Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations

• Published in: Journal of behavioral medicine Vol. 35; no. 6; pp. 591 - 602
• Main Authors: Garland, Eric L., Gaylord, Susan A., Palsson, Olafur, Faurot, Keturah, Douglas Mann, J., Whitehead, William E.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.12.2012; Springer; Springer Nature B.V
• Subjects: Abdomen; Adolescent; Adult; Affect; Aged; Anxiety - complications; Anxiety - therapy; Attention; Awareness; Care and treatment; Catastrophic reactions; Catastrophization - complications; Catastrophization - therapy; Cognition & reasoning; Complications and side effects; Consciousness; Development and progression; Emotions; Family Medicine; Female; Females; General Practice; Health Psychology; Humans; Hypnosis; Irritable bowel syndrome; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - therapy; Medicine; Medicine & Public Health; Middle Aged; Mindfulness; Motility; Pain; Pain Management - psychology; Path analysis; Patients; Quality of Life; Quality of Life - psychology; Risk factors; Severity of Illness Index; Social Support; Support groups; Symptoms; Training; Young Adult; United States; United States > US; Path analysis; Pain; Therapeutic mechanisms; Interoception; Mindfulness; Irritable bowel syndrome
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-011-9391-z

Irritable bowel syndrome (IBS) is a prevalent functional disorder characterized by abdominal pain and hypervigilance to gastrointestinal sensations. We hypothesized that mindfulness training (MT), which promotes nonreactive awareness of emotional and sensory experience, may target underlying mechanisms of IBS including affective pain processing and catastrophic appraisals of gastrointestinal sensations. Seventy five female IBS patients were randomly assigned to participate in either 8 weeks of MT or a social support group. A theoretically grounded, multivariate path model tested therapeutic mediators of the effect of MT on IBS severity and quality of life. Results suggest that MT exerts significant therapeutic effects on IBS symptoms by promoting nonreactivity to gut-focused anxiety and catastrophic appraisals of the significance of abdominal sensations coupled with a refocusing of attention onto interoceptive data with less emotional interference. Hence, MT appears to target and ameliorate the underlying pathogenic mechanisms of IBS.