The Association Between Psychological Distress and Pain Perception in Patients with Irritable Bowel Syndrome: The Mediating Role of Behavioral Activation and Inhibition Systems
Keywords:
Pain perception, Psychological distress, Behavioral activation system, Behavioral inhibition system, Irritable bowel syndromeAbstract
Purpose: This study aimed to examine the association between psychological distress and pain perception in individuals with Irritable Bowel Syndrome (IBS), with particular emphasis on the mediating roles of the Behavioral Activation System (BAS) and the Behavioral Inhibition System (BIS).
Methods and Materials: A descriptive–correlational design based on structural equation modeling (path analysis) was employed. The statistical population consisted of patients diagnosed with IBS who attended the Masoud Gastrointestinal and Liver Clinic in Tehran in 2024. Using convenience sampling, 320 patients were recruited. Data were collected using the Kessler Psychological Distress Scale (Kessler et al., 2002), the McGill Pain Questionnaire (Melzack, 1975), and the BIS/BAS Scales (Carver & White, 1994). Path analysis was conducted using IBM SPSS AMOS version 24.
Findings: Psychological distress showed a significant direct association with pain perception. In addition, BAS and BIS were significantly associated with pain perception. Bootstrapping analyses confirmed that both BAS and BIS significantly mediated the relationship between psychological distress and pain perception in patients with IBS.
Conclusion: The findings indicate that pain perception in IBS is influenced both directly and indirectly by psychological distress through its effects on behavioral activation and inhibition systems. These results highlight the importance of simultaneously addressing emotional distress and behavioral regulation processes in psychological and multidisciplinary interventions aimed at reducing pain perception in individuals with IBS.
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Copyright (c) 2026 Masoumeh HosseinVerdi, Somayeh Keshavarz, Hasan Abdollahzadeh (Author)
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