Relationship Between Cognitive Factors and Anxiety in Individuals with Irritable Bowel Syndrome

Individuals with irritable bowel syndrome (IBS) have high anxiety. There is insufficient information about the relationships between concrete cognitive contents and anxiety in IBS. The present study investigated the relationship between cognitive factors and anxiety in individuals with IBS. The participants were 1,087 college students (male, 506; female, 576; unidentified, 5; age, 19.72 +/- 1.76 years) who completed a set of questionnaires that included the Rome II Modular Questionnaire (based on diagnostic criteria for IBS), Anxiety Sensitivity Index (ASI), Cognitive Appraisal Rating Scale (CARS; subscales: commitment, appraisal of effect, appraisal of threat, and controllability) for measuring symptom-related cognition, an item about attention to abdominal symptoms, the Hospital Anxiety and Depression Scale-Anxiety Scale (HADS-A), and an item regarding the presence of avoidant behavior due to anxiety of IBS symptoms. The participants included 881 individuals without IBS and 206 individuals with IBS. Individuals with IBS had higher ASI and HADS-A scores than those of the individuals belonging to the control group (p < 0.001). Subscale scores of CARS (except those of controllability and attention to IBS symptoms) significantly correlated with the ASI and HADS-A scores (p < 0.01). Individuals with IBS and avoidant behavior had higher subscale scores of CARS (except those of controllability and attention to IBS symptoms) and higher HADS-A scores (p < 0.05). The hypothetical models containing ASI scores, subscale scores of CARS (except those of controllability), and HADS-A scores with and without attention to IBS symptoms exhibited a good fit. Severe anxiety sensitivity in individuals with IBS related to their symptom-related cognition, and the altered cognition increases anxiety, leading to the possible development of a disabling condition.