A randomized clinical trial of mindfulness-based cognitive therapy for women with irritable bowel syndrome-Effects and mechanisms.

A 6-week mindfulness-based cognitive therapy adapted for irritable bowel syndrome (MBCT-IBS) reduced IBS symptoms and improved quality of life in female patients compared with a waitlist control. The therapy appeared to work by reducing maladaptive illness cognitions such as visceral anxiety sensitivity and pain catastrophizing, and by shifting self-referential processing toward less bias toward illness and greater nonjudgmental awareness.

Study at a glance

Abstract

OBJECTIVE Irritable bowel syndrome (IBS) is a chronic disorder of brain-gut interaction. Previous studies suggest that mindfulness could be therapeutic for IBS patients, however no study has evaluated the effects of mindfulness-based cognitive therapy adapted for patients with IBS (MBCT-IBS). A 6-week MBCT-IBS course was designed to reduce symptoms and increase quality of life. This study aimed to evaluate the effects of MBCT-IBS and to investigate its therapeutic mechanisms in a randomized controlled trial. METHOD Sixty-seven female patients with IBS were randomized to MBCT-IBS (MG; n = 36) or a waitlist (WL; n = 31) control condition. Patients completed standardized self-report measures of IBS symptom severity, IBS quality of life, maladaptive illness cognitions (catastrophizing, visceral anxiety sensitivity) and mindfulness at baseline, after 2 treatment sessions, at posttreatment, and at 6-week follow-up. Self-referential processing of illness and health was measured with an implicit association test (IAT). RESULTS The MG reported significantly greater reductions in IBS symptoms (p = .003) and improvements in quality of life (p < .001) at follow-up compared with the WL. Changes in visceral anxiety sensitivity and pain catastrophizing at posttreatment and reductions in the IAT-score after 2 sessions combined with increases in nonjudgmental awareness at posttreatment mediated reductions in IBS symptoms. CONCLUSIONS MBCT-IBS has the potential to reduce IBS symptoms and increase quality of life. MBCT-IBS may exert its effect on IBS symptoms via reducing maladaptive illness cognitions and activating changes in self-processing (reducing biases in self-referent processing of illness and health and increasing nonjudgmental awareness). (PsycINFO Database Record (c) 2020 APA, all rights reserved).