A Phenomenological Investigation of Trauma in 18 Adults Living With Inflammatory Bowel Disease.

While trauma is recognized as being common in Inflammatory Bowel Disease (IBD) cohorts, limited research has explored how trauma impacts the lived experience of IBD. The aim of this study was to develop an understanding of how trauma impacts the experience of living with IBD and its subsequent management. An interpretative phenomenological analysis with thematic analysis was conducted. Eighteen adults with IBD participated in this qualitative research study. Key themes identified included: (1) Trauma was associated with the journey of IBD; (2) the impact of IBD and trauma, and (3) coping strategies. Pre-existing non-IBD trauma was prevalent, with several participants reporting links between traumatic events and their IBD diagnosis. Experiences of IBD trauma were described by participants across all stages of their illness journey. The study can assist healthcare professionals to better understand the experience of living with IBD and trauma and the factors that can contribute to traumatic responses.

Exploring the Impact of Trauma and Psychosocial Processes on the Quality of Life in Individuals Living with Inflammatory Bowel Disease.

BACKGROUND AND AIMS: Post traumatic stress disorder (PTSD) is common in individuals with inflammatory bowel diseases (IBD). Living with a medical condition has been linked to the development of PTSD and to adversely impact patient outcomes. The aim of this study is to extend the common sense model (CSM) and evaluate trauma as an additional psychosocial process in the relationship between IBD symptoms and quality of life (QoL). METHOD: A cross-sectional online study exploring trauma and IBD was performed. RESULTS: 68 (32.2%) of the sample met the criteria for PTSD. Of this trauma group, 37 (54.4%) reported IBD related trauma, 21 (30.9%) reported non-IBD related trauma and 10 (14.7%) did not identify the trauma type. A structural equation model (SEM) based upon the CSM was found to have an excellent fit (χ2 (3)=1.10, p=0.35, RMSEA=0.02, SRMR=0.02, CFI=1.00, GFI=0.99). Results showed that trauma symptoms partially mediated the relationship between illness perceptions and QoL and fully mediated the relationship between maladaptive coping and QoL. CONCLUSION: This study extended the CSM and found that trauma symptoms functioned as a mediator between IBD activity and QoL. These results highlight the need for a holistic approach including psychological assessment and intervention in IBD.

Prevalence and Impact of Post-traumatic Stress Disorder in Gastrointestinal Conditions: A Systematic Review.

Psychological distress is often observed in patients with gastrointestinal illness. To date, there has been limited research conducted to assess the prevalence and impact of post-traumatic stress disorder (PTSD) in gastrointestinal cohorts. The aim of this systematic review is to review the evidence for the prevalence of PTSD in gastrointestinal cohorts versus comparator groups (healthy controls and chronic illness groups), predictive factors associated with the development and management of PTSD and the impact on patient outcomes. Adult studies were identified through systematic searches of eight databases (MEDLINE, Embase, Emcare, PsycINFO, Ovid Nursing, CINAHL, Informit Health Collection, and Cochrane Library) in February 2020. The overall pooled prevalence rate of PTSD in GI cohorts was 36%; however, the prevalence rate in non-veteran-specific gastrointestinal cohorts of 18% across all GI classification groups is likely to be the more representative rate. The non-gastrointestinal chronic illness cohort PTSD prevalence rate was 11%. Predictors identified in the development of post-traumatic stress in gastrointestinal cohorts include: female gender, poor social support, life adversity, subjective pain, and dietary choices. Post-traumatic stress was found to exacerbate gastrointestinal symptoms in a Crohn's Disease sample, whereby disease exacerbation was four times in those who met the criteria for probable PTSD. Post-traumatic stress symptoms affect around one in five individuals (non-veteran status) with a gastrointestinal condition. Further research is needed to understand the psychological and biological mechanisms by which PTSD increases the risk of developing and exacerbating gastrointestinal symptoms.