Role of Anger and Coping Mechanisms in Patients with Irritable Bowel Syndrome

Objectives: Irritable bowel sindrome (IBS) is a painful condition associated with significant psychological distress. The etiology of this sindrome has been attributed to altered gastrointestinal motility, visceral hypersensitivity, and psychosocial factors, but most of all to the disregulation of the brain-gut axis. A number of studies have suggested that stress can lead to IBS exacerbation. The present study aimed to evaluate the experience and expression of anger and the prevalent coping mechanisms in a group of patients with irritable bowel sindrome. Methods: The study was a cross-sectional comparison between a group of patients with IBS (N=37) and healthy subjects (N=32). IBS subjects (after an examination by a gastroenterologist and a total colonoscopy) and healthy subjects underwent a clinical interview and psychometric examination. Assessment was conducted using the State Trait Anger Expression Inventory second edition and Brief COPE Inventory. Results: The results suggest difference in trait anger between IBS patients and healthy controls (p=0,04). Regarding state anger, no significant differences were documented. When considering the different coping mechanisms, IBS patients showed significant differences on Self Distraction (p=0,04), Active Coping (p=0,01), Substance Use (p=0,013), Venting (p=0,01), and Acceptance (p=0,034) Conclusions: IBS patients had significant higher levels of trait anger than controls. Different coping styles may influence the ability to tolerate, reduce or eliminate a source of stress such IBS related symptoms. These results suggest that future research in IBS should investigate the role of anger and coping styles plays in onset, symptom severity and outcome.