LONG-TERM MONITORING OF PSYCHOSOCIAL STRESS AND SYMPTOMATOLOGY IN INFLAMMATORY BOWEL-DISEASE

Eleven subjects with inflammatory bowel disease (IBD) participated in a longterm self-monitoring investigation of the relationship between p sychosocial stress and IBD symptomatology. Two measurement instruments , the IBD Symptom Diary and the Psychosocial Stress Diary, were comple ted by each subject for 7 consecutive days each month for one year. Po oled time-series analysis of the influence of daily stress on IBD acti vity revealed a significant effect. A positive concurrent relationship was found between both daily and monthly psychosocial stress and IBD activity. Investigations of temporal relationship among variables reve aled a negative effect of previous month stress on IBD. Results sugges t a monthly rebound effect whereby IBD symptom severity is negatively responsive to the severity of the previous month stress. The effects o f stress upon IBD were not found to be modified by behavioral coping s trategies. These results support the prevailing impression that psycho social stress contributes to the clinical course of IBD, and specifica lly suggest an influential role of daily and monthly stress. A pattern matching IBD's characteristic waxing and waning clinical course emerg es when the association between stress and IBD is examined from a mont hly viewpoint. Refinement of our knowledge of the IBD-stress model cal ls for replication and explanation of the monthly rebound effect as we ll as investigations into type of stressor and coping strategy that ma y influence IBD activity.