Psychological predictors of wellbeing: a comparison of IBD and non-IBD respondents
thesisposted on 23.02.2017, 00:46 by Holzer, Bianca Christina
Coping with stress in relation to chronic illness remains a central issue in health psychology. Ulcerative colitis (UC) and Crohn’s disease (CD) are two forms of chronic intestinal malfunction known collectively as inflammatory bowel disease (IBD). Recent estimates indicate that more than 80,000 individuals are affected by IBD in Australia and 1,500,000 in North America. Its prevalence is increasing, particularly in industrialized nations and the disease appears to affect females and males equally. Since Lazarus’ pioneering work on coping strategies, psychologists have been interested in how people adapt to chronic health issues, and in turn, how their coping efforts affect psychological wellbeing. Many recent reports have suggested that personal characteristics including personality dispositions and coping strategies affect adjustment to illness in general and IBD in particular. The majority of studies reviewed by the researcher are nonetheless of questionable design, lack a theoretical framework, and fail to incorporate matched comparison groups. The present dissertation is unique in several ways. Specifically, predictions for the current study were based on a logically deduced theoretical framework and included a pool of common, psychometrically validated measures of both positively and negatively worded questionnaires. All major hypotheses generated from the model were systematically tested using groups balanced for IBD type, severity of illness, age, sex and, importantly, a comparison group. Objective: To construct a cohesive framework which investigates how individuals deal with stress, what personality and coping measures influence their wellbeing and whether these factors differ between individuals with or without chronic illness, specifically IBD. It was predicted that IBD volunteers, compared to non-IBD volunteers would exhibit lower scores on the measures of wellbeing. Personality and coping-control mechanisms were also expected to differ between the comparison groups. It was predicted that personal dispositions would provide a stronger influence on wellbeing, compared to the more transitory coping-control measures. Coping-control mechanisms were also assessed as to whether they would significantly contribute to wellbeing, over and above the personality domains. Method: This cross-sectional investigation systematically compared the responses of a group of IBD outpatients (n=95) to a matched non-IBD ethesis-submission.doc May 2009; reviewed December 2011; updated November 2012 3 group (n=87) on a battery of self-report questionnaires tapping measures of personality, coping and wellbeing. Participants were assigned to one of eight groups according to whether they were representative of the following comparison subgroups: illness (IBD vs. non-IBD), type of illness (UC vs. CD), severity of illness (severe vs. mild) and sex (female vs. male). Results: As predicted, IBD participants, compared to non-IBD participants, scored significantly lower on all wellbeing measures; that is, increased general health complaints, perceived stress and depression. The comparison groups were indistinguishable on the majority of measures pertaining to personality and coping-control mechanisms. Regression analyses identified that negative affect (NA) was the strongest personality predictor; and perceived control of internal states (PCOIS) was the best coping- control predictor of wellbeing. As expected, personal dispositions were stronger predictors of wellbeing than the group of coping-control mechanisms. Hierarchical multiple regression analyses illustrated that coping-control mechanisms only negligibly added to the prediction of wellbeing beyond that accounted for by the personal disposition measures. Conclusion: Results failed to provide evidence of an IBD-prone personality as the measures of personal dispositions and coping-control mechanisms were essentially the same for the IBD and non-IBD comparison groups. Although the IBD group, compared to the non-IBD group, scored significantly lower on the selected wellbeing measures, it is emphasized that neither group scored low enough to warrant classification within the clinical range. It was demonstrated that coping-control mechanisms play an important role in influencing wellbeing, but the innate and stable nature of personality dispositions override these more transient influences. The thesis concludes with the argument that between-group designs are not very helpful in identifying differences in predicting psychological wellbeing between the “well” and the “sick”. This method evaluates group trends, but but in doing so failed to identify individual differences. It is suggested that idiographic or n=1 studies, in combination with between-group designs, would prove a more fruitful method of understanding relations between chronic illness and wellbeing.