Trindade Inês A, Ferreira Cláudia, Moura-Ramos Mariana, Pinto-Gouveia José
CINEICC-Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal.
Int J Colorectal Dis. 2017 May;32(5):651-660. doi: 10.1007/s00384-017-2774-z. Epub 2017 Feb 9.
Depressive symptomatology in IBD patients is known to predict disease activity, which, in turn, can increase depressive symptoms in perpetuating a cycle between depression and IBD symptomatology. The mechanisms that contribute to the relationship between disease activity and depressive symptoms are not clearly investigated yet. Since emotion regulation has been considered particularly relevant to define the impact of adverse experiences on different outcomes, the current study aimed to examine the longitudinal influence of two maladaptive emotion regulation processes, cognitive fusion and brooding, on the association between disease activity and depressed mood.
This study was conducted over an 18-month period, using a sample of 116 IBD patients that completed self-report validated measures in three different waves. Correlation analyses and cross-lagged panel models were performed.
The main result from this study discovered that the experience of IBD symptomatology at baseline, although positively linked to the manifestation of depressed mood 18 months later (r = 0.25; p < 0.01), does not directly predict depressive symptoms. This relationship is rather indirect, as it is explained by the engagement in cognitive fusion (p = 0.028) and brooding (p = 0.017). These maladaptive emotion regulation processes, that were revealed to be consistent over time, link IBD symptoms with subsequent depressed mood.
These findings indicate that clinicians should be aware of the emotion regulation processes patients tend to use to handle difficult experiences. The inclusion of psychological assessments and interventions in the healthcare of IBD patients should be seriously considered. Further implications are discussed.
已知炎症性肠病(IBD)患者的抑郁症状可预测疾病活动,而疾病活动反过来又会增加抑郁症状,从而在抑郁与IBD症状之间形成恶性循环。疾病活动与抑郁症状之间关系的机制尚未得到明确研究。由于情绪调节被认为与确定不良经历对不同结果的影响特别相关,因此本研究旨在探讨两种适应不良的情绪调节过程,即认知融合和沉思,对疾病活动与抑郁情绪之间关联的纵向影响。
本研究为期18个月,样本为116名IBD患者,他们分三次完成了自我报告验证测量。进行了相关分析和交叉滞后面板模型分析。
本研究的主要结果发现,基线时的IBD症状体验虽然与18个月后的抑郁情绪表现呈正相关(r = 0.25;p < 0.01),但并不能直接预测抑郁症状。这种关系相当间接,因为它是由认知融合(p = 0.028)和沉思(p = 0.017)所解释的。这些适应不良的情绪调节过程在时间上是一致的,它们将IBD症状与随后的抑郁情绪联系起来。
这些发现表明临床医生应意识到患者倾向于用来应对困难经历的情绪调节过程。应认真考虑在IBD患者的医疗保健中纳入心理评估和干预措施。还讨论了进一步的影响。