Structural Equation Modeling of the Mediating Role of Resilience in the Relationship between Cognitive Emotion Regulation Strategies and Psychological Well-Being of Patients with Irritable Bowel Syndrome

Document Type : Original Article

Authors

1 1. Associate Professor, Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran.

2 2. M.A in Psychology, Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran.

Abstract

Introduction: Irritable bowel syndrome (IBS) is a chronic and often debilitating functional disorder characterized by disrupted gut-brain interactions. It poses a significant public health challenge, impacting individuals' work, social participation, and psychological well-being. In this context, the objective of the current study was to examine the structural equation modeling of the mediating role of resilience in the relationship between cognitive emotion regulation strategies and the psychological well-being of patients with irritable bowel syndrome.
Method: The current study employed a descriptive and correlational methodology. The statistical population consisted of all patients with irritable bowel syndrome who were referred to the Digestive Health Center at Al-Zahra Hospital in Isfahan in 2023. The sample size of 300 individuals was determined using the Klein model (2023) and the convenience sampling method. The research data collection tools included the Compel Seal, the Resilience Scale (CD-RISC) developed by Austin (2007), the Cognitive Emotion Regulation Questionnaire (CERQ) created by Granofsky et al. (2001), and the Psychological Well-Being Scale (PWBS) designed by Reiff (1989). Statistical analysis of the data was conducted using SPSS and AMOS version 28 software.
Results: The research findings indicated that maladaptive cognitive emotion regulation (β = -0.68, p = 0.002) and adaptive cognitive emotion regulation (β = 0.73, p = 0.002) had a direct and significant impact on psychological well-being. Finally, resilience (β = 0.71, p < 0.05) had a direct and significant effect and may serve as an important mediator in the relationship between cognitive emotion regulation strategies and psychological well-being. The final model of the study demonstrated a good fit, with an RMSEA of 0.026 and a p-value of less than 0.05.
Discussion and Conclusion: In conclusion, given the significant mediating role of resilience, it is possible to enhance the psychological well-being of patients with irritable bowel syndrome through effective interventions, such as emotion regulation training and resilience training.

Keywords


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    1. Wang YN, Zhou LY, Huang YH, Jiang M, Dai C. The incidence and predisposing factors for irritable bowel syndrome following COVID-19: a systematic review and meta-analysis. European Journal of Gastroenterology & Hepatology. 2024; 36(2): 168-176. https://doi.org/10.1097/meg.0000000000002688
    2. Travers P, Lacy BE, Cangemi DJ. Irritable bowel syndrome–less irritable, or better treatments?. Current Opinion in Gastroenterology. 2024; 40(1): 27-33. https://doi.org/10.1097/mog.0000000000000987
    3. Chen LJ, Burr R, Cain K, Kamp K, Heitkemper M. Age Differences in Upper Gastrointestinal Symptoms and Vagal Modulation in Women With Irritable Bowel Syndrome. Biological Research for Nursing. 2024; 26(1): 46-55. https://doi.org/10.1177/10998004231186188
    4. Wal A, Srivastava A, Verma N, Pandey SS, Tyagi S. The Role of Nutraceutical Supplements in the Treatment of Irritable Bowel Syndrome: A Mini Review. Current Pediatric Reviews. 2024; 20(1): 66-75. https://doi.org/10.2174/1573396319666230102121953
    5. Steinsvik EK, Valeur J, Hausken T, Gilja OH. Postprandial symptoms in patients with functional dyspepsia and irritable bowel syndrome: Relations to ultrasound measurements and psychological factors. Journal of Neurogastroenterology and Motility. 2020; 26(1): 96–105. https://doi.org/10.5056/jnm19072
    6. Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, Palsson OS. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study. Gastroenterology. 2021; 160(1): 99-114. https://doi.org/10.1053/j.gastro.2020.04.014
    7. Madva EN, Harnedy LE, Longley RM, Rojas Amaris A, Castillo C, Bomm MD, Celano CM. Positive psychological well‐being: A novel concept for improving symptoms, quality of life, and health behaviors in irritable bowel syndrome. Neurogastroenterology & Motility. 2023; 35(4): 1-10. https://doi.org/10.1111/nmo.14531
    8. Ryff Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of personality and social psychology. 1989;  57 (6): 1-10. https://psycnet.apa.org/doi/10.1037/0022-3514.57.6.1069
    9. Knowles SR, Austin DW, Sivanesan S, Tye-Din J, Leung C, Wilson J, Hebbard G. Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness. Psychology, health & medicine. 2017; 22(5): 524-534. https://doi.org/10.1080/13548506.2016.1168932
    10. Reed S, Bugwadia AK, Dave S, Wilson HE, Ramesh P, Michel HK. Sexual and reproductive health considerations in the care of young adults with inflammatory bowel disease: A multidisciplinary conversation. Health Care Transitions. 2024; 2(1): 1-10. https://doi.org/10.1016/j.hctj.2023.100033
    11. Gómez‐Leal R, Gutiérrez‐Cobo MJ, Megías‐Robles A, Fernández‐Berrocal. PThe dark triad and subjective well‐being: The mediating role of cognitive‐emotional regulation strategies. Scandinavian Journal of Psychology. 2023; 64(3): 368-375. https://doi.org/10.1111/sjop.12890
    12. Balzarotti S, Biassoni F, Villani D, Prunas A, Velotti P. Individual differences in cognitive emotion regulation: Implications for subjective and psychological well-being. Journal of Happiness Studies.  2016; 17(1): 125-143. https://doi.org/10.1007/s10902-014-9587-3
    13. Extremera N, Sánchez-Álvarez N, Rey L. Pathways between ability emotional intelligence and subjective well-being: Bridging links through cognitive emotion regulation strategies. Sustainability. 2020; 12(5): 1-10. https://doi.org/10.3390/su12052111
    1. خوش سرور س، کاظمی رضایی ع. نقش راهبرد‌های تنظیم شناختی تنظیم‌شناختی هیجان و حمایت اجتماعی ادراک شده در پیش‌بینی کیفیت زندگی و شدت علائم بیماران با سندرم روده تحریک‌پذیر. نشریه پژوهش توانبخشی در پرستاری. 1398؛ 6(1): 60-68. http://ijrn. r/article-1-404-fa.html
    1. اسکافی‌ثابت ز، قربان شیرودی ش، زربخش بحری م ر، امینیان ک. اثربخشی درمان گروهی مبتنی بر پذیرش و تعهد بر شدت بیماری، کیفیت زندگی و بهزیستی روان‌شناختی بیماران مبتلا به سندرم روده تحریک‌پذیر. نشریه سلامت اجتماعی.1400؛ 9(1): 36-46. https://doi.org/10.22037/ch.v9i1.31290
    2. Brites R, Brandão T, Hipólito J, Ros A, Nunes O. Emotion regulation, resilience, and mental health: A mediation study with university students in the pandemic context. Psychology in the Schools. 2024; 61(1): 304-328. https://doi.org/10.1002/pits.23055
    3. Polizzi CP, Lynn SJ. (Regulating emotionality to manage adversity: A systematic review of the relation between emotion regulation and psychological resilience. Cognitive Therapy and Research. 2021; 1(2): 1-21. https://doi.org/10.1007/s10608-020-10186-1
    4. Liang M, Chen P, Molassiotis A, Jeon S, Tang Y, Hu G, Ye Z. (2023). Measurement invariance of the 10-item resilience scale specific to cancer in Americans and Chinese: A propensity score–based multidimensional item response theory analysis. Asia-Pacific Journal of Oncology Nursing. 2023; 10(2): 1-10. https://doi.org/10.1016/j.apjon.2022.100171
    5. Cachón Zagalaz J, López Manrique I, San Pedro Veledo MB, Zagalaz Sánchez ML, González González de Mesa, C. The importance of the phoenix bird technique (resilience) in teacher training: CD-RISC scale validation. Sustainability. 2020; 12(3): 1-10. https://doi.org/10.3390/su12031002
    6. Renati R, Bonfiglio, NS, Rollo, D. Italian University Students’ Resilience during the COVID-19 Lockdown—A Structural Equation Model about the Relationship between Resilience, Emotion Regulation and Well-Being. European Journal of Investigation in Health, Psychology and Education. 2023; 13(2): 259-270. https://doi.org/10.3390/ejihpe13020020
    7. Fadgyas Stanculete M, Ismaiel A, Popa SL, Capatina OO. Irritable Bowel Syndrome and Resilience. Journal of Clinical Medicine. 2023; 12(13):10-20. https://doi.org/10.3390/jcm12134220
    8. Kilpatrick LA, Gupta A, Tillisch K, Labus JS, Naliboff BD, Mayer EA, Chang, L. Neural correlates of perceived and relative resilience in male and female patients with irritable bowel syndrome. Neurogastroenterology & Motility. 2023; 1(2): 1-10. https://doi.org/10.1111/nmo.14710
    9. Arnout BA, Almoied AA. A structural model relating gratitude, resilience, psychological well‐being and creativity among psychological counsellors. Counselling and Psychotherapy Research. 2021; 21(2): 470-488. https://doi.org/10.1002/capr.12316
    10. حسن‌زاده نمین ف، پیمانی ج، رنجبری‌پور، ط، ابوالمعالی الحسینی خ. مدل پیش بینی بهزیستی روانشناختی بر اساس تاب­آوری با در نظر گرفتن نقش میانجی استرس ادراک شده. مجله علوم روانشناختی. 1398؛ 18(77): 569-578. http://dorl.net/dor/20.1001.1.17357462.1398.18.77.12.5
    11. Beri N, Dorji P. (Role of resilience and psychological wellbeing during difficult situations. Annals of the Romanian Society for Cell Biology, 1572-1580. 2021. https://annalsofrscb.ro/index.php/journal/article/view/1604
    12. Kline R‌B. (2023). Principles and practice of structural equation modeling. Fourth Edition, Guilford publications. https://books.google.com/books?
    13. Rosenberg, M. Determinants of self-esteem-a citation classic commentary on society and the adolescent self-image by Rosenberg, M. Current Contents/Social & Behavioral Sciences. 1989; 1 (11): 16-16. https://garfield.library.upenn.edu/classics1989/A1989T475800001.pdf
    1. خانجانی م، شهیدی ش، فتح‌آبادی ج، مظاهری م ع ، شکری، ا. ساختار عاملی و ویژگی‌های روان‌سنجی فرم کوتاه (18 سوالی) مقیاس بهزیستی روان‌‌شناختی ریف در دانشجویان دختر و پسر. فصل­نامه اندیشه و رفتار در روانشناسی بالینی. 1393؛ 9 (32): 27-36. https://jtbcp.riau.ac.ir/article_67.html
    1. Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Journal Personality and Individual Differences, 2001; 30(8): 1311-1327. https://doi.org/10.1016/S0191-8869(00)00113-6
    2. Derogatis LR, Lipman RS, Covi L. SCL-90. Administration, scoring and procedures manual-I for the R (revised) version and other instruments of the Psychopathology Rating Scales Series. Chicago: Johns Hopkins University School of Medicine. 1977. https://www.scirp.org/(S(lz5mqp453edsnp55rrgjct55))/reference/ReferencesPapers.aspx?ReferenceID=1656144
    3. Beck A‌T, Steer Brown GK. Manual for Beck Depression Inventory-II. San Antonio. TX: Psychological Corporation. 1996. https://psycnet.apa.org/doi/10.1037/t00742-000
    4. حسنی ج. خصوصیات روان‌سنجی پرسشنامة نظم‌جویی شناختی هیجان. مجله روانشناسی بالینی. 1389؛ 2(3): 84-73. https://doi.org/10.22075/jcp.2017.2031
    5. Campbell‐Sills L, Stein MB. Psychometric analysis and refinement of the connor–davidson resilience scale (CD‐RISC): Validation of a 10‐item measure of resilience. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies. 2007; 20(6): 1019-1028. https://doi.org/10.1002/jts.20271
    6. Conner KM, Davidson JR. Development of a new resilience scale. Depression and Anxiety. 2003; 18(2): 76-82. https://doi.org/10.1002/da.10113
    7. قریب‌بلوک م، میکائیلی ن، بشرپور س. نقش میانجی ذهن‌آگاهی در رابطه بین نگرش ناکارآمد و حساسیت اضطرابی با کیفیت خواب در نوجوانان دوره متوسطه دوم دبیرستان. نشریه روان پرستاری. 1401؛ 10(2): 61-72. http://dx.doi.org/https://doi.org/10.22034/IJPN.10.2.61
    8. Schermelleh-Engel K, Moosbrugger H, Müller H. Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of psychological research online. 2003; 8 (2): 23-74. https://psycnet.apa.org/record/2003-08119-003
    9. Rusu PP, Bodenmann G, Kayser K. Cognitive emotion regulation and positive dyadic outcomes in married couples. Journal of Social and Personal Relationships. 2019; 36(1): 359-376. https://doi.org/10.1177/0265407517751664
    10. Parker CH, Naliboff BD, Shih W, Presson AP, Kilpatrick L, Gupta A, et al. The role of resilience in irritable bowel syndrome, other chronic gastrointestinal conditions, and the general population. Clinical Gastroenterology and Hepatology.  2021; 19(12), 2541-2550. https://doi.org/10.1016/j.cgh.2020.08.043
    11. Weiss N‌H, Sullivan TP, Tull MT. Explicating the role of emotion dysregulation in risky behaviors: A review and synthesis of the literature with directions for future research and clinical practice. Current opinion in psychology. 2015; 3(1): 22-29. https://doi.org/10.1016/j.copsyc.2015.01.013