Objective:

To examine the relationship between psychological inflexibility, internalized stigma, and patient outcomes in adults with inflammatory bowel disease (IBD), and to explore if psychological inflexibility mediates this relationship.

Key Findings:

• 40.5% of participants experienced internalized stigma.
• Higher psychological inflexibility was linked to higher internalized stigma, lower committed action, poorer health-related quality of life, lower IBD self-efficacy, higher self-concealment, higher fatigue, and more negative beliefs about emotions.
• Psychological inflexibility partially mediated the relationship between internalized stigma and several patient outcomes.
• Psychological inflexibility completely mediated the relationship between internalized stigma and fatigue.

Interpretation:

Psychological inflexibility significantly impacts the quality of life in individuals with internalized stigma related to IBD, suggesting that increasing psychological flexibility may reduce distress and enhance quality of life, which is crucial for patient care.

Limitations:

• Cross-sectional design limits causal inferences.
• Self-reported data may introduce bias.
• Limited research on internalized stigma in IBD prior to this study.
• Need for longitudinal studies to establish causality.

Conclusion:

Enhancing psychological flexibility in adults with IBD may improve health outcomes and reduce the negative effects of internalized stigma.