Psychological mediators of psychological distress and quality of life in inflammatory bowel disease

Background and aims: Using the Common Sense Model (CSM), this study aimed to examine the extent to which illness beliefs, coping styles, self-efficacy, and mindfulness mediate this relationship. Methods: Two hundred and sixty-one adults (198 females; 169 with Crohn's Disease) with IBD participated in this cross-sectional study. Measures used in this study were the short Crohn's Disease Activity Index, Ulcerative Colitis Lichtiger Index, Inflammatory Bowel Disease Questionnaire, New General Self-Efficacy Scale, Carver Brief COPE scale, Mindful Attention Awareness Scale, Brief Illness Perceptions Questionnaire, and the Depression and Anxiety Stress Scales. Results: Using structural equation modelling, the final model indicated IBD symptoms had a significant direct influence only on illness perceptions (beta = 0.66, p < .001). In turn, illness perceptions had a significant direct influence on depression and anxiety (beta = 0.34, p < .001) and QoL (beta = -0.67, p < .001), and was also linked to higher maladaptive coping (beta = 0.28, p < .001) and lower self-efficacy (beta = -0.49, p < .001), but not with mindfulness or adaptive coping (p > .05). Maladaptive coping (beta = 0.46, p < .001) and mindfulness (beta = 0.23, p < .001) were linked with increased distress. QoL was influenced by distress (beta = -0.40, p < .001). Conclusions: Consistent with the predictions of the CSM, the relationships between IBD symptoms and depression and anxiety, and between IBD symptoms and quality of life, are statistically mediated via psychological variables including illness perceptions and maladaptive coping.