Stress mediators in children with inflammatory bowel disease
The primary purpose of this study was to explore the manner in which children with Inflammatory Bowel Disease (IBD) respond to stress. Also examined were parental perceptions of children's coping abilities. IBD is an inflammatory disease involving a pathological lesion in the bowel. The clinical course and treatment have the potential for interfering with participation in daily living activities.^ The clinical literature indicates that stress plays a predisposing, precipitating and/or perpetuating role in gastrointestinal problems in children. Controlled experimental studies in this area are extremely limited in number, procedure and choice of variables.^ The present investigation looks at the following variables: coping styles, psychophysiological reactivity and perceived stress. Questionnaires were used to evaluate coping styles and stressful life events. Psychophysiological reactivity was measured by skin temperature, pulse rate, galvanic skin response and muscle tension during relaxation and stress conditions. Hypotheses anticipated differences between groups on all variables.^ Thirty-nine IBD and forty-three healthy control children were studied. Twenty-two of the IBD parents and thirty-one of the control parents participated.^ Statistical analyses included a series of two-way analyses of variance and a series of t-tests. With regard to the children's coping styles, IBD subjects rated themselves as being more rigid when coping with internal stressors and more passive when dealing with environmental demands. Parents rated their IBD children as having less effective coping styles as compared to parental ratings of the control children. For the majority of coping style subfactors, the IBD parents agreed with their children's self-ratings while the control parents rated their children higher than the children rated themselves.^ There were no significant findings indicated on any of the perceived stress scores for the life events scale. The two groups did not differ in their assessment of long term reactions to stressful life events.^ There were no differences found between the two groups on any of the four psychophysiological systems which were measured. There were significant differences between the different tasks. Trends indicated that IBD children demonstrated higher amplitudes and inconsistent response patterns.^ The findings of this study extends our understanding of the adaptational functioning of IBD children. It, in general, supports previous clinical and empirical research. From a clinical perspective, the results highlight the value of involving mental health professionals in the treatment planning for this population. ^
Karen S Gitlin,
"Stress mediators in children with inflammatory bowel disease"
(January 1, 1991).
ETD Collection for Pace University.