Date of Award

Fall 8-21-2020

Level of Access Assigned by Author

Open-Access Thesis

Degree Name

Doctor of Philosophy (PhD)




Douglas W. Nangle

Second Committee Member

Cynthia A. Erdley

Third Committee Member

Emily A.P. Haigh

Additional Committee Members

Craig A. Mason

Rebecca Schwartz-Mette


The current study examined the interplay of three key variables: stress, maladaptive social problem-solving (SPS), and Irritable Bowel Syndrome (IBS) symptom severity. According to SPS theory, SPS is the self-directed cognitive and behavioral process by which individuals attempt to manage real-life problems or stressful situations. There are two main types of SPS: adaptive or maladaptive (D’Zurilla & Chang, 1995). Individuals who have adaptive SPS tendencies tend to view problems in an optimistic light; they perceive problems as solvable challenges and opportunities for personal growth. On the other hand, individuals who have maladaptive SPS tendencies often see problems as threatening and unsolvable, and they generally exhibit an impulsive or careless problem-solving style, or an avoidant style such as ignoring problems.

D’Zurilla and Nezu (2001) assert that the connection among stress, SPS, and adjustment is best understood by examining their relational/problem-solving model of stress and wellbeing. The relational/problem-solving model of stress and wellbeing suggests that risk factors such as increased stress or problems, maladaptive problem-solving ability, and decreased wellbeing form transactional relationships that interact with one another and evolve with time (D’Zurilla & Nezu, 2001). This model has been supported by a substantial number of studies that demonstrate links between maladaptive SPS and a wide range of psychological problems such as depression and anxiety (Anderson et al., 2009; Chang & D’Zurilla, 1996; Kant et al., 1997; Siu & Shek, 2010; Wilson, Bushnell, Rickwood, Caputi, & Thomas, 2011) and physical health problems such as non-cardiac chest pain, asthma, and migraines (Eskin et al., 2013; Nezu, Nezu, & Jain, 2008; Witty, Heppner, Bernard, & Thoreson, 2001).

Although the relational/problem-solving model of wellbeing has been tested with several psychological and physical health problems, it had yet to be tested with IBS, which is one of the most common disorders diagnosed in primary care and gastroenterology settings (Mayer, 2008). IBS is characterized by a cluster of potentially debilitating symptoms that can include chronic abdominal pain and cramping, bloating, gas, irregular bowel patterns (i.e., diarrhea, constipation, or watery stools), and uncomfortable sensations of incomplete evacuation.

IBS has no clear etiology or mechanism to explain dysfunction, but the biopsychosocial perspective is the predominant approach for understanding IBS (Kennedy et al., 2012; Tanaka et al., 2011). The biopsychosocial perspective links biological, psychological, and social factors to the onset, severity, and course of IBS (Pletikosić & Tkalčić, 2013; van Tilburg et al., 2013). IBS is often referred to as the “brain-gut disorder” due to the notion that bidirectional relationships exist between the mind (i.e., psychological factors) and the body (i.e., physiological factors), and that individuals with IBS have dysregulation of the communication between the “brain” and the “gut” (Kennedy et al., 2012). For example, individuals who have maladaptive cognitive appraisals might tell themselves: “I can’t handle this” in stressful situations, which, in turn, increases their level of stress. The increased stress leads them to engage in maladaptive SPS which adversely impacts their ability to cope with their environment, and this may result in an increase in the severity of their gastrointestinal symptoms (Kennedy et al., 2012).

The current study’s evaluation of the relational/problem-solving model of stress and wellbeing with IBS contributed to the body of research that has established relationships between stress and SPS (Bell & D’Zurilla, 2009) and stress and IBS symptoms (Dancey et al., 1995). Consequently, the current study examined the interplay amongst stress, maladaptive SPS, and IBS using this model. Results supported all of the testable hypotheses, providing evidence for previously established connections between stress and maladaptive SPS, and stress and IBS. This investigation also contributed to the SPS literature in two major ways: it used a longitudinal design in a research area dominated by cross-sectional studies, and it also found support for a previously unexplored association between IBS and maladaptive SPS.