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Illness Identity in Inflammatory Bowel Disease

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Abstract

Background

We examined the degree to which adults with inflammatory bowel disease (IBD) integrated their illness into their identity and linked illness identity to important patient-reported outcomes.

Methods

A total of 109 adults with IBD, aged 18 to 60 (Mage = 35.93; 77% women) completed questionnaires on the four illness identity dimensions (rejection, acceptance, engulfment, and enrichment), medication adherence, depressive symptoms, life satisfaction, health status, and health-related quality of life (HRQoL). The illness identity scores of adults with IBD were compared to existing data from adults with congenital heart disease (CHD), refractory epilepsy (RE), and multisystemic connective tissue disorders (MSDs) using multivariate analyses of covariance. In adults with IBD, associations between illness identity and patient-reported outcomes were examined through hierarchical regression analyses, controlling for sex, age, illness duration, diagnosis, self-reported flares, and co-existing illnesses.

Results

Adults with IBD scored higher on rejection and engulfment and lower on acceptance than adults with CHD, lower on rejection but higher on engulfment than adults with RE, and higher on engulfment and enrichment but lower on rejection than adults with MSDs. Higher engulfment scores were related to more depressive symptoms, lower life satisfaction, and a poorer health status and HRQoL. In contrast, higher enrichment scores were related to more life satisfaction and a better HRQoL. Rejection and acceptance were not uniquely related to any of the outcomes.

Conclusions

Adults with IBD showed relatively high levels of engulfment. Substantial associations were observed between illness identity and patient-reported outcomes, with engulfment being the strongest, most consistent predictor.

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Notes

  1. Because of the small sample size, we had to limit the number of control variables. Regression analyses including marital status and education level as additional control variables resulted in identical findings.

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Funding

Funding was provided by FWO Flanders.

Author information

Authors and Affiliations

  1. Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102 (box 3717), 3000, Leuven, Belgium

    Jessica Rassart & Koen Luyckx

  2. Research Foundation-Flanders, Brussels, Belgium

    Jessica Rassart & Liesbet Van Bulck

  3. Clearinghouse for Self-Help, KU Leuven, Leuven, Belgium

    Carine Van Wanseele & Koen Matthijs

  4. Crohn’s & Ulcerative Colitis Foundation, Leuven, Belgium

    Lynn Debrun

  5. Faculty of Social Sciences, KU Leuven, Leuven, Belgium

    Koen Matthijs

  6. Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium

    Philip Moons & Liesbet Van Bulck

  7. Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden

    Philip Moons

  8. Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa

    Philip Moons

  9. Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium

    Seher Arat

  10. Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium

    Lukas Van Oudenhove

  11. Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium

    Lukas Van Oudenhove

  12. Unit for Professional Training and Service in the Behavioural Sciences (UNIBS), University of the Free State, Bloemfontein, South Africa

    Koen Luyckx

Authors
  1. Jessica Rassart
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  2. Carine Van Wanseele
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  3. Lynn Debrun
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  4. Koen Matthijs
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  5. Philip Moons
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  7. Seher Arat
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  8. Lukas Van Oudenhove
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  9. Koen Luyckx
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Corresponding author

Correspondence to Jessica Rassart.

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Rassart, J., Van Wanseele, C., Debrun, L. et al. Illness Identity in Inflammatory Bowel Disease. Int.J. Behav. Med. 30, 77–88 (2023). https://doi.org/10.1007/s12529-022-10072-y

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