Abstract
M.A.
The disorder known as Irritable Bowel Syndrome (IBS) is a clinical conundrum. Of
chronic magnitude, this disorder of the gastrointestinal system affects up to 20% of
the population in developed countries. Yet, it remains elusive in terms of its
accurate definition and diagnosis, while its origins and etiology are unknown. To
date, clinical confirmation of this disorder is complex and uncertain, while medical
intervention has proven to be largely unsuccessful.
Symptomatology relating to IBS varies widely and is not confined to the gastrointestinal
tract. Diagnoses are made on the grounds of the manifestation of certain
physical symptoms such as constipation, diarrhoea, abdominal pain and distension
and disordered bowel habits.
The role of psychological factors in the manifestation of IBS is controversial,
although many clinicians postulate IBS to be a psychosomatic disorder due to the
presence of many concomitant psychological features such as anxiety and
depression. By all appearances, one of the most dramatic psychosocial
concomitants of IBS is stress. Research has indicated that factors such as income,
social support, life stress, psychological status, coping styles and personality all
play a role in terms of whether the disorder develops and how successfully or
adaptively the sufferer copes with his/her disorder.
In terms of a research project undertaken by the Counselling and Research Centre
for Gastroenterology under the auspices of the Department of Counselling
Psychology at the Rand Afrikaans University, an exhaustive investigation into the
physiological and psychological concomitants of IBS was conducted. As part of
this endeavour to bring IBS to the attention of the medical profession, the public at
large, and the individuals who suffer from this disorder, a number of individual
studies were undertaken by MA (Psychology) students as part of the larger project.
These researchers attempted to highlight various essential aspects associated with
IBS, the focus of which included psychopathological features, stress, abuse, coping
styles and strategies, defence mechanisms, personality factors and eating
disorders. A second phase of this research project is currently in operation in order
to provide remediation in the form of psychotherapy and stress management to the
subjects who participated in the initial research project.
The focus of the present treatise aims to provide an all-encompassing integration
of the various research studies referred to above. Thereafter, on the basis of the
data obtained from these studies, attention turns to the identification of a
psychological profile with respect to the typical patient suffering from IBS.
In accordance with the scientific demands of psychosocial research, a thorough
review of the literature and various theoretical explanations of IBS were conducted
as part of the integrative process. A number of theoretical models were
considered in terms of their application to IBS, including the Digestive Disease
model; the Psychiatric model; the Psychophysiological model; a Behavioural
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model; a Biopsychosocial model and a relatively recent newcomer, the
Salutogenic Orientation proposed by Antonovsky, that offers an unusual approach
to health and disease.
In terms of the psychological profile mentioned above, the data demonstrated
interesting findings. It was ascertained that the large majority of IBS patients are
women, a finding that has been internationally verified. These women tend to be
married with children, well-educated and employed on a full-time basis.
The emotional status of the typical IBS patient reflects varying degrees of
psychopathological tendencies, while her interpersonal relationships are
characteristically unstable. Demonstrating high stress levels, the IBS patient tends
to utilize inadequate coping skills, while these women also report using a
maladapative defence mechanism to cope with the difficulties of their lives.
Furthermore, personality traits such as introversion and neuroticism have been
observed in these women. Lastly, it has been noted that the typical IBS patient
exhibits certain aberrant eating patterns that are characteristic of women who
are diagnosed as anorexic and/or bulimic.
The IBS patient experiences her physical symptoms as severely disruptive and
debilitating. Living in a very stressful and demanding world, she is lonely and
isolated and shows the tendency to somatize her problems in the form of a disorder
that is neither life-threatening, nor results in other more serious diseases, but which
causes major distress in her life.