E R Thakur1,2,3, H J Holmes1, N A Lockhart1, J N Carty1, M S Ziadni1, H K Doherty1, J M Lackner4, H Schubiner5, M A Lumley1. 1. Department of Psychology, Wayne State University, Detroit, MI, USA. 2. Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA. 3. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. 4. Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA. 5. Department of Internal Medicine, St. John/Providence Health System, Southfield, MI, USA.
Abstract
BACKGROUND: Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBS patients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition-relaxation training-and a waitlist control condition. METHODS:Adults with IBS (N=106; 80% female, Mean age=36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks posttreatment and 10 weeks follow-up (primary endpoint). KEY RESULTS: Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at posttreatment). CONCLUSIONS & INFERENCES: Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027).
RCT Entities:
BACKGROUND: Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBSpatients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition-relaxation training-and a waitlist control condition. METHODS: Adults with IBS (N=106; 80% female, Mean age=36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks posttreatment and 10 weeks follow-up (primary endpoint). KEY RESULTS: Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at posttreatment). CONCLUSIONS & INFERENCES: Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027).
Authors: Alireza Farnam; Mohammad H Somi; Sara Farhang; Nafiseh Mahdavi; Mohammad Ali Besharat Journal: J Psychiatr Pract Date: 2014-01 Impact factor: 1.325
Authors: Francis Creed; Lakshmi Fernandes; Elspeth Guthrie; Stephen Palmer; Joy Ratcliffe; Nicholas Read; Christine Rigby; David Thompson; Barbara Tomenson Journal: Gastroenterology Date: 2003-02 Impact factor: 22.682
Authors: Amanda J Burger; Mark A Lumley; Jennifer N Carty; Deborah V Latsch; Elyse R Thakur; Maren E Hyde-Nolan; Alaa M Hijazi; Howard Schubiner Journal: J Psychosom Res Date: 2015-12-11 Impact factor: 3.006
Authors: Larry E Beutler; Roger J Daldrup; David Engle; Elena M Oró-Beutler; Keith Meredith; John T Boyer Journal: Pain Date: 1987-06 Impact factor: 6.961
Authors: Dorcas J Dobie; Daniel R Kivlahan; Charles Maynard; Kristen R Bush; Tania M Davis; Katharine A Bradley Journal: Arch Intern Med Date: 2004-02-23
Authors: Hannah J Holmes; Elyse R Thakur; Jennifer N Carty; Maisa S Ziadni; Heather K Doherty; Nancy A Lockhart; Howard Schubiner; Mark A Lumley Journal: Gen Hosp Psychiatry Date: 2018-05-03 Impact factor: 3.238
Authors: Maisa S Ziadni; Jennifer N Carty; Heather K Doherty; John H Porcerelli; Lisa J Rapport; Howard Schubiner; Mark A Lumley Journal: Health Psychol Date: 2017-11-20 Impact factor: 4.267
Authors: Kendra J Kamp; Kristen R Weaver; LeeAnne B Sherwin; Pamela Barney; Sun-Kyung Hwang; Pei-Lin Yang; Robert L Burr; Kevin C Cain; Margaret M Heitkemper Journal: J Psychosom Res Date: 2019-08-29 Impact factor: 3.006
Authors: Jennifer N Carty; Maisa S Ziadni; Hannah J Holmes; Janice Tomakowsky; Kenneth Peters; Howard Schubiner; Mark A Lumley Journal: Pain Med Date: 2019-07-01 Impact factor: 3.750