The psychobiological model of disorders of gut–brain interaction: introduction of a novel, integrated, and testable model

Abstract

Psychogastroenterology encompasses both basic mechanistic research, which identifies psychological mechanisms (eg, fear-learning) that contribute to disorders of gut–brain interaction (DGBIs), and clinical applied research, which evaluates the efficacy of gut–brain behavioural therapies in DGBIs. However, progress in the field is hindered by inadequate communication between these areas, such that mechanistic processes are rarely translated into clinical targets, and interventions are developed with an incomplete understanding of the potential mechanisms by which they work or for whom they work. To bridge this translational gap, we propose the psychobiological model of DGBIs—an integrated and testable model that illustrates how psychological mechanisms central to DGBIs interact with each other and with biological processes along the gut–brain axis. In this Personal View, we introduce our model, review current evidence in psychogastroenterology, and propose specific mechanisms and causal pathways that can be tested. With this model, we aim to unify research, clarify underlying mechanisms, and identify treatment targets, with the potential to transform future research in both psychogastroenterology and DGBIs.