Advertisement

Classification and differentiation of bladder and bowel related anxieties: A socio-cognitive exploration

  • Kenley L. J. Kuoch
  • Denny Meyer
  • David W. Austin
  • Simon R. KnowlesEmail author
Article
  • 4 Downloads

Abstract

The current study aimed to explore the validity of a single, self-report measure for bladder and bowel anxieties (Bladder and Bowel Anxiety Grouping Item; BABAGI), using two appropriate scales entitled the Shy Bladder and Bowel Scale (SBBS) and the Bladder and Bowel Incontinence Phobia Severity Scale (BBIPSS). This study also aimed to examine the similarities and differences in dysfunctional attitudes (DAs), fear of negative and positive evaluation (FNE and FPE), concerns of social reprisal (CSR), and disqualification of positive social outcomes (DPSO) across individuals who self-identify as having paruresis/parcopresis, incontinence anxiety, or neither condition according to the BABAGI measure. Three-hundred-and-six undergraduate students (77.1% female; mean age = 31.18 years) completed a cross-sectional, online study. The results supported the hypothesis that by using the BABAGI, self-reported paruresis/parcopresis could be reliably identified by SBBS scores of above 6.75 and that self-reported incontinence anxiety could be reliably identified by BBIPSS scores above 15.21. The results also supported the hypothesis that individuals who self-identified as having paruresis/parcopresis or incontinence anxiety would score higher in socio-cognitive processes (DAs, FNE, FPE, CSR, DPSO) compared to individuals who self-identified as having neither condition. Given that the paruresis/parcopresis and incontinence anxiety groups do not significantly differ from each other with respect to socio-cognitive processes, this suggests that both sets of conditions share similar underlying psychosocial processes.

Keywords

Paruresis Parcopresis Bladder and bowel incontinence anxiety Socio-cognitive Psychosomatic 

Notes

Acknowledgments

The authors would like to thank all the individuals who participated in our research.

Funding

This research was conducted through the support of the Australian Government Research Training Program Scholarship.

Compliance with Ethical Standards

Conflict of Interest

None.

Provenance and peer review.

Not commissioned, externally peer reviewed.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. Al-Osail, A. M., Al-Sheikh, M. H., Al-Osail, E. M., Al-Ghamdi, M. A., Al-Hawas, A. M., Al-Bahussain, A. S., & Al-Dajani, A. A. (2015). Is Cronbach's alpha sufficient for assessing the reliability of the OSCE for an internal medicine course? BMC Research Notes, 8, 582.  https://doi.org/10.1186/s13104-015-1533-x.CrossRefGoogle Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington D.C.Google Scholar
  3. Beevers, C. G., Strong, D. R., Meyer, B., Pilkonis, P. A., & Miller, I. W. (2007). Efficiently assessing negative cognition in depression: An item response theory analysis of the dysfunctional attitude scale. Psychological Assessment, 19(2), 199–209.CrossRefGoogle Scholar
  4. Beidel, D. C., & Bulik, C. M. (1990). Flooding and response prevention as a treatment for bowel obsessions. Journal of Anxiety Disorders, 4, 247–256.CrossRefGoogle Scholar
  5. Boschen, M. J. (2008). Paruresis (psychogenic inhibition of micturition): Cognitive behavioral formulation and treatment. Depression and Anxiety, 25(11), 903–912.  https://doi.org/10.1002/da.20367.CrossRefGoogle Scholar
  6. Carleton, R. N., Collimore, K. C., & Asmundson, G. J. (2007). Social anxiety and fear of negative evaluation: Construct validity of the BFNE-II. Journal of Anxiety Disorders, 21(1), 131–141.  https://doi.org/10.1016/j.janxdis.2006.03.010.CrossRefGoogle Scholar
  7. Cosci, F. (2013). "bowel obsession syndrome" in a patient with chronic constipation. General Hospital Psychiatry, 35(4), 451 e451–451 e453.  https://doi.org/10.1016/j.genhosppsych.2012.05.006.CrossRefGoogle Scholar
  8. Deloitte Access Economics. (2011). The economic impact of incontinence in Australia: Continence Foundation of Australia. Retrieved from.Google Scholar
  9. Epstein, S., & Jenike, M. A. (1990). Disabling urinary obsessions. Psychosomatics, 31(4), 450–452.  https://doi.org/10.1016/s0033-3182(90)72143-3.CrossRefGoogle Scholar
  10. Field, A. (2014). Discovering statistics using IBM SPSS statistics (t. Edition Ed.). London: Sage Publications.Google Scholar
  11. Finch, H. (2005). Comparison of the performance of nonparametric and parametric MANOVA test statistics when assumptions are violated. Methodology, 1(1), 27–38.  https://doi.org/10.1027/1614-1881.1.1.27.CrossRefGoogle Scholar
  12. Hammelstein, P., & Soifer, S. (2006). Is "shy bladder syndrome" (paruresis) correctly classified as social phobia? Journal of Anxiety Disorders, 20(3), 296–311.  https://doi.org/10.1016/j.janxdis.2005.02.008.CrossRefGoogle Scholar
  13. Hazel, M., Keaten, J., & Kelly, L. (2014). The relationship between personality temperament, communication reticence, and fear of negative evaluation. Communication Research Reports, 31(4), 339–347.  https://doi.org/10.1080/08824096.2014.963219.CrossRefGoogle Scholar
  14. Heimberg, R. G., & Becker, R. E. (2002). Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies. New York: Guilford Press.Google Scholar
  15. Kamboj, S. K., Langhoff, C., Pajak, R., Zhu, A., Chevalier, A., & Watson, S. (2015). Bowel and bladder-control anxiety: A preliminary description of a viscerally-centred phobic syndrome. Behavioural and Cognitive Psychotherapy, 43(2), 142–157.  https://doi.org/10.1017/S1352465813000726.CrossRefGoogle Scholar
  16. Knowles, S. R., & Skues, J. (2016). Development and validation of the shy bladder and bowel scale (SBBS). Cognitive Behaviour Therapy, 45(4), 324–338.  https://doi.org/10.1080/16506073.2016.1178800.CrossRefGoogle Scholar
  17. Kuoch, K. L. J., Meyer, D., Austin, D. W., & Knowles, S. R. (2017). A systematic review of paruresis: Clinical implications and future directions. Journal of Psychosomatic Research, 98, 122–129.  https://doi.org/10.1016/j.jpsychores.2017.05.015.CrossRefGoogle Scholar
  18. Kuoch, K. L. J., Austin, D. W., & Knowles, S. R. (2019a). Latest thinking on paruresis and parcopresis: A new distinct diagnostic entity? The Australian Journal of General Practice, 48(4).Google Scholar
  19. Kuoch, K. L. J., Cook, S., Meyer, D., Austin, D. W., & Knowles, S. R. (2019b). Exploration of the socio-cognitive processes underlying paruresis and parcopresis. Current Psychology.  https://doi.org/10.1007/s12144-019-0125-7.
  20. Kuoch, K. L. J., Meyer, D., Austin, D. W., & Knowles, S. R. (in press). Development and validation of the bladder and bowel incontinence phobia severity scale (BBIPSS). Journal of Cognitive Psychotherapy.Google Scholar
  21. Kuoch, K. L. J., Meyer, D., Austin, D. W., & Knowles, S. R. (under review-a). Socio-cognitive processes associated with bladder and bowel incontinence anxiety: A proposed bivalent model.Google Scholar
  22. Kuoch, K. L. J., Meyer, D., Austin, D. W., & Knowles, S. R. (under review-b). Socio-cognitive processes associated with paruresis and parcopresis symptoms: A proposed bivalent model.Google Scholar
  23. Maia Barros, R. E. (2011). Paruresis and parcopresis in social phobia: A case report. Revista Brasileira de Psiquiatria, 33, 416–417.CrossRefGoogle Scholar
  24. Malouff, J. M., & Lanyon, R. I. (1985). Avoidant paruresis: An exploratory study. Behavior Modification, 9(2), 225–234.  https://doi.org/10.1177/01454455850092006.CrossRefGoogle Scholar
  25. Mansueto, G., Caselli, G., Ruggiero, G. M., & Sassaroli, S. (2019). Metacognitive beliefs and childhood adversities: An overview of the literature. Psychology, Health & Medicine, 24(5), 542–550.  https://doi.org/10.1080/13548506.2018.1550258.CrossRefGoogle Scholar
  26. Martini, F. H., Nath, J. L., & Bartholomew, E. F. (2012). Fundamentals of anatomy & physiology (9th ed.). San Francisco: Pearson.Google Scholar
  27. Mercer, A. (2016). Oversampling is used to study small groups, not bias poll results. Pew research Centre. Retrieved from http://pewrsr.ch/2eIepyc. Accessed April 2019.
  28. Norton, C., Whitehead, W., Bliss, D., Metsola, P., & Tries, J. (2016). Conservative and pharamcological management of faecal incontinence in adults. Paper presented at the The International Continence Society. https://www.ics.org/Publications/ICI_4/files-book/comite-16.pdf. Accessed April 2019.
  29. Pajak, R., & Kamboj, S. K. (2014). Experimental single-session imagery rescripting of distressing memories in bowel/bladder-control anxiety: A case series. Frontiers in Psychiatry, 5, 182.  https://doi.org/10.3389/fpsyt.2014.00182.CrossRefGoogle Scholar
  30. Pajak, R., Langhoff, C., Watson, S., & Kamboj, S. K. (2013). Phenomenology and thematic content of intrusive imagery in bowel and bladder obsession. Journal of Obsessive-Compulsive and Related Disorders, 2(3), 233–240.  https://doi.org/10.1016/j.jocrd.2013.04.005.CrossRefGoogle Scholar
  31. Palmieri, S., Mansueto, G., Scaini, S., Fiore, F., Sassaroli, S., Ruggiero, G. M., Borlimi, R., & Carducci, B. J. (2018). Role of rumination in the relationship between metacognition and shyness. World J Psychiatry, 8(4), 108–113.  https://doi.org/10.5498/wjp.v8.i4.108.CrossRefGoogle Scholar
  32. Porcelli, P., & Leandro, G. (2007). Bowel obsession syndrome in a patient with ulcerative colitis. Psychosomatics, 48(5), 448–450.  https://doi.org/10.1176/appi.psy.48.5.448.CrossRefGoogle Scholar
  33. Rusticus, S. A., & Lovato, C. Y. (2014). Impact of sample size and variability on the power and type I error rates of equivalence tests: A simulation study. Practical Assessment, Research & Evaluation, 19(11), 1–10.Google Scholar
  34. Sinclair, A. J., & Ramsay, I. N. (2011). The psychosocial impact of urinary incontinence in women. The Obstetrician & Gynaecologist, 13, 143–148.CrossRefGoogle Scholar
  35. Soifer, S. (2012). Shy bladder syndrome (paruresis): An update: International Paruresis association Inc.Google Scholar
  36. Soifer, S., Zgourides, G. D., Himle, J., & Pickering, N. L. (2001). Shy bladder syndrome: Your step-by-step guide to overcoming paruresis: New harbinger publications.Google Scholar
  37. Soifer, S., Himle, J., & Walsh, K. (2010). Paruresis (shy bladder syndrome): A cognitive-behavioral treatment approach. Social Work in Health Care, 49(5), 494–507.  https://doi.org/10.1080/00981381003684898.CrossRefGoogle Scholar
  38. Tape, T. G. (2001). Interpretation of diagnostic tests. Annals of Internal Medicine, 135(1), 72.  https://doi.org/10.7326/0003-4819-135-1-200107030-00043.CrossRefGoogle Scholar
  39. Vythilingum, B., Stein, D. J., & Soifer, S. (2002). Is "shy bladder syndrome" a subtype of social anxiety disorder? A survey of people with paruresis. Depression and Anxiety, 16(2), 84–87.  https://doi.org/10.1002/da.10061.CrossRefGoogle Scholar
  40. Weeks, J. W. (2010). The disqualification of positive social outcomes scale: A novel assessment of a long-recognized cognitive tendency in social anxiety disorder. Journal of Anxiety Disorders, 24(8), 856–865.  https://doi.org/10.1016/j.janxdis.2010.06.008.CrossRefGoogle Scholar
  41. Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., & Liebowitz, M. R. (2005). Empirical validation and psychometric evaluation of the brief fear of negative evaluation scale in patients with social anxiety disorder. Psychological Assessment, 17(2), 179–190.  https://doi.org/10.1037/1040-3590.17.2.179.CrossRefGoogle Scholar
  42. Weeks, J. W., Heimberg, R. G., & Rodebaugh, T. L. (2008). The fear of positive evaluation scale: Assessing a proposed cognitive component of social anxiety. Journal of Anxiety Disorders, 22(1), 44–55.  https://doi.org/10.1016/j.janxdis.2007.08.002.CrossRefGoogle Scholar
  43. Weeks, J. W., Menatti, A. R., & Howell, A. N. (2015). Psychometric evaluation of the concerns of social reprisal scale: Further explicating the roots of fear of positive evaluation. Journal of Anxiety Disorders, 36, 33–43.  https://doi.org/10.1016/j.janxdis.2015.06.008.CrossRefGoogle Scholar
  44. Westin, L. K. (2001). Receiver Operating Characteristic (ROC) analysis: Evaluating discriminance effects among decision support systems. Retrieved from https://www.semanticscholar.org/paper/Receiver-operating-characteristic-(-ROC-)-analysis-Westin-Kallin/dfc1e148b1d08500954f5c78f0a1001affbfc041. Accessed April 2019.
  45. Wong, S. S. (2008). The relations of cognitive tirad, dysfunctional attitudes, automatic thoughts, and irrational beliefs with test anxiety. Current Psychology, 27, 177–191.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kenley L. J. Kuoch
    • 1
  • Denny Meyer
    • 2
    • 3
  • David W. Austin
    • 4
  • Simon R. Knowles
    • 1
    • 5
    • 6
    • 7
    Email author
  1. 1.Department of Psychological SciencesSwinburne University of TechnologyMelbourneAustralia
  2. 2.Department of Statistics, Data Science and EpidemiologySwinburne University of TechnologyMelbourneAustralia
  3. 3.Centre for Mental HealthSwinburne University of TechnologyMelbourneAustralia
  4. 4.School of PsychologyDeakin UniversityGeelongAustralia
  5. 5.Department of PsychiatrySt Vincent’s HospitalMelbourneAustralia
  6. 6.Department of MedicineThe University of MelbourneMelbourneAustralia
  7. 7.Department of Gastroenterology and HepatologyRoyal Melbourne HospitalMelbourneAustralia

Personalised recommendations