Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations

Abstract

Irritable bowel syndrome (IBS) is a prevalent functional disorder characterized by abdominal pain and hypervigilance to gastrointestinal sensations. We hypothesized that mindfulness training (MT), which promotes nonreactive awareness of emotional and sensory experience, may target underlying mechanisms of IBS including affective pain processing and catastrophic appraisals of gastrointestinal sensations. Seventy five female IBS patients were randomly assigned to participate in either 8 weeks of MT or a social support group. A theoretically grounded, multivariate path model tested therapeutic mediators of the effect of MT on IBS severity and quality of life. Results suggest that MT exerts significant therapeutic effects on IBS symptoms by promoting nonreactivity to gut-focused anxiety and catastrophic appraisals of the significance of abdominal sensations coupled with a refocusing of attention onto interoceptive data with less emotional interference. Hence, MT appears to target and ameliorate the underlying pathogenic mechanisms of IBS.

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Acknowledgments

The authors gratefully acknowledge funding support for this trial from the National Institutes of Health, National Center for Complementary and Alternative Medicine Grant # R21AT003619 and Grant # T32AT003378 from the National Center for Complementary and Alternative Medicine, as well as the National Institutes of Health, National Institute of Diabetes, Digestive and Kidney Disease (NIDDK) grant #s R24 DK067674 and R01 DK031369. The first author acknowledges support from National Institute on Drug Abuse grant # R03 DA032517 in preparing this manuscript.

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Correspondence to Eric L. Garland.

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Garland, E.L., Gaylord, S.A., Palsson, O. et al. Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med 35, 591–602 (2012). https://doi.org/10.1007/s10865-011-9391-z

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Keywords

  • Mindfulness
  • Irritable bowel syndrome
  • Pain
  • Therapeutic mechanisms
  • Path analysis
  • Interoception