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The role of high expectations of self and social desirability in emotional processing in individuals with irritable bowel syndrome: A qualitative study
Author(s) -
Sibelli Alice,
Chalder Trudie,
Everitt Hazel,
Workman Paul,
Bishop Felicity L.,
MossMorris Rona
Publication year - 2017
Publication title -
british journal of health psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.05
H-Index - 88
eISSN - 2044-8287
pISSN - 1359-107X
DOI - 10.1111/bjhp.12264
Subject(s) - psychology , coping (psychology) , thematic analysis , clinical psychology , irritable bowel syndrome , psychological intervention , cognition , distress , qualitative research , assertiveness , psychotherapist , psychiatry , social science , sociology
Objectives Although high levels of distress are associated with the onset and severity of Irritable bowel syndrome (IBS), it is unclear how this relates to emotional processing, particularly in relation to maintenance of symptoms and treatment outcome. This qualitative study embedded within a randomized controlled trial aimed to explore how individuals with refractory IBS experience, express, and manage their emotions after either therapist‐delivered cognitive behavioural therapy ( TCBT ) or Web‐based CBT ( WBCBT ) compared to treatment as usual ( TAU ). Design Cross‐sectional qualitative study. Methods Fifty‐two semi‐structured interviews were conducted at post‐treatment with 17 TCBT , 17 WBCBT , and 18 TAU participants. The transcripts were analysed using inductive thematic analysis with grounded theory elements. NV ivo 11 was used to compare themes across groups. Results Across all groups, high expectations of self was a recurring reason for how participants experienced and expressed their emotions. Three themes with subthemes captured how high expectations related to specific aspects of emotional processing: perceived causes of emotions, strategies for coping with emotions (bottling up, avoiding emotions, and active coping strategies), and the perceived interplay between emotions and IBS symptoms. Conclusions Patients recognized that their IBS symptoms both triggered and were triggered by negative emotions. However, there was a tendency to bottle up or avoid negative emotions for reasons of social desirability regardless of whether patients had CBT for IBS or not. Future psychological interventions in IBS may benefit from addressing negative beliefs about expressing emotions, promoting assertive emotional expression, and encouraging the experience of positive emotions.Statement of contribution What is already known on this subject?High levels of distress are consistently associated with both the onset and maintenance of IBS symptoms. Little is known about how this relates to the concept of emotional processing. Preliminary findings suggest a positive correlation between poor emotional processing and IBS. However, further studies need to confirm its role in relation to aetiology, maintenance of symptoms, and response to treatment.What does this study add?High expectations of self and social desirability seem to be important aspects shaping the way individuals with IBS experience, express, and manage their emotions. Emotional avoidance and bottling up were reported as key strategies to cope with negative emotions. The study revealed that bottling up is not perceived as an all‐or‐nothing strategy but can be applied selectively depending on the context. Psychological interventions in IBS may benefit from addressing not only illness‐related causes of negative emotions but also personal and social triggers of distress.