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Title: A cognitive behavioural model of understanding and improving negative adjustment outcomes for adults with inflammatory bowel disease
Author: Jordan, Cheryl Dawn
ISNI:       0000 0004 7656 5171
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2018
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The present research consists of a number of studies which sought to examine the psychological processes associated with negative adjustment outcomes for adults with inflammatory bowel disease (IBD) and considered the potential benefits of a novel psychological intervention for improving outcomes in this population. The first study in this thesis (Chapter 2) systematically examined the evidence between psychological factors and adjustment outcomes in adults with IBD. Emotion focused coping strategies, perceived stress, IBD related cognitions (such as illness perceptions), emotions and emotional control (such as hostility, aggression and alexithymia), interpersonal traits (such as anxious attachment style) and personality traits (such as neuroticism and perfectionism), were linked to negative adjustment outcomes for adults with IBD after controlling for the influence of sociodemographic and disease related factors. The second qualitative study (Chapter 4) found that adults with IBD described concerns pertaining to underperformance at work and preventing an accident in public as linked to their symptoms of anxiety. Low mood was reported to be associated with a perceived lack of understanding of IBD from others and stigma. Distinct cognitive and behavioural responses were described by participants in each of these domains. Participants in this study stated a desire for psychological support delivered by a professional with specialised knowledge of IBD to evaluate and build their coping strategies. The third quantitative study (chapter 5) found that unhelpful cognitive, emotional and behavioural responses (assessed at baseline), after adjusting for sociodemographic and disease related factors, were associated with negative adjustment outcomes at baseline (cross sectional) and 3 month follow up. The final clinical, pilot study found that transdiagnostic cognitive behaviour therapy (TD-CBT) had clinical benefits for adults with IBD who were distressed. Uncontrolled effect sizes were superior to those of a previous RCT. This series of studies consistently identified unhelpful cognitive, emotional and behavioural responses that are associated with and predictive of negative adjustment outcomes for adults with IBD. Further, TD-CBT was found to be of benefit. These findings provide insight into how psychological interventions should be designed and delivered to be helpful and acceptable for people with IBD and disturbance to mood and quality of life.
Supervisor: Chalder, Trudie ; Fear, Nicola Townsend Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available