This article is derived from the author’s master’s thesis titled “Comparison of perceived stress, personality traits and resilience in patients with gastrointestinal problems and normal counterparts “. This study examines the psychological profile of irritable bowel syndrome (IBS) patients through a multidimensional assessment of stress perception, personality traits and resilience capacity. Using a matched case-control design. we evaluated 100 participants (50 IBS patients, 50 healthy controls) using standardized measures including the Perceived Stress Scale (PSS-14), NEO Five-Factor Inventory (NEO-FFI), and Connor-Davidson Resilience Scale (CD- RISC-25). Data were analyzed using ANOVA and MANOVA. key findings demonstrate that IBS patients exhibit significantly elevated stress levels (p<0.001), higher neuroticism (p<0.001), Lower scores in extraversion (p = 0.01), openness to experience (p = 0.002), agreeableness (p = 0.003), and conscientiousness (p = 0.001) compared to control group and markedly reduced resilience across all subscales (p < 0.05). The results highlight substantial psychological challenges in IBS patients, underscoring the need for integrated psychological interventions alongside medical treatment.

• Stress perception

• Personality traits

• Resilience

• Irritable bowel syndrome (IBS)

• Mental health

Maserrat S (2025) Psychological and Personality Correlates of Irritable Bowel Syndrome: A Comprehensive Case-Control Study. Ann Psychiatry Ment Health 13(2): 1204.

Irritable bowel syndrome represents one of the most prevalent functional gastrointestinal disorders, affecting approximately 11.2% of the global population according to recent epidemiological data [1]. This syndrome is characterized by symptoms including abdominal pain, bloating, diarrhea, or constipation that manifest without detectable structural abnormalities in the digestive tract [2].

While traditionally classified as a digestive disorder, emerging evidence underscores the critical role of brain-gut interactions in IBS pathophysiology [3]. The bidirectional communication between the central nervous system and enteric nervous system, mediated through neuroimmune pathways, provides a plausible mechanism for how psychological factors may influence gastrointestinal symptom severity [3,4].

Recent years have witnessed growing scholarly interest in the robust association between psychological factors and IBS [5]. Empirical evidence indicates that IBS patients experience elevated stress levels and exhibit distinct personality patterns that may contribute to symptom onset and persistence [6]. Perceived stress, defined as an individual’s subjective appraisal of life event pressures and threats [7], originates from Lazarus and Folkman’s (1984) transactional stress theory emphasizing cognitive evaluation’s role in stress experience [8].

However, existing studies frequently suffer from methodological limitations such as small sample sizes, lack of matched controls, or incomplete psychological assessment batteries. Our study addresses these gaps through a comprehensive evaluation of multiple psychological domains in a carefully characterized IBS cohort.

Personality traits, relatively stable patterns of cognition, emotion, and behavior, significantly influence stress response and disease susceptibility [9]. The Five-Factor Model (FFM) of personality (neuroticism, extraversion, openness, agreeableness, and conscientiousness) provides a robust framework for investigating these relationships [10].

Resilience, conceptualized as successful adaptation to adverse circumstances [11], may serve as a protective factor against stress-related physiological and psychological consequences [12].

Given IBS’s high prevalence and substantial quality-of life impacts, this study comparatively examines perceived stress, personality traits, and resilience in IBS patients versus healthy controls. The findings may enhance understanding of IBS-psychology linkages and inform more comprehensive treatment approaches.

Participants

This causal-comparative study was conducted in 2022 at Valiasr International Hospital (AJ) in Tabriz, Iran Inclusion criteria for the patient group included: 1. IBS diagnosis by a gastroenterologist based on Rome IV criteria, 2. age 25-45 years, and 3. minimum high school diploma education. Exclusion criteria involved having other chronic diseases or psychiatric disorders. We recruited 50 IBS patients from the gastroenterology clinic at Valiasr International Hospital, along with 50 age, sex and education-matched Healthy companions of hospital visitors serving as controls. All participants underwent structured clinical interviews to confirm diagnoses and exclude psychiatric comorbidities. The IBS group comprised 32 females (64%) and 18 males (36%), with. a mean age of 35.2 ± 6.8 years and mean symptom duration of 4.3 ± 2.1 years.

Research Instruments

Measures

1. Perceived Stress Scale (PSS-14): Assesses the degree to which situations are appraised as stressful [13].

2. NEO Five-Factor Inventory (NEO-FFI): Evaluates personality across five domains [14].

3. Connor-Davidson Resilience Scale (CD-RISC-25): Measures ability to cope with adversity [15].

Procedure: Following informed consent acquisition, questionnaires were administered by the researcher. Ethical approval was obtained from Tabriz University of Medical Sciences Ethics Committee (IR.TBZMED.REC.1401. XXX).

Statistical Analysis

Data were analyzed using SPSS v.28. We employed multivariate analysis of variance (MANOVA) to examine group differences across psychological domains, followed by post-hoc tests with Bonferroni correction. Effect sizes were calculated using partial eta squared (ηp²).

Psychological Characteristics

IBS patients demonstrated significantly higher stress levels (36.92 ± 6.48 vs. 21.06 ± 9.32; F=41.82, p<0.001, ηp²=0.32) and neuroticism scores (39.00 ± 11.44 vs. 21.06 ± 9.32; F=63.14, p<0.001, ηp²=0.41) compared to controls. Resilience scores were substantially lower across all subscales (p<0.001 for all comparisons).

Personality Profiles

The IBS group showed significantly lower scores on extraversion (28.20 ± 10.42 vs. 42.70 ± 15.65; p=0.01), openness (32.22 ± 10.21 vs. 45.88 ± 12.07; p=0.002), agreeableness (28.20 ± 6.39 vs. 42.86 ± 10.21; p=0.003), and conscientiousness (28.20 ± 6.39 vs. 42.52 ± 6.39; p=0.001).

Demographic Characteristics

The mean age of participants was 35.2 ± 6.8 years, with 68% female and 32% male. Educational attainment included: 42% associate degree holders, 34% bachelor’s degree holders, and 16% with master’s degrees or higher. No significant demographic differences existed between groups (p> 0.05).

Perceived Stress Comparison

ANOVA revealed significant between-group differences in perceived stress (F=41.82, p<0.001). IBS patients demonstrated markedly higher stress scores (36.92±6.48) versus controls (21.06±9.32).

Personality Traits Analysis

MANOVA indicated significant group differences across all personality dimensions (p<0.05): Neuroticism: Higher in patients (39.00±11.44) than controls (21.06±9.32; p<0.001) Extraversion: Controls (42.70±15.65) scored higher than patients (28.20±10.42; p=0.01)

Openness: Controls (45.88±12.07) exceeded patients (32.22±10.21; p=0.002) Agreeableness: Controls (42.86±10.21) surpassed patients (28.20±6.39; p=0.003) Conscientiousness: Controls (42.52±6.39) outperformed patients (28.20±6.39; p=0.001).

Resilience Components

Significant MANOVA results emerged for all resilience components (p<0.05)

- Personal competence (24.04±4.74 vs 15.64±4.22)

- Trust in instincts (22.14±5.50 vs 9.48±2.67)

- Negative emotion tolerance (15.64±2.57 vs 6.50±1.66)

- Control (9.48±1.88 vs 2.67±1.66)

- Spirituality (6.50±1.77 vs 1.66±1.77)

Our findings reveal a distinct psychological signature in IBS patients characterized by stress hyper-reactivity, neurotic predisposition, and compromised resilience. These results suggest that psychological factors may contribute to both IBS susceptibility and symptom chronicity.

The findings about resilience suggest that psychological interventions targeting coping flexibility and stress tolerance could potentially modify disease course.

Our findings demonstrate that IBS patients experience elevated perceived stress and neuroticism compared to healthy individuals, aligning with Admon et al.’s (2017), work on stress- gastrointestinal associations [16]. These results support Lazarus and Folkman’s (1984), cognitive appraisal theory of stress [8].

The personality profile of IBS patients, characterized by heightened neuroticism and reduced scores in other domains, corroborates findings by Faeli et al. (2017), and Khalidian et al. (2019) [17,18]. Elevated neuroticism may predispose individuals to somatic symptom hypersensitivity and catastrophizing interpretations [19].

Reduced resilience in IBS patient’s mirrors results from Roshan et al. (2016), and Mohammadi & Fazlali (2021). Impaired resilience likely diminishes stress-coping capacity, potentially creating a vicious cycle of symptom exacerbation.

Study limitations include single-center sampling, self-report methodology, and unmeasured IBS symptom severity. Future research should employ multicenter designs with larger samples and evaluate psychological interventions targeting stress and resilience in this population.

This study provides robust evidence for psychological differences between IBS patients and healthy controls across multiple domains. Future research should examine whether targeted psychological interventions can normalize these differences and improve clinical outcomes.

The findings of this study demonstrate that IBS patients face significant psychological challenges, exhibiting: Elevated levels of perceived stress and neuroticism, Reduced extraversion, openness to experience, agreeableness, and conscientiousness, markedly lower resilience across all measured components.

These results underscore the critical need for comprehensive treatment approaches that integrate psychological interventions alongside standard medical care for IBS management. The distinct psychological profile observed in IBS patients suggests that:

1. Stress-reduction protocols should be incorporated into therapeutic regimens

2. Personality assessment may help identify high-risk patients requiring additional support

3. Resilience-building interventions could potentially break the stress-symptom cycle

The study contributes to growing evidence supporting the biopsychosocial model of IBS, highlighting the inseparable interaction between psychological factors and gastrointestinal pathophysiology.

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