# Selective recall of gastrointestinal-sensation words:



## eric (Jul 8, 1999)

FYI:Am J Gastroenterol 2001 Apr;96(4):1133-8 Related Articles, Books Selective recall of gastrointestinal-sensation words: evidence for a cognitive-behavioral contribution to irritable bowel syndrome. Gibbs-Gallagher N, Palsson OS, Levy RL, Meyer K, Drossman DA, Whitehead WE. Department of Medicine, University of North Carolina at Chapel Hill, USA. OBJECTIVE: Selective attention to GI sensations has been suggested as an important mechanism that affects symptom perception in patients with irritable bowel syndrome (IBS), but this hypothesis has not yet been tested empirically. Differential recall of words describing negative affect has been used to demonstrate that depressed patients selectively attend to negative affect words. This technique may be useful for examining selective attention to somatic sensations. The aim of this study was to determine whether patients with IBS demonstrate selective recall of GI sensations compared with neutral words and words describing respiratory sensations. METHODS: A total of 16 IBS patients, nine asthmatic patients (medical controls), and eight healthy controls were shown 10 GI sensation words or phrases, 10 respiratory sensation words or phrases, and 10 neutral words in random order for 3 s each. After a distraction task, subjects wrote down all of the words or phrases they could remember. RESULTS: As predicted, IBS patients were more likely to recall GI words than other categories. Asthmatic patients were more likely to recall respiratory words in comparison with healthy controls. CONCLUSIONS: IBS patients selectively recall words describing GI sensations; this suggests that they may selectively attend to GI sensations, thus supporting the cognitive-behavioral theory of IBS. PMID: 11318007------------------Moderator of the Cognitive Behavioral Therapy, Anxiety and Hypnotherapy forumI work with Mike and the IBS Audio Program. www.ibshealth.com www.ibsaudioprogram.com


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## SteveE (Jan 7, 1999)

Ok...it is pretty early in the morning, and I've been out of the field of psychology for 5 1/2 years, but what does this really mean? I'll bet every dime I have that if they had included 10 Eskimos and different words for snow, the Eskimos would exhibit what they are calling "selective attention" for those words as well.When they say that this data supports a "cognitive behavioral theory," I have to disagree. If they had concluded that cognitive behavioral techniques may be useful to tone-down our selective attention to our IBS problems which may in turn help reduce the severity of symptoms, then I MIGHT believe it. Even then, I'll bet that if you gave some IBS patients CB therapy and treated them to a point where they were reporting 80% reduction in their symptoms (because nobody has been "cured" 100% with CB therapy, right?) THEN present them with such a test of selective attention, you'd still find the selective attention to be there for the words. It can't be helped because it is what we experience physically more frequently than normal healthies even with CB therapy.I think that GI journal should stick to publishing medical research and leaving the psychology to a psychology journal. I'll lay another bet that the more prestigious psych journals would've poked similar holes in this article and not published it. Of course I haven't read the whole study, but on the surface, it sounds like they simply proved/defined what selective attention is rather than support any special theory of what causes or cures IBS.Thanks for posting anyway eric. I'm certain it does some people good just to understand the nature of how selective attention might apply to our circumstances.


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## eric (Jul 8, 1999)

Steve, I think the picture is bigger then that if we were to read the whole text.I can tell you that DR Drossman is the lead investigator in the world on IBS. He has experts from all fields working with him and is the lead researcher in the whole IBS community.------------------Moderator of the Cognitive Behavioral Therapy, Anxiety and Hypnotherapy forumI work with Mike and the IBS Audio Program. www.ibshealth.com www.ibsaudioprogram.com


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## SteveE (Jan 7, 1999)

eric--I do respect Dr. Drossman's expertese, but this seems a little out of his scope of knowledge. Besides, he is just a co-author on this one. Sometimes scientists' names are included with the PI with even a very modest contribution--say, for example, consulting about what methodology should be used to determine that a patient really belongs in the IBS group.I'll look at the full text, but the abstract's conclusion seems shakey at best.


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## Kathleen M. (Nov 16, 1999)

Dr. Drossman is a Principle investigator in on of the most extensive studies of CBT in IBS to date, so I think CBT in IBS is in his scope of knowledge.The study should be finishing up this summer with publicationi late this year on the initial part of the study with a paper on the one year follow up a year later.CBT is one of the more effective treatments for IBS. I think they are trying to figure out why.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## SteveE (Jan 7, 1999)

Thanks for the clarification/correction and the preview, K. I didn't realize his ties were that strong to psychology.I guess I'm operating under some other assumptions that probably need to be checked in this context too.For example, don't you think it is likely that the only reason CBT is one of the more effective treatments for IBS is that it keeps the patient's negative cognitions from snowballing needlessly into an anxious state which increases symptom severity?I mean if we have physical evidence that the colon of an IBSer is more sensitive than a healthy control, and we know that anxious momments can stimulate the gut in even these healthy controls......then why is it any suprise that any kind of therapy...be it hyno, biofeedback, CBT, or zen meditation leading to a reduction in frequency of anxious moments would lead to a reduction in severity of IBS?Am I over-simplifying that somehow?


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## Kathleen M. (Nov 16, 1999)

Well given that I have essentially no anxiety, and have IBS, and CBT worked really well for me I don't think lowering anxiety is all there is to it.I'm one of those calm, cool colleced people even during big exams, big presenations, just pooped in my pants in the middle of the grocery store. Just not anxious, much to the annoyance of those around me sometimes (the HOW can you be CALM at a TIME LIKE THIS!!! response that I get fairly regularly).The gut and brain connections are not well understood, my personal pet theory of the moment (subject to change without notice) is that the adaptable mind can learn how to tell the probably less adaptable gut brain (enteric nervous system) how to work around problems when they arise.The brain in your head is really adaptable, heck sometimes you can lose parts of it and slowly over time other parts of the brain can take over and you can recover. Not because the nerves grow back, but because other parts take over. Now the younger you are and what parts were messed up makes a big difference, but I know people who had brain injuries as childrem who have no business walking around, holding down jobs and generally being OK.The gut brain doesn't seem to be as adaptable, but if you can get use the connection between the two and use your mind to take over some of the messed up functions (just like you can learn to change your heart rate or control other normally non-concious things conciously) you can work around whatever problems the gut brain can't work around on its own.Now there probably is some learning that when I think or worry or am anxious about X my mind tells my gut it needs to be anxious too, and thus it acts up, and learning not to do that, along with some learning how to tell the gut to shut up when it is telling you perfectly normal sensations are very painful (I cut my finger badly once and damaged the nerve to the tip. For awhile it was numb, but when the nerve grew back the first day or two every stimulus was reported as painful, but eventually it got feedback (or whatever) and started only yelling about things it was suupposed to yell about).K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## SteveE (Jan 7, 1999)

Again, another interesting perspective. Thanks, K. I guess that might also explain the very high placebo effect found in IBS.


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## Kathleen M. (Nov 16, 1999)

Psycho-social issues probably play a role in many disorders, and the whole going to see a doctor and health-care workers that listen and are nice to you (you gotta be nice to the patients in the clinical trial or they drop out and you have to recruit new ones) causes a high placebo control effectiveness rate in a large number of diseases including arthritis and asthma, so this effect is not unique to IBS, but is seen in all disorders, some more commonly than others.It also explains alot of why alternative practioners are often so effective in healing. They play the psycho-social card very well. You have long appointments with them the listen to you much more and longer than doctors can with the HMO's and they are generally always certain that they can do something to help you. In some clinical trials with multiple doctors each doctor has a differnt placebo control cure rate. Mostly because of how well or how badly they are at the psycho-social aspects of healing.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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