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Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial.

Abstract

BACKGROUND

Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBS patients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition-relaxation training-and a waitlist control condition.

METHODS

Adults with IBS (N=106; 80% female, Mean age=36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks posttreatment and 10 weeks follow-up (primary endpoint).

KEY RESULTS

Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at posttreatment).

CONCLUSIONS & INFERENCES

Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027).

Authors+Show Affiliations

Department of Psychology, Wayne State University, Detroit, MI, USA. Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.Department of Psychology, Wayne State University, Detroit, MI, USA.Department of Psychology, Wayne State University, Detroit, MI, USA.Department of Psychology, Wayne State University, Detroit, MI, USA.Department of Psychology, Wayne State University, Detroit, MI, USA.Department of Psychology, Wayne State University, Detroit, MI, USA.Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA.Department of Internal Medicine, St. John/Providence Health System, Southfield, MI, USA.Department of Psychology, Wayne State University, Detroit, MI, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28643436

Citation

Thakur, E R., et al. "Emotional Awareness and Expression Training Improves Irritable Bowel Syndrome: a Randomized Controlled Trial." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 29, no. 12, 2017.
Thakur ER, Holmes HJ, Lockhart NA, et al. Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial. Neurogastroenterol Motil. 2017;29(12).
Thakur, E. R., Holmes, H. J., Lockhart, N. A., Carty, J. N., Ziadni, M. S., Doherty, H. K., ... Lumley, M. A. (2017). Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 29(12), doi:10.1111/nmo.13143.
Thakur ER, et al. Emotional Awareness and Expression Training Improves Irritable Bowel Syndrome: a Randomized Controlled Trial. Neurogastroenterol Motil. 2017;29(12) PubMed PMID: 28643436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial. AU - Thakur,E R, AU - Holmes,H J, AU - Lockhart,N A, AU - Carty,J N, AU - Ziadni,M S, AU - Doherty,H K, AU - Lackner,J M, AU - Schubiner,H, AU - Lumley,M A, Y1 - 2017/06/22/ PY - 2016/11/10/received PY - 2017/05/29/accepted PY - 2017/6/24/pubmed PY - 2018/6/23/medline PY - 2017/6/24/entrez KW - clinical trial KW - emotional expression KW - irritable bowel syndrome KW - relaxation JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol. Motil. VL - 29 IS - 12 N2 - BACKGROUND: Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBS patients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition-relaxation training-and a waitlist control condition. METHODS: Adults with IBS (N=106; 80% female, Mean age=36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks posttreatment and 10 weeks follow-up (primary endpoint). KEY RESULTS: Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at posttreatment). CONCLUSIONS & INFERENCES: Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027). SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/28643436/Emotional_awareness_and_expression_training_improves_irritable_bowel_syndrome:_A_randomized_controlled_trial_ L2 - https://doi.org/10.1111/nmo.13143 DB - PRIME DP - Unbound Medicine ER -