Identifying the Risk and Protective Factors of Anxiety and Depression in Inflammatory Bowel Disease

Craven, Meredith

doi:https://doi.org/10.21985/n2-j6f6-vq88

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Identifying the Risk and Protective Factors of Anxiety and Depression in Inflammatory Bowel Disease

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Inflammatory bowel disease (IBD) is a chronic, progressive disease associated with physical, financial, and psychological burdens. Depression and anxiety, common comorbidities, are associated with poor outcomes including worse disease course, higher disability, decreased health related quality of life and reduced medication adherence. Prevention of psychological comorbidities and promotion of well-being are increasingly recognized as imperative in IBD management. Approaches inherent in the fields of public health and positive psychology provide frameworks to guide prevention and promotion research. This dissertation study utilized these frameworks through a multi-site cross-sectional study to identify the risk and protective factors of anxiety and depression, and to identify factors associated with well-being. The presence of disparities in prevalence of emotional disorders was also explored. One hundred and two adults with endoscopy-confirmed IBD completed an online survey that assessed clinical, psychological, and psychosocial factors. Perceived stress was identified as an influential covariate. When stress was controlled for, perceived discrimination was a significant risk factor for clinical anxiety and IBD activity increased the risk for clinical depression. In terms of protective factors, self-compassion and resilience buffered against clinical anxiety and depression. Additionally, resilience and self-compassion significantly predicted well-being. Our exploratory analysis revealed potential disparities in anxiety/depression based on SES (income and education), ethnicity, and experiences of discrimination. The results of this dissertation study identify two aspects of psychological capital that can be fostered to potentially prevent emotional disorders and promote well-being in IBD.

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