The specifics of emotional dysregulation in women with various types of irritable bowel syndrome

BACKGROUND. To this day, relatively little is known about the specifics and mechanisms by which psychological factors, such as a general tendency to anger and the style of expressing anger, can be associated with pro-inflammatory processes and visceral hypersensitivity, which contribute to the appearance of signs of irritable bowel syndrome and lead to its refractory course.

AIM. The purpose of the work. to identify the specifics of differences in the presence and severity of depression, anxiety, anger expression and satisfaction with the quality of life in women (average age 39.2±10.6) with refractory IBS of constipated, diarrheal and mixed types (duration of the disease 33.8±48.1 months), based on the hypothesis that women with different types of IBS may have different styles of expressing negative emotions (for example, anger) and ways of controlling behavior.

MATERIAL AND METHODS. PHQ-15 — Patient Health Questionnaire-15; GAD-7 — General Anxiety Disorder-7; PHQ-9 — Patient Health Questionnaire-9; IBS-QOL — Irritable Bowel Syndrome Quality of Life; STAXI — State–Trait Anger Expression Inventory.

RESULTS. Correlations between subtypes of IBS and negative aspects of the emotional sphere are observed and it is shown that subtypes of IBS-C and IBS-D demonstrate affective profiles characterized by a higher level of anxiety, depression and changes in the expression of anger with difficulties of expression both verbally and nonverbally. All types are characterized by autoaggression, suppression of anger, but these aspects are more pronounced in IBS-D and IBS-C. There is intense control of anger expression. With IBS-C and IBS-M, there is greater control over the expression of anger externally than with IBS-D. Women with IBS-C have more pronounced indicators of anger as a mental state. There are difficulties in verbal expression of anger, hetero- and autoaggression. Anger is a trait of character and is included in the structure of temperament. Women with IBS-D have pronounced indicators of anger as a reaction to a current life event, autoaggression, anger control inside. The level of affect somatization, the presence and severity of generalized anxiety disorder, depression, changes in life satisfaction are among the predictors that determine both the level of anger and the ways of its expression.

CONCLUSION. Intestinal motility can be considered as an indicator of behavior control, as an indicator of the regulatory function of the patient, the intensity of affective involvement in a particular situation. Changes in the cognitive, emotional and executive components of the mental organization play only a significant role in the refractory course of IBS.