802555975 · Cited by 26
“Childhood factors that are thought to contribute to the continuation of abdominal pain and progression of IBS include adverse psychosocial conditions [15], affluent childhood socio-economic status [16], infantile or childhood trauma [17,18], and learning to respond to physical symptoms with disability from parental re…”
BackgroundResultSelf-citationPsychosomatik viszeraler Schmerzsyndrome
Häuser, W., & Grandt, D. (2002) · Der Schmerz · doi:10.1007/s00482-002-0190-x · Cited by 25
Abuse in Women and Men with and without Functional Gastrointestinal Disorders
Ålander, T., Heimer, G. M., Svärdsudd, K., & Agréus, L. (2007) · Digestive Diseases and Sciences · doi:10.1007/s10620-007-0101-1 · Cited by 24
“[22] found abuse to be significantly associated with IBS and/or functional dyspepsia, but less important when psychosocial factors were controlled for, a finding confirmed by others [49, 50].”
BackgroundResultVenter, M. D., Illegems, J., Royen, R. V., Moorkens, G. H., Sabbe, B., & Eede, F. V. D. (2017) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2017.07.006 · Cited by 24
“to increase somatization tendencies [52].”
Rapoza, K. A., Wilson, D. T., Widmann, W. A., Riley, M. A., Robertson, T. W., Maiello, E., Villot, N., Manzella, D. J., & Ortiz-Garcia, A. L. (2014) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2014.01.009 · Cited by 23
SSRIs in IBS: sensing a dash of disappointment.
Talley, N. J. (2003) · Clinical Gastroenterology and Hepatology · doi:10.1016/s1542-3565(03)70030-5 · Cited by 22
Self-citationPsychosocial Assessment of Functional Gastrointestinal Disorders in Clinical Practice
Williams, M. J. A., Budavari, A. I., Olden, K. W., & Jones, M. P. (2005) · Journal of Clinical Gastroenterology · doi:10.1097/01.mcg.0000180637.82011.bb · Cited by 21
Self-citationPsychological Factors Affecting Functional Gastrointestinal Disorders
Porcelli, P., & Todarello, O. (2007) · KARGER eBooks · doi:10.1159/000106796 · Cited by 21
Fingerstick Helicobacter Pylori Antibody Test: Better Than Laboratory Serological Testing?
Laine, L., Knigge, K. L., Faigel, D. O., Margaret, N., Marquis, S., Vartan, G., & Fennerty, B. M. (1999) · The American Journal of Gastroenterology · doi:10.1016/s0002-9270(99)00569-9 · Cited by 21
Genes and environment in irritable bowel syndrome: one step forward
Talley, N. J. (2006) · Gut · doi:10.1136/gut.2006.108837 · Cited by 22
Self-citation
Metadata
- Authors
- Talley, N. J., Boyce, P. M., & Jones, M.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Talley, N J
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1998-01-01
- Volume
- 42
- Issue
- 1
- Pages
- 47-53
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1726948
- OpenAlex
- W2152492482
- Cited by
- 154
- References
- 37
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 3 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 9 · 2013: 4 · 2012: 5
- FWCI
- 9.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Royal Australasian College of Physicians
- University of Sydney
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- irritable bowel syndrome, childhood abuse, adult abuse, neuroticism, psychological morbidity, sexual abuse, gastrointestinal symptoms, Rome criteria, Eysenck Personality Questionnaire, General Health Questionnaire, path analysis
- MeSH terms
- Adult, Aged, Aged, 80 and over, Child, Child Abuse, Child Abuse, Sexual, Colonic Diseases, Functional, Female, Humans, Male, Middle Aged, Neurotic Disorders, Personality Disorders, Psychiatric Status Rating Scales, Surveys and Questionnaires, Violence, Logistic Models
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