Titles of published articles

Dancey, C.P. & Backhouse, S. (1993) Towards a better understanding of patients with irritable bowel syndrome. Journal of Advanced Nursing, 18, 9, 1443-1450.

This study was undertaken by sending a questionnaire to 148 people suffering from irritable bowel syndrome (IBS). The respondents all were members of the IBS Network, a national independent organisation formed to help alleviate the suffering and distress of people diagnosed as having irritable bowel. They were asked about their symptoms, the medical tests they had undergone, how they felt about the treatment they received, and how IBS affected their lives. The study found that IBS affected all aspects of their lives: work, leisure, travel and relationships. Sufferers indicated that they felt they would have coped better if they had been provided with more information about IBS, its possible causes and treatment, and greater sensitivity from members of the medical profession in dealing with them.

Dancey, C.P., Whitehouse, A.R.W., Painter, J. & Backhouse, S. (1995). The relationship between hassles, uplifts and irritable bowel syndrome: a preliminary study. Journal of Psychosomatic Research, 39, 7, 827-832.

In a preliminary study, 30 sufferers of irritable bowel syndrome filled in daily symptom sheets and the combined Hassles and Uplifts questionnaire for five weeks. Initially, analyses were carried out for each symptom separately. Results showed that ratings on the hassles and symptoms questionnaires completed in the same week were more highly associated than ratings for hassles and symptoms in different weeks. No one symptom in any week was significantly associated with the following week's hassles. Similarly, hassles in any one week were not associated with the following week's symptoms. However, total symptoms were found to be significantly associated with hassles in the following weeks, whereas the association between hassles and total symptoms in the following weeks was not significant. The study suggests that there is a cumulative effect of symptoms such that an increase in the severity of the combined effect of symptoms exacerbate symptoms. There was no evidence of an association between uplifts and IBS symptoms.

The present study set out to discover nurses' attitudes towards, and beliefs about, irritable bowel syndrome (IBS) and IBS sufferers. A 54-item questionnaire was completed by 254 qualified nurses from 18 London hospitals. Nurses rated statements relating to IBS on a scale from disagree (1) to agree (5). Questionnaire items fell into four broad categories. The first related to the way nurses felt about the sufferers of IBS; the vast majority of nurses agreed with items stating that IBS patients are demanding, unable to cope with life, lazy and crave attention, and waste doctors' time. The second category related to nurses' beliefs regarding their knowledge of the syndrome; only half the sample
believed that they would recognise the symptoms of IB and that they had a good understanding of the disorder. Ratings on items relating to the nurses' general knowledge of the symptoms showed that between a quarter and a half of the sample felt uncertain about the veracity of the statements. A fourth category was the nurses' beliefs regarding the attitudes held by health professionals, with half of the sample believing that doctors and health professionals generally had a poor understanding of IBS. Surprisingly, results showed that older, more experienced nurses, and those suffering from the syndrome were not more sympathetic and understanding than younger, non-sufferers. The present study shows that the majority of nurses hold negative attitudes towards IBS sufferers which can only be detrimental to the treatment of those patients with IBS.

Introduction: this study was to ascertain the prevalence of symptoms of irritable bowel in a sample of school children 11 to 17 years of age and to determine whether children with such symptoms differed from children without symptoms on various psychosocial questions
Method: Eight hundred and fifty-one school children completed a 20-item questionnaire consisting of questions related to symptoms of irritable bowel, psychosocial questions, and filler questions. Questions referred to a 1-week timeframe to minimize memory distortion.
Results: Of the sample, 133 (16.2%) had one or more symptoms of irritable bowel. A significant association was found between bowel symptoms and other factors. Children with symptoms were more likely to report that they felt different from other children, were embarrassed about their health, and felt their health prevented them from going out with their friends.
Discussion: The study suggests that a large number of children have symptoms of irritable bowel and that having such symptoms can have a significant impact on children's lives beyond the immediate physical effects. Because children with symptoms of irritable bowel are likely to come to the attention of health professionals, nurses are in an ideal position to give such children both information and reassurance about their condition.

Traditionally, the psychology of women's health has tended to reinforce the views already existing within the medical model, and a patriarchal ideology has pervaded the area of health psychology. Disorders affecting women have been pathologised and woman, her body and her experiences have been reduced to "all in the mind". The psychologisation of women's illness is so pervasive that practitioners' stereotypical views of women (stressed, hysterical, neurotic) can lead to their symptoms being attributed to psychological factors, often without even a physical examination, leading to misdiagnosis and inadequate treatment. In this study, a "woman-centered" approach has been adopted in looking at 20 women who had been incorrectly diagnosed with Irritable Bowel Syndrome (a functional disorder) when in fact they had endometriosis (a gynaecological disease).

Irritable Bowel Syndrome (IBS), a chronic disorder which includes symptoms such as abdominal pain and altered bowel habits, affects up to 22% of people in Western populations. The causes of IBS are not well understood, but are believed to be multifactorial. Although stress is widely believed to be implicated, empirical evidence in support of this is lacking, perhaps because a typical between-participants analysis ignores individual differences and therefore may obscure any link. The present study used a within-person, lagged time-series approach to investigate the links between everyday stress and symptomatology in thirty-one IBS sufferers. Both everyday stress and symptomotology exhibited serial dependence for a statistically significant proportion of sufferers. Multiple regression analysis carried out on same day and lagged relationships up to and including four days found that for over half the participants, everyday stress and symptoms were related. The best regression model was one in which symptoms were a function of hassles and symptoms of the previous two days, and hassles on the same day, fitting the data for 67% of participants. This prospective study confirms other studies which have suggested stress is a significant factor in IBS, and concludes that stress management programs may be both useful and cost-effective in the treatment of IBS.

Dancey, C.P. & Fox, R.J. (September 1998). IBS - Neglected area. Health Update.

Dancey, C.P. Fox, R. & Devins, G.M. (1999). The measurement of IBS-related misconceptions in people with irritable bowel syndrome.

Irritable Bowel Syndrome (IBS) is a common chronic disorder affecting between 15% and 22% of Western populations; core symptoms include abdominal pain and disturbed bowel function. Adjusting to living with IBS may entail considerable coping efford and, because medical treatments are largely ineffective, people with IBS must learn to manage the condition themselves. Self-management programs that include an increased awareness of and information relating to chronic illness have been shown to lead to positive benefits. The present article describes the development of the IBS misconceptions scale, an instrument designed to measure the misconceptions held by people with IBS. The final 17-item questionnaire was able to differentiate between three groups expected to differ in terms of IBS-related misconceptions, and showed good validity and reliability. The IBS-MS may be a useful tool in patient education programs, because it should be sensitive to changes in illness-related knowledge gained during intervention programs, and it is hoped that further research will lend further support to its reliability, validity and usefulness.

Stenner, PHD., Dancey, C.P. & Watts, S. (2000). The understanding of their illness amongst people with irritable bowel syndrome: A Q methodological study.

Irritable Bowel Syndrome (IBS) refers to a collection of gastrointestinal symptoms which affect up to 22% of the Western Population. Although the disorder costs the British National Health Service and employers vast sums of money in terms of repeated physician visits, medications, and loss of productivity, the cause or causes of IBS are still unknown, and there is no cure which is lastingly effective. Since IBS is not life-threatening, and the symptoms can be hidden from others, many consider it to be a trivial disorder. For an individual with IBS, however, the uncertainty regarding cause, diagnosis and treatment may lead to anxiety and constant searching for causes, or to hopelessness and resignation. The present study aims to help clarify these problems by discovering how those who suffer from IBS understand the nature and causality of their own illness. Through use of Q methodology with a sample of 60 people with IBS, a taxonomy of 7 clear and distinct accounts is identified and described. These data (based on Q factor analysis) are described in qualitative detail and discussed in relation to the problem of improving communication with doctors, and untangling issues of responsibility for illness.

Vitkovitch, M., Bishop, S., Dancey, C.P. & Richards, A. (2002).  Stroop interference and negative priming in patients with multiple sclerosis. Neuropsychologia.

The experiment reported represents a preliminary assessment of the ability of multiple sclerosis patients to inhibit distracting stimuli in a selective attention task.  Twenty multiple sclerosis and twenty matched control participants were given a card version of the Stroop colour-word interference task.  Four condtions were included; neutral (strings of coloured Xs), congruent (colour and word matched), Stroop interference (colour and word conflicted) and ignored repeated (again, conflicting colour and words, but colour on trial n matched the word on trial n - 1).  Response times to thirty colour naming trials in each condition were measured to the nearest second.  Increased Stroop interference scores were evident for the MS patients relative to the control group.  However, a negative priming effect was evident for both MS and control groups; response times were longer for the ignored repeated condition relative to the Stroop interference condtion.  This suggsts that both groups were able to inhibit distractors on trial n - 1, and that increased Stroop interference scores for MS patients were not due to a complete breakdown of inhibitory processing.  although negative priming effects did not differ across the groups, the possibility of a partial breakdown in inhibitory processes could not be ruled out.  Other explanations for increased Stroop interference in MS patients are also briefly considered.

Dancey, C.P., Hutton-Young, S.A., Moye, S. & Devins, G.M. (2002).  Perceived stigma, illness intrusiveness and quality of life in men and women with irritable bowel syndrome.

Illness intrusiveness - illness-induced disruptions to lifestyles, activities and interests - compromises quality of life (QOL) in chronic disease.  Illness intrusvieness derives from aspects of disease (e.g. severity of symptoms) and treatment and its impact is moderated by psychological, social factors and biological sex/gender.  The present study tested (a) the validity of the illness intrusiveness framework in irritable bowel syndrome (IBS) and (b) the hypothesis that the psychosocial impact of IBS differs between men and women.  A mail survey, completed by 117 national charity members, included the Illness Intrusiveness Ratings Scale and self-report QOL measures.  Results indicated that both the severity of IBS symptoms and perceived stigma correlated significantly with QOL.  As hypothesised, illness intrusiveness mediated these relationships and sex differences were evident.   Although symptom severity was associated with a more powerful QOL impact among women as compared to men, perceived stigma was associated with a greater QOL impact in men.  A sex * illness intrusiveness interaction indicated that QOL decreased more precipitously among men than women as illness intrusiveness increased.  Illness intrusiveness was also a more powerful mediator of the relation between symptom severity and QOL among men than women: reduced QOL was related more directly to symptom severity among women than men.  These results bear on the ways in which gender socialisation shapes sex differences in the wider experience of IBS and raise implications for general vs. sex-specific treatments.

Attree, E.A., Dancey, C.P., Keeling, D. & Wilson, C. (2003).  Cognitive function in people with chronic illness: Inflammatory Bowel Disease and Irritable Bowel Syndrome. 

Recent research has shown that people with chronic illnesses often experience cognitive deficits, such deficits may be specific to a particular type of illness, reflecting the disease process itself, or they may be deficits that are common across a number of chronic illnesses. Our study investigated whether people with an organic disease (Inflammatory Bowel Disease) show cognitive dysfunction relative to the control group and people with a functional illness (Irritable Bowel Syndrome), and if so, to elucidate the mechanisms by which such dysfunction occurs. A quasi-experimental design using three groups of participants provided scores on IQ, memory, and cognitive flexibility. Differences in absolute scores were slight. However, a noticeable interaction effect was found between group and IQ: The illness groups showed a deficit in verbal IQ relative to both their own performance IQ and to that of the control group's verbal IQ. This verbal deficit cannot be explained by depression, cognitive load, or medication.