Trial reportGastroenterology2007
How does cognitive behavior therapy for irritable bowel syndrome work? A mediational analysis of a randomized clinical trial.
Trial report in Gastroenterology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Face-to-Face Versus Digital, Telephone-Delivered, and Self-Help Cognitive Behavioral Therapy for Irritable Bowel Syndrome: Systematic Review and Bayesian Indirect Treatment Comparison Meta-Analysis.Journal of medical Internet research · 2026Pooled it
- Pooled it
- Trial
- Potential Choroidal Mechanisms Underlying Atropine's Antimyopic and Rebound Effects: A Mediation Analysis in a Randomized Clinical Trial.Investigative ophthalmology & visual science · 2023Trial
- Written expressive disclosure in adults with irritable bowel syndrome: A randomized controlled trial.Complementary therapies in clinical practice · 2021Trial
- Trial
- Cognitive mediators of treatment outcomes in pediatric functional abdominal pain.The Clinical journal of pain · 2014Trial
- Trial
- Prediction of symptomatic improvement after exposure-based treatment for irritable bowel syndrome.BMC gastroenterology · 2013Trial
- Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations.Journal of behavioral medicine · 2012Trial
- The Irritable Bowel Syndrome Outcome Study (IBSOS): rationale and design of a randomized, placebo-controlled trial with 12 month follow up of self- versus clinician-administered CBT for moderate to severe irritable bowel syndrome.Contemporary clinical trials · 2012Trial
- Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial.The American journal of gastroenterology · 2011Trial
- Comprehensive self-management for irritable bowel syndrome: randomized trial of in-person vs. combined in-person and telephone sessions.The American journal of gastroenterology · 2009Trial
- Mindfulness for irritable bowel syndrome: protocol development for a controlled clinical trial.BMC complementary and alternative medicine · 2009Trial
- Self-administered cognitive behavior therapy for moderate to severe irritable bowel syndrome: clinical efficacy, tolerability, feasibility.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2008Trial
- Multidomain patient-reported outcomes of irritable bowel syndrome: exploring person-centered perspectives to better understand symptom severity scores.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes ResearchTrial
- Patient Identification of the most important outcomes in a gastrointestinal behavioral health program.Journal of patient-reported outcomes · 2026Article
- Sleep Disturbances Among Adult Patients with Mood Disorders: A Saudi Cross-Sectional Study.Nature and science of sleep · 2026Article
- A Practical Guide to Incorporating a Psychologist Into a Gastroenterology Practice.Gastroenterology · 2025Article
- Dietary intake and five types of mental disorders: a bidirectional Mendelian randomization study.BMC psychiatry · 2025Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsAlthough multiple clinical trials support the efficacy of psychological treatments for reducing irritable bowel syndrome (IBS) symptoms, the mechanisms responsible for symptomatic improvement are unknown. One hypothesis is that psychological treatments work by alleviating comorbid psychological distress implicated in the worsening of bowel symptoms and quality of life. An alternative hypothesis assumes that changes in distress are not strictly a cause but a consequence of IBS that will decrease with symptomatic improvement.
methodsWe evaluated these 2 hypotheses by applying structural equation modeling (SEM) to the data set of a large number (n = 147) of Rome II diagnosed participants randomized to CBT, psychoeducation, or wait list. Per Rome guidelines, the primary end point was global improvement of gastrointestinal (GI) symptoms measured 2 weeks after a 10-week regimen. Secondary end points were distress and quality of life (QOL).
resultsSEM analyses lend support to a model in which CBT is associated with improvements in IBS symptoms, but that therapeutic gains do not depend on changes in patients' overall level of psychological distress. Symptom severity, but not clinical status (pain catastrophizing, predominant bowel habits, symptom duration, abuse, diagnosable psychiatric disorder) or relevant sociodemographic variables (eg, gender, age), moderated treatment outcome.
conclusionCBT has a direct effect on global IBS symptom improvement independent of its effects on distress. Improvement in IBS symptoms is associated with improvements in the QOL, which may lower distress. Symptom improvements are not moderated by variables reflecting the mental well-being of IBS patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.