News & Perspectives

Coping Style Affects Course Of Gastrointestinal Disorders

What The Study Showed
How It Was Done
Why It's Important

What The Study Showed
Poor coping skills in life (such as tending to think the worst will always happen) were linked to increased stomach upset in the women who were recruited for this 2000 study done at the University of North Carolina. The findings were published in the journal Psychosomatic Medicine.

How It Was Done
Investigators recruited 239 female patients from the university's gastroenterology clinic. All were seeking treatment for gastrointestinal disorders, such as Crohn's disease, ulcerative colitis, and irritable bowel syndrome (IBS).

At the start of the 12-month study, the women filled out a series of questionnaires detailing their medical history. They were also interviewed in depth about their gastrointestinal (GI) symptoms and any history of physical or sexual abuse--both types of traumatic events that have been linked to stomach problems.

In addition, the patients were closely questioned about their coping style. For example, if their disease symptoms were to worsen, were they likely to deny the problem or attempt to actively solve it? How did they deal with chronic pain? By worrying that it would never end, for example?

Over the course of the study, the participants periodically answered additional questionnaires designed to assess their level of psychological distress and quality of life. The development of new or altered symptoms were also recorded, as were the number of visits to doctors, clinics, and hospitals.

Results were based on the 174 patients who completed the study.

Why It's Important
This well-designed study provides women with gastrointestinal ailments some new and important information about the types of coping strategies that might benefit their health. Clearly, the better one's coping skills, the better the overall prognosis is for painful inflammatory GI disorders such as Crohn's disease.

In this study, patients with coping skills rated as "poor" (described as a tendency to catastrophize or feel powerless to alleviate one's symptoms) were more likely to be depressed and at risk for worsening overall health. Regardless of the severity of their disease at the start of the study, these "poor" copers experienced more psychological distress and ultimately made more visits to the doctor and spent more time laid up in bed.

On the bright side, patients with "good" coping skills fared quite well over the course of the year-long study, making increasingly fewer visits to health-care providers and experiencing far less psychological distress and pain.

Effective coping skills included focusing on problems one by one and finding ways to tackle each independently. Put another way, breaking complaints down into individual "problems" helped the patient avoid the sensation of being overwhelmed. In addition, effective coping skills also entailed trying to change the stressor by seeking social support, for example, or re-evaluating the stressful event and putting it into proper context.

Source: Drossman DA, et al. Effects of coping on health outcome among women with gastrointestinal disorders. Psychosomatic Medicine 2000;62:309-317.

Date Published: 03/19/2001
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