Major disasters, stress, and GI symptoms: The September 11th tragedy and its effect on persons with irritable bowel syndrome
Gudleski, Gregory Daniel
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Conventional wisdom and anecdotal evidence suggest that life stressors precede exacerbation of gastrointestinal symptoms in patients diagnosed with irritable bowel syndrome (IBS). However, research supporting this hypothesis has been mixed. One of the major methodological limitations of previous research has been the use of retrospective data. The main purpose of the present study was to investigate, prospectively, the impact of a major, naturalistic stressor on GI symptoms in persons diagnosed with IBS. The naturalistic stressor in question was the September 11 th , 2001 terrorists attack on the United States. Participants were 22 IBS patients who were in the process of monitoring baseline GI symptoms and life stressors for a federally funded study investigating the efficacy of cognitive therapy on the symptoms of IBS. The instruments used for data collection were the Daily Stress Inventory (Brantley et al., 1987) and the Gastrointestinal Symptoms Diary (Blanchard et al., 1987). The time frame for the analyses was the 7 days prior to the attacks and the 7 days following the attacks (including September 11 th ). Results indicate that the terrorist attacks were, indeed, perceived as a significant source of stress and that a composite score of GI symptoms was significantly worse in the week following the attacks than in the week prior to the attacks ( p < .05). Furthermore, participants with a comorbid diagnosis of Generalized Anxiety Disorder (GAD) responded to the terrorist attacks with a greater increase in the severity of their GI symptoms than those without a diagnosed anxiety disorder. The results suggest that worry, a cardinal feature of GAD, may play a crucial role in the exacerbation of GI symptoms subsequent to a major stressor. Theoretical and treatment implications regarding the results of the present study are discussed.