The mediating role of psychological inflexibility on internalized stigma and patient outcomes in a sample of adults with inflammatory bowel disease - Report - MDSpire
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The mediating role of psychological inflexibility on internalized stigma and patient outcomes in a sample of adults with inflammatory bowel disease
Psychological Inflexibility Mediates Internalized Stigma and Health Outcomes in IBD
Overview
This study of 382 adults with inflammatory bowel disease (IBD) found that psychological inflexibility significantly mediates the relationship between internalized stigma and various patient outcomes, including psychological distress, fatigue, and quality of life. Approximately 40.5% of participants experienced internalized stigma, which was associated with poorer health-related outcomes.
Background
Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, affects a significant portion of the population and is associated with symptoms like abdominal pain, fatigue, and bowel urgency. These symptoms contribute to psychosocial distress and stigma, particularly internalized stigma, where patients adopt negative societal beliefs about their condition. Psychological flexibility, the ability to adapt behavior in the presence of distressing internal experiences, may buffer the negative effects of internalized stigma. Understanding the mediating role of psychological inflexibility can inform interventions to improve patient outcomes.
Data Highlights
Measure
Association with Psychological Inflexibility
Internalized Stigma
Higher psychological inflexibility correlated with higher internalized stigma
Committed Action
Lower committed action associated with higher psychological inflexibility
Health-Related Quality of Life
Lower quality of life linked to higher psychological inflexibility
IBD Self-Efficacy
Lower self-efficacy correlated with higher psychological inflexibility
Self-Concealment
Higher self-concealment associated with higher psychological inflexibility
Fatigue
Higher fatigue completely mediated by psychological inflexibility
Psychological Distress
Partially mediated by psychological inflexibility
Key Findings
40.5% of adults with IBD experienced internalized stigma.
Psychological inflexibility is positively correlated with internalized stigma and negatively correlated with committed action and self-efficacy.
Psychological inflexibility partially mediates the relationship between internalized stigma and psychological distress, quality of life, self-efficacy, and self-concealment.
Psychological inflexibility fully mediates the relationship between internalized stigma and fatigue.
Higher psychological inflexibility is linked to more negative beliefs about emotions and greater fatigue.
Clinical Implications
Clinicians should consider assessing psychological inflexibility in patients with IBD who experience internalized stigma, as it significantly impacts psychological distress and quality of life. Interventions aimed at increasing psychological flexibility, such as Acceptance and Commitment Therapy, may reduce distress and improve self-management and health outcomes in this population.
Conclusion
Psychological inflexibility plays a critical mediating role in the impact of internalized stigma on health outcomes among adults with IBD. Targeting psychological flexibility may offer a promising avenue to enhance quality of life and reduce distress in this patient group.
References
Original Article 2020 -- The Role of Psychological Inflexibility in Mediating Internalized Stigma and Health Outcomes Among Adults with Inflammatory Bowel Disease
