Investigating the role of psychological flexibility and the use of an acceptance and commitment therapy based intervention in irritable bowel syndrome
dc.contributor.advisor
Gillanders, David
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dc.contributor.advisor
Morris, Paul
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dc.contributor.advisor
Eugenicos, Maria
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dc.contributor.author
Ferreira, Nuno Monteiro Da Rocha Bravo
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dc.contributor.sponsor
Fundação para a Ciência e Tecnologia (Portugal)
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dc.date.accessioned
2012-08-22T13:38:56Z
dc.date.available
2012-08-22T13:38:56Z
dc.date.issued
2011-11-25
dc.description.abstract
Irritable Bowel Syndrome (IBS) is a common chronic illness thought to be originated
and maintained by a combination of physiological, psychological and social factors.
IBS is known to be associated with a high psychosocial impact on patients’ lives.
Acceptance and Commitment Therapy (ACT) is an emerging model of
conceptualization and treatment that states that most suffering in chronic illness can
be explained by a lack of psychological flexibility or acceptance to experience
aversive bodily sensations, thoughts or emotions. ACT treatments target the increase
of psychological flexibility as a key change for improvement in outcomes. Recent
studies suggest that ACT could not only be an effective alternative treatment for IBS,
as it might provide a valuable model of understanding of the relations between the
different factors related to this condition and its outcomes. The first aim of the
present research was to investigate the role of psychological flexibility in IBS, in
particular, how acceptance relates to psychological, emotional and physical factors in
this condition. The second aim was to investigate the effectiveness of an ACT based
intervention in increasing psychological flexibility in IBS and thereby improving IBS
Outcomes.
These aims were addressed by conducting two related studies. In Study 1, a sample
of 121 IBS patients attending a specialized gastroenterology clinic completed a series
of self-report measures of psychological flexibility (acceptance), psychological
factors known to be associated with IBS and IBS outcomes. Results indicated that higher levels of acceptance were generally associated with and predicted better levels
of IBS biopsychosocial factors. Results also showed that acceptance mediated most
of the relationships between IBS predictors and Outcomes. Also, psychometric
analyses of a novel measure of IBS Acceptance (i.e. IBS Acceptance and Action
Questionnaire) created for this study demonstrated that it had good reliability and
validity. In Study 2, fifty six IBS patients enrolled in an intervention involving a one
day ACT workshop and an ACT based self-help workbook. Thirty six participants
provided follow-up data up to 6 months after the workshop. Results indicated that
there were significant increases in acceptance and significant improvement in IBS
outcomes between pre-treatment and follow-up. Further to that, analyses indicated
that changes in IBS Outcomes occurred through changes in acceptance as
hypothesized by the ACT model.
These studies suggest that psychological flexibility processes are important in the
understanding of IBS and that improvement in this condition may result from a more
psychologically flexible stance to it. Although preliminary, these studies provide a
basis for the further development and application of the ACT model of
conceptualization and treatment in IBS.
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dc.identifier.uri
http://hdl.handle.net/1842/6312
dc.language.iso
en
dc.publisher
The University of Edinburgh
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dc.relation.hasversion
Ferreira, N. B., Eugenicos, M., Morris, P., Gillanders, D. "Acceptance of irritable bowel syndrome as a mediator between anxiety and outcomes in irritable bowel syndrome (IBS)‖. Gut, UEGW abstracts Supplement, A139.
en
dc.relation.hasversion
Ferreira, N. B., Eugenicos, M., Morris, P., Gillanders, D. "The role of Illness Perceptions and Acceptance in Outcomes of Irritable Bowel Syndrome". Psychology and Health, Volume 25, Supl.1, pp15-100
en
dc.relation.hasversion
Ferreira, N. B., Eugenicos, M., Morris, P., Gillanders, D. ―The role of Acceptance in Quality of Life and Symptom Severity of Irritable Bowel Syndrome patients‖. Journal of Psychosomatic Research, Vol.68, Iss.6, p.625
en
dc.relation.hasversion
Ferreira, N. B., Eugenicos, M., Morris, P., Gillanders, D. ―Acceptance: a predictor factor in Irritable Bowel Syndrome (IBS)‖. Gut, Vol. 59, suppl. 1.
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dc.subject
Irritable Bowel Syndrome
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dc.subject
IBS
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dc.subject
acceptance
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dc.subject
acceptance and commitment therapy
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dc.title
Investigating the role of psychological flexibility and the use of an acceptance and commitment therapy based intervention in irritable bowel syndrome
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dc.type
Thesis or Dissertation
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dc.type.qualificationlevel
Doctoral
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dc.type.qualificationname
PhD Doctor of Philosophy
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