Author ORCID Identifier

https://orcid.org/0000-0002-3375-1287

Date of Graduation

2024

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Christina L. Duncan

Committee Member

Kathleen Morrison

Committee Member

Shari A. Steinman

Committee Member

Jennifer Ludrosky

Committee Member

Christa L. Lilly

Abstract

Inflammatory Bowel Disease (IBD) is a prevalent disorder among youth in the United States. IBD is one of the leading causes of chronic pain in adolescence and symptoms can lead to reduced quality of life, social embarrassment, and lower self-esteem. Adherence to medical regimens for IBD is incredibly important to prevent morbidity, mortality, and impaired health-related quality of life (HRQOL). However, adolescents struggle generally with adherence and the regimen for IBD can be complicated and include aversive side effects. Psychological factors, such as depressive symptoms, are key factors associated with non-adherence. Nevertheless, gut-specific anxiety (GSA) is a psychological factor that has not been investigated in relation to adherence and HRQOL in pediatric IBD. Given GSA’s relevance to youth with IBD, understanding its association with disease outcomes will inform behavioral interventions to address GSA in adolescents with IBD. The current study sought to elucidate the relations among GSA, regimen non-adherence, and HRQOL. Using a cross-sectional observational design, a sample of 51 adolescents with IBD and their caregivers completed measures of depression, general anxiety, GSA, HRQOL, and adherence to medication. For Aim 1, the odds of non-adherence were not significantly increased for patients with high GSA (OR=0.99, p=0.69). For Aim 2, GSA did not moderate the relation between non-adherence and HRQOL (B=0.15, F=0.15, p=0.70). Finally, for Aim 3, GSA also was not found to mediate the relation between non-adherence and HRQOL (LLCI=-9.68, ULCI=4.59). Despite the lack of significance related to hypotheses, a significant relation between GSA and HRQOL was identified for child-reported (B=-0.48, pB=-0.53, p=0.05), such that lower GSA was associated with higher HRQOL. This relation prompts further investigation into the relation between GSA and HRQOL and the potential for screening for GSA in pediatric IBD clinics.

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