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

Aleksey I. Melehin
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Abstract

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 39.210.6) with refractory IBS of constipated, diarrheal and mixed types (duration of the disease 33.848.1 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 StateTrait 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.
不同类型肠易激综合征女性情绪失调的特点
背景。到目前为止,人们对心理因素的具体情况和机制知之甚少,如愤怒的一般倾向和表达愤怒的方式,这些因素与促炎过程和内脏过敏有关,而促炎过程和内脏过敏导致肠易激综合征的症状出现,并导致其难治性病程。的目标。工作的目的。基于不同类型IBS女性可能具有不同的消极情绪(如愤怒)表达方式和控制行为方式的假设,确定便秘型、腹泻型和混合型(病程33.848.1个月)难治性IBS女性(平均年龄39.210.6岁)在抑郁、焦虑、愤怒表达和生活质量满意度方面的存在和严重程度的具体差异。材料和方法。PHQ-15患者健康问卷-15;GAD-7一般焦虑障碍-7;PHQ-9患者健康问卷-9;IBS-QOL肠易激综合征生活质量;状态-特质愤怒表达量表。结果。观察到IBS亚型与情绪领域消极方面之间的相关性,表明IBS- c和IBS- d亚型表现出以更高水平的焦虑、抑郁和愤怒表达变化为特征的情感特征,并伴有语言和非语言表达困难。所有类型的特点都是自我攻击,抑制愤怒,但这些方面在IBS-D和IBS-C中更为明显。对愤怒的表达有强烈的控制。与IBS-D相比,IBS-C和IBS-M患者对外部愤怒表达的控制更强。患有IBS-C的女性在精神状态上有更明显的愤怒迹象。在言语表达愤怒、异性攻击和自身攻击方面存在困难。愤怒是一种性格特征,包含在气质的结构中。患有IBS-D的女性有明显的愤怒迹象,这是对当前生活事件的反应,自我攻击,内心的愤怒控制。情感躯体化水平、广泛性焦虑症、抑郁症的存在和严重程度、生活满意度的变化都是决定愤怒水平及其表达方式的预测因素。结论。肠道蠕动可以被认为是行为控制的指标,作为患者调节功能的指标,在特定情况下情感参与的强度。心理组织的认知、情绪和执行成分的变化在IBS的难治性病程中只起重要作用。
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