Symptoms Catastrophizing Versus Social Hypervigilance in Irritable Bowel Syndrome Patients

Abstract

Western studies have revealed that symptoms catastrophizing (SC), a self-focused illness coping pattern, mediates poorer health outcomes in irritable bowel syndrome (IBS) patients. In light of the collective orientation of Chinese culture, an others-focused illness coping pattern named “symptoms-related social hypervigilance” (SSH) was constructed and explored together with SC in the current study. A cross-sectional questionnaire survey with 309 IBS patients recruited by 100% consecutive sampling was conducted. Exploratory factor analysis on the SSH scale provided a 9-item 3-factor solution. The three factors were 1) Anticipating negative perceptions from others; 2) Hiding symptoms in social situations; and 3) Assuming responsibility for total symptoms control. SC showed partial mediator properties between IBS symptoms severity and lowered health-related quality of life. Whereas SSH did not show similar mediating effects, it was associated with ‘proactive’ illness behaviors which, if excessive, can lead to relentless pursuit of total symptoms elimination.

Keywords:

• illness coping strategy
• Irritable Bowel Syndrome
• catastrophizing
• social hypervigilance

Acknowledgments

The authors would like to thank Dr. Grace Wong and Dr. Joe Ching for coordinating data collection at two of the study sites; and Ms. Chang Yun-ying for her amazing patience and tactfulness in performing questionnaire surveys with hundreds of participants.