In a population-based study of 207 subjects with irritable bowel syndrome (IBS) or functional dyspepsia (FD) and controls (n = 100), we aimed to determine whether dimensions of abnormal illness behavior from the Abnormal Illness Behaviour Questionnaire and aspects of social learning of illness behavior from the Social Learning of Illness Behaviour scale were independent predictors of health care seeking for IBS and FD. Results showed that dimensions of abnormal illness behavior and aspects of social learning of illness behavior (encouragement, reinforcement, and modeling) did not significantly differentiate between consulters and nonconsulters with IBS and/or FD. The Disease Conviction scale (OR = 1.55; 95% CI, 1.15–2.09) of the Abnormal Illness Behaviour Questionnaire was an independent predictor of having a diagnosis of IBS and/or FD, independent of age and gender, psychiatric diagnoses, and symptom severity. We conclude that a belief in the presence of serious pathology characterizes community subjects with IBS and FD, but not health care seeking.
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1. Levy RL, Jones KR, Whitehead WE, Feld SI, Talley NJ, Corey LA: Irritable bowel syndrome in twins: Heredity and social learning both contribute to etiology. Gastroenterology 121:799–804, 2001
2. Muller-Lissner SA, Pirk O: Irritable bowel syndrome in Germany. A cost of illness study. Eur J Gastroenterol Hepatol 14:1325–1329, 2002
3. Longstreth GF, Wilson A, Knight K, Wong J, Chiou CF, Barghout V, Frech F, Ofman JJ: Irritable bowel syndrome, health care use, and costs: A US managed care perspective. Am J Gastroenterol 98:600–607, 2003
4. Sandler RS: Epidemiology of irritable bowel syndrome in the United States. Gastroenterology 99:409–415, 1990
5. Nyren O, Lindberg G, Lindstrom E, Marke LA, Seesalu R: Economic costs of functional dyspepsia. PharmacoEconomics 1:312–324, 1992
6. Talley NJ, Gabriel SE, Harmsen WS, Zinsmeister AR, Evans RW: Medical costs in community subjects with irritable bowel syndrome. Gastroenterology 1109:1736–1741, 1995
7. Mechanic D: Sex, illness, illness behavior and the use of health services. Soc Sci Med 12:207–214, 1978
8. Drossman DA, McKee DC, Sandler R, Mitchell CM, Cramer E, Lowman B, Amy L: Psychosocial factors in the irritable bowel syndrome: A multivariate study of patients and non-patients with irritable bowel syndrome. Gastroenterology 95:701–708, 1988
9. Gick ML, Thompson WG: Negative effect and the seeking of medical care in university students with irritable bowel syndrome: a preliminary study. J Psychosom Res 43:535–540, 1997
10. Colgan S, Creed F, Klass H: Symptom complaints, psychiatric disorder and abnormal illness behavior in patients with upper abdominal pain. Psychol Med 18:887–892, 1988
11. Sandler RS, Drossman DA, Nathan HP, McKee DC: Symptom complaints and health care seeking behavior in subjects with bowel dysfunction. Gastroenterology 87:314–318, 1984
12. Whitehead WE, Crowell MD, Heller BR, Robinson JC, Schuster MM, Horn S: Modeling and reinforcement of the sick role during childhood predicts adult illness behavior. Psychosom Med 56:541–550, 1994
13. Whitehead WE, Winget C, Fedoravicius AS, Wooley S, Blackwell B: Learned illness behavior in patients with irritable bowel syndrome and peptic ulcer. Dig Dis Sci 27:202–208, 1982
14. Levy RL, Whitehead WE, Von Korff MR, Feld AD: Intergenerational transmission of gastrointestinal illness behavior. Am J Gastroenterol 95:451–456, 2000
15. Lowman BC, Drossman DA, Cramer EM, McKee DC: Recollection of childhood events in adults with irritable bowel syndrome. J Clin Gastroenterol 9:324–330, 1987
Australian Bureau of Statistics: Census of population and housing, basic community profile: Area 6350 Penrith. ABS Catalogue no. 2722. Sydney, Australian Bureau of Statistics, 1991
17. Heaton KW, Ghosh S, Braddon FE: How bad are the symptoms and bowel dysfunction of patients with the irritable bowel syndrome?. A prospective, controlled study with emphasis on stool form. Gut 32:73–79, 1991
18. Talley NJ, Boyce PM, Owen BK, Newman P, Paterson KJ: Initial validation of a bowel symptom questionnaire and measurement of chronic gastrointestinal symptoms in Australians. Austral NZ J Med 25:302–308, 1995
19. Pilowsky I: Dimensions of abnormal illness behaviour. Austral NZ J Psychiatry 9:141–147, 1975
20. Pilowsky I: Aspects of abnormal illness behaviour. Psychother Psychosom 60:62–74, 1993
World Health Organization: Composite International Diagnostic Interview, Version 2.1. Geneva, World Health Organization, 1997
22. Andrews G, Peters L: The psychometric properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatry Epidemiol 33:80–88, 1988
23. Kettell J, Jones R, Lydeard S: Reasons for consultation in irritable bowel syndrome: Symptoms and patients characteristics. Br J Gen Pract 42:459–461, 1992
24. Howell S, Talley NJ: Does fear of serious disease predict consulting behavior amongst patients with dyspepsia in general practice?. Eur J Gastroenterol Hepatol 11:881–886, 1999
25. Talley NJ, Boyce PM, Jones M: Predictors of health care seeking for irritable bowel syndrome: A population-based study. Gut 41:394–398, 1997
26. Talley NJ, Boyce P, Jones M: Dyspepsia and health care seeking in a community. How important are psychological factors?. Dig Dis Sci 43:1016–1022, 1998
27. Whitehead WE, Busch CM, Heller BR, Costa PT, Jr: Social learning influences on menstrual symptoms and illness behaviour. Health Psychol 5:13–23, 1986
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Koloski, N.A., Boyce, P.M. & Talley, N.J. Is Health Care Seeking for Irritable Bowel Syndrome and Functional Dyspepsia a Socially Learned Response to Illness?. Dig Dis Sci 50, 153–162 (2005). https://doi.org/10.1007/s10620-005-1294-9
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DOI: https://doi.org/10.1007/s10620-005-1294-9