Does hypervigilance predict Functional Gastrointestinal Disorder symptoms over and above known psychosocial predictors?

Abstract

Functional Gastrointestinal Disorders (FGIDs) are chronic medically unexplained disorders of the gut. Research has shown that, broadly, FGIDs are caused by dysregulation of the neurohormonal brain-gut axis. Biopsychosocial conceptualisations of the brain-gut axis imply a need to treat not only biological but also social and psychological contributors to dysregulation. Past research suggests that attentional bias might play a role in dysregulation. We investigated the relationship between hypervigilance and FGID symptoms over and above known psychosocial predictors of symptoms: anxiety, stress, neuroticism, pain catastrophising and self-efficacy. Electroencephalography was used to record Event Related Potentials (ERPs) to measure attention for any bias in FGID-sufferers. Participants also filled out scales measuring known psychosocial predictors of symptoms. FGID symptoms were tracked using a 14-day daily diary in which participants reported daily on pain, mood and non-pain symptoms. Averages and standard deviations in these indices across 14 days served as the outcome variables in regression models (12 in total). It was found that conscious attentional bias was marginally statistically significant when predicting mood. However, stress and neuroticism together predict significant variation in mood but not in symptomrelated (pain and non-pain) daily diary variables. We also observed an effect of self-efficacy on fluctuations in pain. Daily Diary measures seem to be difficult to predict with existing survey measures and they do not seem to be predicted by measures of attention. With respect to daily diary measures, mood is a variable for future research to consider further.