Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are two gastrointestinal (GI) conditions known to be exacerbated by traumatic life experiences. One way in which these experiences might influence individuals' susceptibility to GI pathology, is by reducing their ability to deal with adversities effectively and predisposing them to passive coping styles that leave them vulnerable to the somatic effects of trauma. To validate this hypothesis, the present cross-sectional study assessed the mediating effect of coping dispositions on the association between trauma and GI disease activity in an adult sample of 189 bowel patients (94 IBD, 95 IBS) and 92 controls. Results confirmed that GI patients exhibit significantly more cumulative trauma, pervasive feelings of uncontrollability and passive coping strategies than controls. Moreover, the use of passive coping styles was positively associated with the accumulation of trauma and the expression of GI symptoms. Using hierarchical regression and mediation analyses, we found support for the sequential model postulating passive coping styles as (partial) mediators of trauma-induced (GI) disease manifestations. Specifically, out of all coping styles associated with cumulative trauma, behavioural disengagement most powerfully mediated the effect of trauma on GI symptom severity, accounting for 12% (IBD) to 14% (IBS) of its total effect. A somewhat smaller mediating role was observed for social support coping, the reduced reliance on which explained 7% (IBS) to 10% (IBD) of trauma's total effect. Finally, neuroticism acted as a channel through which past traumatization affected subjects' proneness to behavioural disengagement and, consequently, their GI disease activity.

中文翻译：

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应对方式对创伤与胃肠道症状关联的中介作用

炎症性肠病 (IBD) 和肠易激综合征 (IBS) 是已知会因创伤性生活经历而加剧的两种胃肠道 (GI) 疾病。这些经历可能影响个体对胃肠道病理的易感性的一种方式是降低他们有效应对逆境的能力，并使他们倾向于被动的应对方式，从而使他们容易受到创伤的躯体影响。为了验证这一假设，本横断面研究在 189 名肠道患者（94 名 IBD、95 名 IBS）和 92 名对照的成人样本中评估了应对处置对创伤和胃肠道疾病活动之间关联的中介作用。结果证实，胃肠道患者比对照组表现出明显更多的累积创伤、普遍的不可控感和被动应对策略。此外，被动应对方式的使用与创伤的积累和胃肠道症状的表达呈正相关。通过分层回归和中介分析，我们发现了对序贯模型的支持，该模型假设被动应对方式是创伤诱发（GI）疾病表现的（部分）中介因素。具体来说，在与累积创伤相关的所有应对方式中，行为脱离对创伤对胃肠道症状严重程度的影响最为有力，占其总影响的 12% (IBD) 至 14% (IBS)。观察到社会支持应对的中介作用稍小，对社会支持应对的依赖减少解释了创伤总效应的 7% (IBS) 至 10% (IBD)。最后，神经质充当了一个渠道，过去的创伤影响受试者的行为脱离倾向，从而影响他们的胃肠道疾病活动。