PSYCHOPHYSIOLOGY OF IRRITABLE BOWEL SYNDROME

描述：肠易激综合征(IBS)，其特征是 腹痛和排便习惯改变，是最常见的胃肠道疾病 混乱，影响到9.4%的人口。50%至60%的 IBS患者报告直肠扩张量异常低时疼痛， 提示内脏痛觉过敏可能是IBS的发病机制。一个 提出了导致疼痛增加的认知行为模型。 IBS敏感性的两个假设：(1)两个认知特征--选择性 重视胃肠道感觉和疾病归因 对这些感觉的意义--是压力和压力 其他因素也会影响疼痛感知。(2)儿童时期的社会学习 增加对躯体主诉的关注形式和对病人的建模 家长的角色行为，是选择性的最重要决定因素 注意力和疾病归因。 对先前记忆的单词的不同回忆，取决于它们 内容，将被用来开发一种选择性注意力测试。词句 描述胃肠道感觉加控制词描述 呼吸感觉和中性词语将进行测试，以确定是否 健康受试者回忆的概率。然后是肠易激综合征患者， 乳糖吸收不良(一种导致慢性 类似IBS的胃肠道症状)、哮喘患者和健康 控制组将记住这些单词，15分钟后将进行测试 召回。用于评估选择性注意的其他技术，将是 与召回任务相比的是Stroop颜色测试和识别 通过速测仪简要介绍上述类别中的单词。这个 疾病归因测试将通过提交相同的测试来开发 胃肠道和呼吸系统的感觉，并要求受试者 它们是否可能是疾病的症状。在开发出有效的和 可靠的措施，IBS患者的新样本，乳糖不耐受患者， 和控件将完成这些加固测试和建模 直肠扩张与胃肠相关疾病的作用、行为和测试 痛觉阈值。随后的研究将确定实验性的 应激增加疼痛敏感性和渐进性肌肉放松 降低IBS患者的疼痛敏感性，以及这些心理因素 对知觉的影响与选择性注意的变化有关 对胃肠道的感觉。

DESCRIPTION: The irritable bowel syndrome (IBS), which is characterized by abdominal pain and altered bowel habits, is the most common gastrointestinal disorder, affecting 9.4 percent of the population. Fifty to 60 percent of IBS patients report pain at abnormally low volumes of rectal distention, suggesting that visceral hyperalgesia may be the mechanism for IBS. A cognitive behavioral model is presented which accounts for increased pain sensitivity in IBS by two hypotheses: (1) Two cognitive traits--selective attention on gastrointestinal sensations and attribution of disease significance to these sensations--are the mechanisms by which stress and other factors influence pain perception. (2) Childhood social learning in the form of increased attention for somatic complaints and modeling of sick role behavior by parents, is the most important determinant of selective attention and disease attribution. The differential recall of previously memorized words, depending on their content, will be used to develop a test for selective attention. Words describing gastrointestinal sensations plus control words describing respiratory sensations and neutral words will be tested for a prior probability of recall by healthy subjects. Then IBS patients, patients with lactose malabsorption (an enzyme deficiency producing chronic gastrointestinal symptoms similar to IBS), patients with asthma, and healthy controls will memorize these words, and 15 minutes later will be tested for recall. Other techniques for assessing selective attention which will be compared to the recall task are the Stroop Color Test and recognition of words in the above categories presented briefly by a tachistoscope. The test of disease attribution will be developed by presenting the same gastrointestinal and respiratory sensations and asking subjects to rate whether they could be symptoms of disease. After developing valid and reliable measures, new samples of IBS patients, lactose intolerant patients, and controls will complete these tests of reinforcement and modeling of gastrointestinal-related sick role behavior and tests of rectal distention pain thresholds. A subsequent study will determine whether experimental stress increases pain sensitivity and progressive muscle relaxation decreases pain sensitivity in IBS patients, and whether these psychological influences on perceptions are associated with changes in selective attention to gastrointestinal sensations.