This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Labus, J. S. Articles by Naliboff, B. D. Search for Related Content PubMed PubMed Citation Articles by Labus, J. S. Articles by Naliboff, B. D.

The Central Role of Gastrointestinal-Specific Anxiety in Irritable Bowel Syndrome: Further Validation of the Visceral Sensitivity Index

From the Departments of Medicine (L.C., E.A.M.), Physiology (E.A.M.), Psychiatry and Biobehavioral Sciences (J.S.L., E.A.M.), and Brain Research Institute (E.A.M., B.D.N.), Center for Neurovisceral Sciences and Women’s Health, David Geffen School of Medicine at UCLA; VA Greater Los Angeles Healthcare System (L.C., B.D.N.), Los Angeles, California.

Address correspondence and reprint requests to Jennifer Labus, Center for Neurovisceral Sciences and Women’s Health, Peter V. ueberroth Bldg., Rm. 2338c2, 10946 Le Conte Avenue, Los Angeles, CA 90095. E-mail: jlabus{at}ucla.edu

Objectives: The Visceral Sensitivity Index (VSI) was developed as the first instrument to assess gastrointestinal-specific anxiety, the cognitive, affective, and behavioral response to fear of gastrointestinal sensations, symptoms, and the context in which these visceral sensations and symptoms occur. The purpose of the current study was to a) replicate the previously reported psychometric properties of the VSI, b) assess the known-groups and concurrent validity of the instrument, and c) test conceptual hypotheses regarding gastrointestinal-specific anxiety in comparison to other general measures of psychological distress as a crucial mechanism (mediator/moderator) underlying irritable bowel syndrome diagnosis and its symptoms.

Methods: Two undergraduate student samples (n > 500) were administered the VSI along with measures assessing presence of lower gastrointestinal symptoms, nongastrointestinal pain, health-service utilization, anxiety, depression, vitality, neuroticism, and anxiety sensitivity. Path analyses tested the hypothesis that gastrointestinal-specific anxiety mediates the relationship between affective variables and irritable bowel syndrome diagnosis and symptoms. A ‘known-groups’ validity approach elucidated the relevance of gastrointestinal-specific anxiety across a spectrum of irritable bowel syndrome patients.

Results: Good concurrent, divergent and discriminant validity was demonstrated. Logistic regression revealed that gastrointestinal-specific anxiety is the key explanatory variable of irritable bowel syndrome diagnostic status. Path analysis demonstrated that gastrointestinal-specific anxiety mediates the relationship between general psychological distress measures and gastrointestinal symptom severity. The VSI was related to gastrointestinal, but not nongastrointestinal, symptom severity.

Conclusions: Overall, the VSI demonstrated excellent psychometric properties providing further support for its use in mechanistic studies of the role of anxiety in irritable bowel syndrome presentation.

Key Words: gastrointestinal • anxiety • assessment • irritable bowel syndrome

Abbreviations: ANX = anxiety; ASI = Anxiety Sensitivity Index; BSQ-SF = Bowel Symptom Questionnaire-Short Form; DEP = depression; EPQN = Eysenck Personality Questionnaire-Short Form; GI = gastrointestinal; HAD = Hospital Anxiety and Depression Scale; IBS = irritable bowel syndrome; VIT = Medical Outcomes Study-SF-36 energy/fatigue subscale; VSI = Visceral Sensitivity Index.

This article has been cited by other articles:

				B. D. Naliboff, A. M. Waters, J. S. Labus, L. Kilpatrick, M. G. Craske, L. Chang, H. Negoro, H. Ibrahimovic, E. A. Mayer, and E. Ornitz Increased Acoustic Startle Responses in IBS Patients During Abdominal and Nonabdominal Threat Psychosom Med, October 1, 2008; 70(8): 920 - 927. [Abstract] [Full Text] [PDF]

				E A Mayer, S Bradesi, L Chang, B M R Spiegel, J A Bueller, and B D Naliboff Functional GI disorders: from animal models to drug development Gut, March 1, 2008; 57(3): 384 - 404. [Abstract] [Full Text] [PDF]

				S. M. Berman, B. D. Naliboff, B. Suyenobu, J. S. Labus, J. Stains, G. Ohning, L. Kilpatrick, J. A. Bueller, K. Ruby, J. Jarcho, et al. Reduced Brainstem Inhibition during Anticipated Pelvic Visceral Pain Correlates with Enhanced Brain Response to the Visceral Stimulus in Women with Irritable Bowel Syndrome J. Neurosci., January 9, 2008; 28(2): 349 - 359. [Abstract] [Full Text] [PDF]