Positive Psychological Constructs and Irritable Bowel Syndrome: A Qualitative Study

Elizabeth Madva, MD

Massachusetts General Hospital
Positive Psychological Constructs and Irritable Bowel Syndrome: A Qualitative Study

Scientific Abstract

Background: Irritable bowel syndrome (IBS) is a highly prevalent condition associated with reduced health-related quality of life (HRQoL). Existing behavioral health interventions for IBS fail to target positive psychological and well-being constructs (e.g., optimism), which are deficient in IBS and associated with superior HRQoL in medical populations. Accordingly, we are performing a qualitative study to assess positive emotional state deficits and their connections to HRQoL, health behavior participation, and health outcomes in patients with IBS in order to inform the development of an IBS- specific behavioral health intervention.

Methods: Participants with IBS will complete semistructured phone interviews and a series of questionnaires about associations between positive psychological constructs, HRQoL, health behaviors (e.g., physical activity, medication and diet adherence) and perceptions about benefits, motivation, and barriers to health behavior participation. Interviews will be recorded, transcribed, and independently coded by two team members with NVivo 12 software, with a goal reliability of K > 0.80. We will use directed content analysis, such that a conceptual model will inform the initial coding tree structure.

Multiple regression analyses and t-tests will be performed to test the relationship between IBS symptoms, HRQoL, overall function, health behavior engagement, and positive psychological characteristics.

Results: Recruitment is ongoing. Initial interviews (n=6) suggest that engaging in health behaviors is associated with feelings of gratitude, energy, pride, and determination. These positive psychological states are in turn associated with improved HRQoL. Perceived benefits, facilitators, and modifiable barriers to health behavior participation are being described.

Conclusions: Participants with IBS describe many specific positive psychological constructs that both promote and result from health behavior participation. An intervention to increase positive psychological constructs may be a novel way to improve HRQoL and downstream health outcomes in IBS.

research Areas


Elizabeth N Madva, MD, Regina M Longley, BA, Helen Burton Murray, PhD, Kyle Staller, MD, MPH, Braden Kuo, MD, Jeff C Huffman, MD, Christopher M Celano, MD.

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