Dysfunctional attitudes, gender, and psychopathology as predictors of pain affect in patients with irritable bowel syndrome

This cross-sectional study investigated the relationship between dysfunctional attitudes and the emotional unpleasantness of pain (pain affect) in a large sample (N = 281) of severely affected patients with irritable bowel syndrome (IBS). Subjects completed measures of pain, dysfunctional attitudes, and psychopathology as part of baseline assessment of an NIH-funded clinical trial featuring cognitive therapy for IBS. Drawing from the cognitive model of emotion, we predicted that patients with IBS would have a propensity toward negative thinking, as measured by the Dysfunctional Attitude Scale (DAS), and as a result rate pain affect as higher than patients with healthier cognitions. Consistent with these predictions, DAS scores for a sizable proportion of IBS patients were elevated compared to those from normative samples. Further, multiple regression analyses showed that dysfunctional attitudes account for approximately 11% of the variance in pain affect when control variables (gender, age, psychopathology) were held constant. These data are discussed in light of clinical implications for treating patients from a cognitive therapy orientation.