The central role of gastrointestinal-specific anxiety in irritable bowel syndrome: Further validation of the visceral sensitivity index
The central role of gastrointestinal-specific anxiety in irritable bowel syndrome: Further validation of the visceral sensitivity index
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DOI：
10.1097/psy.0b013e31802e2f24
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发表时间：
2007-01-01
影响因子：
3.3
通讯作者：
Naliboff, Bruce D.
中科院分区：
文献类型：
--
作者：
Labus, Jennifer S.;Mayer, Emeran A.;Naliboff, Bruce D.
目的：内脏敏感指数（VSI）是第一个评估胃肠道特异性焦虑、对胃肠道感觉、症状的认知、情感和行为反应以及这些内脏感觉和症状发生的背景的工具。本研究的目的是a）复制先前报道的VSI的心理测量学特性，B）评估已知组和工具的并行有效性，以及c）测试关于胃肠道特异性焦虑与其他心理困扰的一般测量相比作为肠易激综合征诊断及其症状的关键机制（中介者/调节者）的概念假设。研究方法：两个本科生样本（n > 500）进行了VSI沿着评估下消化道症状，非胃肠疼痛，卫生服务利用，焦虑，抑郁，活力，神经质和焦虑敏感性的措施。路径分析检验了胃肠特异性焦虑介导情感变量与肠易激综合征诊断和症状之间关系的假设。一种“已知组”的有效性方法阐明了胃肠道特异性焦虑在肠易激综合征患者中的相关性。结果：具有良好的同时效度、发散效度和区分效度。Logistic回归分析显示，胃肠道特异性焦虑是肠易激综合征诊断状态的关键解释变量。通径分析表明，胃肠道焦虑介导的一般心理困扰措施和胃肠道症状严重程度之间的关系。VSI与胃肠道症状严重程度相关，但与非胃肠道症状严重程度无关。结论：总体而言，VSI表现出良好的心理测量特性，进一步支持其用于肠易激综合征表现中焦虑作用的机制研究。
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.