Gastrointestinal specific anxiety in irritable bowel syndrome: validation of the Japanese version of the visceral sensitivity index for university students.

Tatsuo Saigo,Toyohiro Hamaguchi,Bruce D Naliboff,Motoyori Kanazawa,Peter J Bernick,Tadaaki Tomiie,Naoki Nakaya,Jun Tayama,Shin Fukudo,Susumu Shirabe,Jennifer S Labus

doi:10.1186/1751-0759-8-10

Abstract

ObjectiveThe visceral sensitivity index (VSI) is a useful self-report measure of the gastrointestinal symptom-specific anxiety (GSA) of patients with irritable bowel syndrome (IBS). Previous research has shown that worsening GSA in IBS patients is related to the severity of GI symptoms, suggesting that GSA is an important endpoint for intervention. However, there is currently no Japanese version of the VSI. We therefore translated the VSI into Japanese (VSI-J) and verified its reliability and validity.Material and methodsParticipants were 349 university students aged 18 and 19 years and recruited from an academic class. We analyzed data from the VSI-J, Anxiety Sensitivity Index (ASI), Hospital Anxiety and Depression scale (HAD), and Irritable Bowel Syndrome Severity Index (IBS-SI). The internal consistency, stability, and factor structure of the VSI-J and its associations with anxiety, depression and severity measures were investigated.ResultsThe factor structure of the VSI-J is unidimensional and similar to that of the original VSI (Cronbach’s α = 0.93). Construct validity was demonstrated by significant correlations with ASI (r = 0.43, p < 0.0001), HAD-ANX (r = 0.19, p = 0.0003), and IBS-SI scores (r = 0.45, p < 0.0001). Furthermore, the VSI-J was a significant predictor of severity scores on the IBS-SI and demonstrated good discriminant (p < 0.0001) and incremental (p < 0.0001) validity.ConclusionThese findings suggest that the VSI-J is a reliable and valid measure of visceral sensitivity.

Highlights

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder not associated with organic disease that consists of chronic abdominal discomfort associated with abnormal bowel habits [1,2]
Construct validity was demonstrated by significant correlations with Anxiety Sensitivity Index (ASI) (r = 0.43, p < 0.0001), Hospital Anxiety and Depression scale (HAD)-ANX (r = 0.19, p = 0.0003), and Irritable Bowel Syndrome Severity Index (IBS-SI) scores (r = 0.45, p < 0.0001)
The Visceral Sensitivity Index (VSI)-J was a significant predictor of severity scores on the IBS-SI and demonstrated good discriminant (p < 0.0001) and incremental (p < 0.0001) validity

Summary

Introduction

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder not associated with organic disease that consists of chronic abdominal discomfort associated with abnormal bowel habits [1,2]. In studies that used colonic barostats, the thalamus, insular cortex, anterior cingulate gyrus, and prefrontal cortex were activated; these activations were associated with abdominal pain and psychological abnormalities such as anxiety and depression [12,17,18,19]. Patients with IBS show greater activation of the prefrontal cortex and anterior cingulate gyrus than do healthy individuals, and perceive more abdominal pain [12,16,17,18]. Excessive activity of the amygdala can activate the insular cortex [26], prefrontal cortex, and the anterior cingulate gyrus, which may lead to GSA and aggravated GI symptoms [4,27]. Interventions aimed at reducing GSA associated with IBS should contribute to an improvement in the QOL of patients with IBS [27,28]

Methods

Results

Conclusion