Examining interactions of illness perceptions, avoidance behavior and patient status in predicting quality of life among people with irritable bowel syndrome

Figures & data

Table 1. Situations and activities that participants reported avoiding due to their IBS symptoms.

Reportedly avoided situation or activity	n (%)
Leisure time activities	64 (52)
Social situations	53 (43)
Places or situations with unknown access to the bathroom	37 (30)
Eating in public	27 (22)
Transport or traveling	21 (17)
Work or school	6 (5)
Romantic relationships	2 (2)

Table 2. Means and standard deviations of included variables, as well as correlations between them.

Variables	M	SD	1	2	3	4	5	6	7	8	9	10	11	12
1. IBS-Qol	32.3	19.78	-
2. Avoidance behavior	34.4	1.49	0.76***
3. Depressive reactions (UCL)	11.8	0.20	0.50***	0.36***
4. Palliative reactions (UCL)	14.1	0.21	0.12	0.08	0.06
5. Avoidance (UCL)	17.6	0.24	0.33**	0.31***	0.43***	0.20**
6. Timeline	22.6	4.15	0.34***	0.38***	0.06	0.11	0.15*
7. Timecycle	14.8	3.08	−0.03	−0.01	0.00	0.05	0.08	0.05
8. Consequences	18.1	5.03	0.66***	0.64***	0.44***	−0.02	0.27***	0.31***	0.02
9. Personal control	17.2	3.61	−0.18**	−0.20**	−0.04	0.04	−0.027	−0.242***	0.09	−0.186
10. Treatment control	14.2	3.30	−0.17*	−0.24***	−0.03	0.08	−0.03	−0.421***	−0.02	−0.118	0.35***
11. Illness coherence	14.8	4.09	−0.32***	−0.21**	−0.25***	0.05	−0.13	−0.004	−0.26***	−0.38***	0.26***	0.08
12. Emotional representations	17.5	4.98	0.66***	0.49***	0.49***	0.08	0.23***	0.10	0.01	0.64***	−0.07	−0.05	−0.4***

*p < 0.05 **p < 0.01 ***p <0.001.

Figure 1. Full mediation model including all variables under study. Solid lines indicate significant paths and dotted lines indicate insignificant paths.

A mediation diagram with gray boxes and lines showing the relationships between illness perceptions, avoidance behaviors and quality of life. Insignificant relationships are shown as thing gray lines and significant relationships are show in thicker black lines.

Figure 2. Simplified mediation analyses, which exclude variables not significantly related to quality of life. Models are presented separately for participants who reported seeking treatment for their IBS symptoms (Panel B), and for participants who did not report seeking treatment for their IBS symptoms (Panel A). Solid lines indicate significant indirect paths and dotted lines indicate insignificant indirect paths.

A two section moderated mediation diagram with gray boxes and lines showing the indirect effects from illness perceptions through avoidance behaviors to quality of life for patients who seek treatment and for patients who do not seek treatment. Insignificant relationships are shown as dotted lines and significant relationships are show in black lines.

Table 3. Results of simplified moderated mediation models.

Moderator	IV	a path	95% C.I.	Mediator	b path	95% C.I.	DV	ab path	95% C.I.
Treatment-seeking	Consequences	2.12***	1.45–2.79	Avoidance behavior	0.37***	0.28–0.45	IBS – QoL	0.78***	0.47–1.08
	Consequences	0.14*	0.03–0.25	Depressive reactions	0.095***	0.44–1.47	IBS – QoL	0.13*	0.01–0.26
	Emotional representations	1.08***	0.47–1.72	Avoidance behavior	0.37***	0.28–0.45	IBS – QoL	0.40**	0.15–0.65
	Emotional representations	0.26***	0.15–0.36	Depressive reactions	0.095***	0.44–1.47	IBS – QoL	0.24**	0.08–0.41
	Timeline	1.51***	0.83–2.19	Avoidance behavior	0.37***	0.28–0.45	IBS – QoL	0.55***	0.27–0.83
	Timeline	0.02	−0.09–0.13	Depressive reactions	0.095***	0.44–1.47	IBS – QoL	0.02	−0.08–0.13
Not seeking treatment	Consequences	2.26**	0.88–3.64	Avoidance behavior	0.28***	0.20–0.38	IBS – QoL	0.64*	0.21–1.08
	Consequences	0.18	−0.04–0.41	Depressive reactions	0.75**	0.23–1.26	IBS – QoL	0.14	−0.05–0.33
	Emotional representations	0.02	−1.39–1.43	Avoidance behavior	0.28***	0.20–0.38	IBS – QoL	0.01	−0.40–0.41
	Emotional representations	0.17	−0.06–0.40	Depressive reactions	0.75**	0.23–1.26	IBS – QoL	0.13	−0.06–0.32
	Timeline	0.65	−0.35–0.00	Avoidance behavior	0.28***	0.20–0.38	IBS – QoL	0.19	−0.13–0.50
	Timeline	−0.18	−0.45–1.76	Depressive reactions	0.75**	0.23–1.26	IBS – QoL	−0.13	−0.29–0.03

* p < 0.05 **p < 0.01 *** p < 0.001.

Data availability statement

All data and syntax are available from the project’s Open Science Framework page (https://osf.io/cwkfq)