The Role of Spirituality and Disease Acceptance in Predicting Psychological Well Being in a Group of Individuals With Inflammatory Bowel Disease

Abstract

Background: Inflammatory Bowel Disease (IBD) is a long term health condition, characterised by the complex interplay between physical and psychosocial health. In the absence of a cure, psychological interventions that help with adjustment to IBD may be vital for effective disease management. Acceptance and spirituality are well-known coping strategies in chronic health conditions and both are considered to be linked to adjustment. Third wave Cognitive Behavioural Therapy (CBT) interventions draw upon features of spirituality through their utility in mindful acceptance and values, offering a framework in which, potentially valuable, coping strategies for IBD can be harnessed. However, the dearth of literature in this area limits the extent to which clinical recommendations can be made for third wave CBT’s. The current study aims to elucidate whether acceptance and spirituality are valuable components to psychological wellbeing in IBD. In doing so, offering preliminary evidence for an intervention study.

Methods: A total of 120 participants were recruited from an online, web-based survey. This constituted an IBD group and a general population group. Predictor variables included anxiety, depression, spirituality, acceptance and disease severity. A cross-sectional, quantitative, exploratory design was undertaken. Analyses included correlations, followed by a series of regression analyses to examine predictors of psychological wellbeing.

Results: Disease severity was linked to psychological wellbeing and social support. Compared to the general population, acceptance was the most significant predictor of psychological wellbeing in IBD. To smaller degrees, spirituality and social support were also significant contributors of anxiety or depression between IBD and the general population. Associations were not found between spirituality and acceptance in any group. Additional qualitative reports indicated beneficial effects of using complementary and alternative therapies, although quantitatively these findings were not supported.

Discussion: This is the first study to explore the potential for acceptance and spirituality to assist psychological wellbeing in a UK based IBD population. Disease severity and acceptance were unequivocally the most important factors contributing to psychological wellbeing. Spirituality may be protective of anxiety while social support appears to be a mediator of depression. The implementation of a pilot acceptance based intervention, such as an Acceptance and Commitment Therapy (ACT) group, for IBD is warranted.