Abstract
M.A.
Although the irritable bowel syndrome (IBS) is one of the most common conditions
referred to gastroenterologists in the developed world, it remains one of the least
understood and hence most enigmatic of the functional gastrointestinal (GI) conditions,
which are disorders without identifiable structural and organic abnormalities. The more
common names of IBS include "spastic colitis", "spastic colon" and "irritable colon",
which highlight the most salient complaints of sufferers ranging from abdominal pain,
bloating or distension, through to various symptoms of disordered defecation.
The functional gastrointestinal disorders (GI) represent one of the greatest challenges
for behavioural medicine for various reasons. Firstly, they are one of the many chronic
disorders that accounts for more than half of all health problems in the developed world.
Secondly, their causes, development and treatments are poorly understood; and thirdly,
there is clearly a need for psychologically informed services. However, IBS can be
conceptualized as a disorder that lends itself imminently to reinterpretation away from
the biomedical model towards a more biopsychosocial paradigm, which conceptualizes
the development of IBS to be a multicausal, complex process where both physiological
and psychosocial processes are operative.
According to Drossman and other gastroenterologists (Drossman et al., 1994) working
within the biopsychosocial model, psychosocial mechanisms like the influence of culture,
family, personality, health behaviours, life stressors and coping mechanisms act as
modulators of biological states. These modulating or mediating factors shape symptom
severity, medication use and healthcare seeking or illness behaviour and ultimately
determine the individual's so called Health Related Quality of Life (HRQOL). Of these
mediating factors, this study seeks to investigate the role that personality and health
behaviours may play in IBS, given that the personality-gut relationship represents the
ideal interface for the study of the mind-body link.
Although past research suggests a strong role for personality influencing vulnerability to
illness and illness progression, as well as health and health promotion (Booth-Kewley &
Friedman, 1987; Marshal et al., 1994; Matthew & Haynes, 1986), the exact nature of this relationship has not yet been determined. However, based on Friedman's (1991)
suggestion that personality operates through two routes, an internal route that links to
stress and emotional dysfunction, and an external behavioural route, linked to personal
lifestyle and habits of living, this study seeks to investigate whether certain personality
dimensions and certain health behaviours can be associated with IBS. If any association
can be discerned, then understanding the impact of personality through these two routes
has enormous practical value for IBS sufferers.