Abstract
Objectives
Although high levels of distress are associated with the onset and severity of IBS, it is unclear how this relates to emotional processing, particularly in relation to maintenance of symptoms and treatment outcome. This qualitative study embedded within a randomised controlled trial aimed to explore how individuals with refractory IBS experience, express and manage their emotions after either therapist-delivered Cognitive Behavioural Therapy (TCBT) or web-based CBT (WBCBT) compared to Treatment as Usual (TAU).
Design
Cross-sectional qualitative study.
Methods
Fifty two semi-structured interviews were conducted at post-treatment with 17 TCBT participants, 17 WBCBT and 18 TAU. The transcripts were analysed using inductive thematic analysis with grounded theory elements. NVivo 11 was used to compare themes across groups.
Results
Across all groups, high expectations of self was a recurring reason for how participants experienced and expressed their emotions. Three themes with sub-themes captured how high expectations related to specific aspects of emotional processing: perceived causes of emotions, strategies for coping with emotions (bottling up, avoiding emotions and active coping strategies) and the perceived interplay between emotions and IBS symptoms.
Conclusions
Patients recognised that their IBS symptoms both triggered and were triggered by negative emotions. However, there was a tendency to bottle up or avoid negative emotions for reasons of social desirability regardless of whether patients had CBT for IBS or not. Future psychological interventions in IBS may benefit from addressing negative beliefs about expressing emotions, promoting assertive emotional expression and encouraging the experience of positive emotions.
Although high levels of distress are associated with the onset and severity of IBS, it is unclear how this relates to emotional processing, particularly in relation to maintenance of symptoms and treatment outcome. This qualitative study embedded within a randomised controlled trial aimed to explore how individuals with refractory IBS experience, express and manage their emotions after either therapist-delivered Cognitive Behavioural Therapy (TCBT) or web-based CBT (WBCBT) compared to Treatment as Usual (TAU).
Design
Cross-sectional qualitative study.
Methods
Fifty two semi-structured interviews were conducted at post-treatment with 17 TCBT participants, 17 WBCBT and 18 TAU. The transcripts were analysed using inductive thematic analysis with grounded theory elements. NVivo 11 was used to compare themes across groups.
Results
Across all groups, high expectations of self was a recurring reason for how participants experienced and expressed their emotions. Three themes with sub-themes captured how high expectations related to specific aspects of emotional processing: perceived causes of emotions, strategies for coping with emotions (bottling up, avoiding emotions and active coping strategies) and the perceived interplay between emotions and IBS symptoms.
Conclusions
Patients recognised that their IBS symptoms both triggered and were triggered by negative emotions. However, there was a tendency to bottle up or avoid negative emotions for reasons of social desirability regardless of whether patients had CBT for IBS or not. Future psychological interventions in IBS may benefit from addressing negative beliefs about expressing emotions, promoting assertive emotional expression and encouraging the experience of positive emotions.
| Original language | English |
|---|---|
| Pages (from-to) | 737-762 |
| Journal | British Journal of Health Psychology |
| Volume | 22 |
| Issue number | 4 |
| Early online date | 1 Sept 2017 |
| DOIs | |
| Publication status | Published - Nov 2017 |