Relationship between adverse childhood experiences and illness anxiety in irritable bowel syndrome – The impact of gender, 2019, Berens et al

Andy

Andy

Retired committee member
Not a recommendation.
"Highlights"
• Irritable bowel syndrome (IBS) patients showed higher levels of illness anxiety.
• IBS patients reported higher prevalences for adverse childhood experiences (ACE).
• ACE and illness anxiety were correlated in female IBS patients, but not in males.
• The correlation disappeared after controlling for depression and anxiety.

Abstract
Objective
Irritable bowel syndrome (IBS) is a functional disorder with a complex biopsychosocial etiopathogenesis. Various psychosocial factors like adverse childhood experiences (ACE) and illness anxiety appear to be relevant, but underlying mechanisms are still not fully understood. Furthermore, there are indicators of gender specific effects of ACE on IBS. Therefore, this study analyzed group differences between IBS patients and healthy controls (HCs) according to ACE and illness anxiety, and the relationship between ACE and illness anxiety by taking gender differences into consideration.

Methods
A cross-sectional multi-center study was conducted comparing IBS patients with HCs. Illness anxiety was recorded using the Whiteley-Index-7, childhood adversities via the 10-item Adverse-Childhood-Experiences-score, anxiety by the Generalized Anxiety Disorder seven-item questionnaire and depressive symptoms using the nine-item depression module of the patient-health-questionnaire. Group differences between IBS patients and HCs were analyzed and correlation analyses were performed.

Results
Overall, 127 gender and education matched participants per group were included. Compared to HCs, IBS patients were characterized by higher prevalences for adverse childhood experiences (63.8% vs. 48.0%, p = .02, OR = 1.33) and increased levels of illness anxiety (p < .001, η2 = 0.595). Taking into account gender specific effects, there was a significant correlation between adverse childhood experiences and illness anxiety in female IBS patients, but not in male (r = 0.242, p = .03 vs. r = 0.162, p = .29). However, after controlling for depression and anxiety, this correlation disappeared.

Conclusion
Our findings suggest a possible gender-specific association of ACE with illness anxiety in female IBS patients that might be linked to increased levels of depression and anxiety.
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Open access, https://www.sciencedirect.com/science/article/pii/S0022399919305136
 
I don't see what useful information researchers could hope to get out of these sorts of studies on childhood trauma.

We already don't want children to be raped, beaten, or otherwise abused, or have their parents killed, or any there horrible thing, so there's not much point in looking at it from an angle about IBS or any other illness.

Even if you establish a convincing correlation (and it certainly could be true) - it doesn't tell you anything about what to do since there's no reason to think some sort of psychoanalytical therapy or any other psychotherapy is of any use. Or maybe it's more accurate to say there's good reason to think they're of no use.

So about the best you can get out of it is a deepened appreciation of the tragedy of the human condition, but you can get that for free in myriad ways.
 
Conclusion
Our findings suggest a possible gender-specific association of ACE with illness anxiety in female IBS patients that might be linked to increased levels of depression and anxiety.
Click to expand...

I strongly suspect, based on my personal experience, that getting a diagnosis of absolutely anything is harder for females than it is for males. As a result, every interaction with the medical profession becomes fraught with anxiety. The things that go through my head...

1) Will I get a diagnosis that can be treated and which, now being known, will improve my quality of life (if it gets treated)? Answer : Almost certainly No.
2) In the unlikely event that I get a physical diagnosis will it be recorded accurately in my medical records? Answer : Almost certainly No.
3) In the event that I am assumed to be "making it up" will it be recorded in my medical records? Answer : Almost certainly Yes.
2) Will they believe me this time? Answer : Almost certainly No, particularly if the condition and/or symptoms I am describing are invisible.
3) Will they insult me and dismiss what I have to say as hypochondria, but disguise what they think with fake smiles? Answer : Almost certainly yes.
4) Will I have to face condescension and patronising as usual? Answer : Almost certainly Yes.
 
chrisb said:
Isn't that the point? They don't want it for free. They want to be seen to be doing something for which they can be paid.
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Unfortunately so.

But I think it's significant that cursory examination of the question reveals that it cannot generate any useful information. At least with PACE, etc. you can theoretically get a useful answer to the basic question - which they accidentally did.

With that in mind I think it's also worth adding that these studies are dredging up people's traumatic memories for the sport of it, which is plainly ghoulish. Additionally, by definition it leads to adverse effects in respondents who are traumatized by past experiences, because they are prompted to revisit these experiences when they otherwise would not; furthermore, doing so plausibly leads to negative consequences beyond emotional suffering in the moment.

Frankly they are trying to use people's traumatic experiences as data to tell a certain story about 'functional' illnesses, or illnesses in general, with callous disregard to the actual traumatic nature of these experiences.

This type of study should be rejected by IRBs as unethical by default.
 
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