Moving beyond perceptions: internalized stigma in the irritable bowel syndrome

Area of Science:

• Psychiatry
• Gastroenterology
• Health Psychology

Background:

• Internalized stigma (IS) is a significant factor in chronic illness, impacting patient outcomes.
• No prior research has investigated IS in patients diagnosed with Irritable Bowel Syndrome (IBS).

Purpose of the Study:

• To evaluate the prevalence and impact of internalized stigma (IS) in patients with Irritable Bowel Syndrome (IBS).
• To assess the relationship between IS, perceived stigma, and various patient-reported outcomes in IBS.

Main Methods:

• A cohort of 243 participants completed modified ISMI, perceived stigma scales, anxiety/depression scales, IBS quality of life, and health competence measures.
• Demographical and clinical data, including symptom severity and treatment choices, were collected.

Main Results:

• The modified ISMI demonstrated reliability and validity in the IBS population.
• Participants reported both perceived and internalized stigma, with alienation being the most common.
• IS significantly predicted psychological functioning, quality of life, healthcare utilization, and health competence (25-40% variance).
• IBS patients experienced more stigma from personal relationships than healthcare providers.
• Hispanic participants reported higher perceived stigma, suggesting cultural variations.
• Symptom severity and treatment influenced stigma perception and internalization.

Conclusions:

• IBS patients experience both perceived and internalized stigma, particularly alienation.
• Internalized stigma is a significant predictor of patient outcomes, independent of perceived stigma.
• Cultural factors and illness characteristics may modulate the perception and internalization of stigma in IBS.