An evaluation of the illness and symptom severity hypotheses in physician consultation by students with the irritable bowel syndrome.

摘要

This dissertation is an evaluation of two hypotheses related to physician consultation for Irritable Bowel Syndrome. It begins with a historical overview of the conceptualization of IBS over time. Modern conceptualizations begin with Sir Willfam Osler in 1892. A new hypothesis about the relationship between physical and psychological symptoms is introduced, the systemic sensitivity hypothesis. This is in contrast to either the psychosomatic or somatopsychic models of causation. Shaw et al., (1997) put forward a hypothesis about physician consultation called the Illness hypothesis. This proposes that psychiatric disturbance is not directly linked to IBS symptomology but influences the person's decision to seek health care. In contrast to this, Taub, et al. (1994) have suggested that the severity of physical symptoms of IBS relates to consultation of a physician, not neuroticism or psychopathology.;Data for this study came from an earlier study performed at the University of Alabama at Birmingham. 370 students were recruited from the undergraduate student body there who met criteria for asymptomatic, symptomatic, and consulting symptomatic groups. Symptomatic individuals reported at least three Manning Criteria symptoms over the prior six months and had either consulted a physician or not. Results indicate that symptomatic individuals were significantly higher on all measures of interest of the SCL-90R, the NEO-PI and were older. A Discriminant Analysis was done to identify which of three measures best discriminated between consulters and non-consulters. Results indicated that only symptom severity was a significant discriminant of consultation. Neither the Global Severity Index of the SCL-90R, or the Neuroticism scale of the NEO-PI achieved significance as a discriminant. In addition, it was discovered that the asymptomatic subjects had significantly lower scores than the normative groups for the respective instruments, giving rise to questions about appropriate comparison groups for research on these types of disorders.