便秘を自覚する成人女性における体験の回避が腹痛および腹満感の頻度に及ぼす影響  [in Japanese] Influence of Experiential Avoidance on Frequency of Abdominal Pain and Abdominal Bloating in Adult Women who are Aware of Constipation  [in Japanese]

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Abstract

<p>過敏性腸症候群 (IBS) では, 腹部症状に関連する思考, 感情, 身体感覚などを回避する患者が多いことから, アクセプタンス & コミットメント・セラピー (ACT) の有用性が示唆されている. そこで, ACTの治療標的である体験の回避が, 消化器症状に関連した不安や腹痛頻度および腹満感頻度に及ぼす影響について検討する. <b>方法</b> : 便秘を自覚する女性244名 (IBSのRome Ⅲ診断基準を満たした128名を含む) に対して, 腹痛頻度および腹満感頻度, 体験の回避 (AAQ-Ⅱ), 消化器症状に関連した不安 (VSI-J), 抑うつ気分・不安気分 (DAMS) に関する質問紙調査を実施した. <b>結果</b> : 構造方程式モデリングの結果, 体験の回避が消化器症状に関連した不安に対して正の影響 (0.30) を示した. さらに, 消化器症状に関連した不安と腹痛頻度および腹満感頻度には有意な正のパス係数 (0.55) が示された (<i>Χ</i><sup>2</sup>=1.13, <i>df</i>=2, p=0.57, GFI=0.998, AGFI=0.988, RMSEA=0.000). <b>結論</b> : 体験の回避は消化器症状に関連した不安を介して, 腹痛頻度および腹満感頻度に影響を及ぼすことが示された.</p>

<p><b>Background and Objective</b> : Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that causes abdominal pain and bloating with bowel movement changes, despite no organic diseases. The results of the Japanese health checkup showed that the ratio of women among patients with IBS was 1.56 times higher than that among patients without IBS. The acceptance and commitment therapy (ACT) has been acknowledged as effective to alleviate symptoms and improve the psychological component of anxiety in patients with IBS. Patients with IBS tend to avoid gastrointestinal-specific anxiety, such as thinking, emotion, and feeling, associated with abdominal pain and bloating. Hence, this study aimed to investigate the influence of experiential avoidance, which is the therapeutic target of ACT, on gastrointestinal-specific anxiety and frequency of abdominal pain and abdominal bloating.</p><p><b>Methods</b> : The study was initiated by the chair of the Waseda University after the approval was obtained from the review board of ethics committee. Informed consents were obtained from all participants. The study conducted from August 2016 to October 2016. The survey comprised abdominal pain and bloating caused by functional constipation Rome Ⅲ Diagnostic Criteria for IBS, Acceptance and Action Questionnaire-Ⅱ (AAQ-Ⅱ), Visceral Sensitivity Index Japanese Version (VSI-J), and Depression and Anxiety Mood Scale distributed among 253 women with constipation (age : 20-59 years). We surveyed 244 women who were aware of constipation ; and 128 of them met the criteria of IBS with Rome Ⅲ, with an average age of 36.3±9.3 years.</p><p><b>Results</b> : The structural equation modeling analysis revealed a positive association between experiential avoidance and gastrointestinal-specific anxiety (.30) and between gastrointestinal-specific anxiety and abdominal pain with bloating (.55). As a result of conducting the structural equation modeling and examining the validity, the evaluation of the whole model and its fitness index obtained high flexibility (Χ<sup>2</sup>=1.129, <i>df</i>=2, <i>p</i>=.569, GFI=.998, AGFI=.988, RMSEA=.000).</p><p><b>Conclusions</b> : Gastrointestinal-specific anxiety mediated the relationship between frequency of abdominal pain/bloating and experiential avoidance. These findings suggest that the experiential avoidance, through gastrointestinal-specific anxiety, influences the frequency of abdominal pain and abdominal bloating.</p>

Journal

  • Japanese Journal of Psychosomatic Medicine

    Japanese Journal of Psychosomatic Medicine 60(4), 339-348, 2020

    Japanese Society of Psychosomatic Medicine

Codes

  • NII Article ID (NAID)
    130007839363
  • NII NACSIS-CAT ID (NCID)
    AN00121636
  • Text Lang
    JPN
  • ISSN
    0385-0307
  • NDL Article ID
    030382941
  • NDL Call No.
    Z19-26
  • Data Source
    NDL  J-STAGE 
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