A Comparative Study of Perceived Stress, Personality Traits, and Resilience in Patients with Gastrointestinal Disorders and Healthy Controls

Introduction

Gastrointestinal (GI) disorders represent a significant portion of the global burden of non-communicable diseases, imposing considerable economic and psychological strain on individuals and healthcare systems.¹ Notably, functional GI disorders like Irritable Bowel Syndrome (IBS) are highly prevalent and are frequently accompanied by co-morbid psychological distress.^2,3 These disorders are characterized by chronic symptoms without a clear structural cause, often leading to a reduced quality of life.⁴

The biopsychosocial model is crucial for understanding GI disorders. Psychological constructs such as perceived stress, defined as an individual’s cognitive appraisal of their ability to cope with life demands,⁵ are strongly implicated. Research indicates that up to 75% of physical illnesses are linked to stress, which is a known risk factor for numerous conditions.^6,7 Patients with IBS often report higher perceived stress, which is correlated with a lower quality of life.⁸

Personality traits, as outlined in the Five-Factor Model (neuroticism, extraversion, openness, agreeableness, conscientiousness), represent enduring patterns of thoughts, feelings, and behaviors that can influence an individual’s reaction to stress and susceptibility to illness.⁹ Studies have shown that patients with IBS tend to score higher on neuroticism-a trait associated with negative emotionality-and lower on traits like extraversion and conscientiousness compared to healthy individuals.^10,11

Resilience, the capacity to adapt successfully in the face of adversity, is another critical protective factor.¹² It enables individuals to utilize adaptive coping strategies, buffering against the development and exacerbation of psychosomatic illnesses. Lower levels of resilience have been documented in patients with IBS, making them more vulnerable to psychological distress and its physical manifestations.^13,14

Given the high comorbidity between GI symptoms and psychological factors, this study seeks to comprehensively compare perceived stress, personality traits (based on the Five-Factor Model), and resilience in patients diagnosed with GI disorders and a matched sample of healthy controls.

Methods

Participants and Procedure This study utilized a causal-comparative design. The sample comprised 100 individuals: 50 patients with a confirmed medical diagnosis of IBS (the clinical group) and 50 healthy controls selected from patient companions at the Valiasr International Hospital Gastroenterology Clinic in Tabriz, Iran. Participants were selected via purposive sampling based on the following inclusion criteria: (a) age between 25 and 45 years, (b) a minimum education of a high school diploma, and (c) for the clinical group, a confirmed medical record of IBS. Exclusion criteria included a diagnosis of other major physical (e.g., hypertension, heart disease) or psychological disorders.

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Research Ethics Committee of Islamic Azad University, Tabriz Medical Sciences Branch (Reference Number: IR.IAU.TABRIZ.REC.1402.045). All participants were provided with a detailed information sheet explaining the study’s purpose, procedures, and their rights. Written informed consent was obtained from every participant prior to their inclusion in the study.

Results

Discussion

The present study found significant psychological differences between patients with GI disorders and healthy controls. As hypothesized, patients reported markedly higher levels of perceived stress. This aligns with previous research^6,8,15 suggesting that the chronic and unpredictable nature of GI symptoms acts as a persistent stressor, while a heightened stress response may also exacerbate gut sensitivity and symptom severity through the gut-brain axis.³

The personality profile of the clinical group was characterized by significantly higher neuroticism and lower scores on the other four traits. High neuroticism, a well-established risk factor for internalizing disorders, is linked to a tendency to experience negative emotions, anxiety, and poor coping strategies,^9,16 which can intensify the perception of physical symptoms. Conversely, lower levels of extraversion, agreeableness, conscientiousness, and openness suggest a potential deficit in social engagement, adaptive coping, goal-directed behavior, and cognitive flexibility, all of which are resources for managing chronic illness.^10,11,17

Furthermore, patients with GI disorders demonstrated lower resilience across all measured components. Resilience enables individuals to bounce back from adversity, utilize social support, and maintain emotional regulation.^12,13 A deficit in this capacity likely leaves individuals less equipped to manage the daily challenges of a chronic condition, leading to a greater psychological and physical burden.¹⁴

These findings underscore the profound interconnection between psychological factors and GI health. They support a holistic, biopsychosocial approach to treating disorders like IBS, where psychological intervention is not an adjunct but a core component of care.

Conclusion

This study provides robust evidence that patients with GI disorders exhibit a distinct psychological profile characterized by elevated perceived stress, a specific pattern of personality traits (high neuroticism, low extraversion, openness, agreeableness, and conscientiousness), and diminished resilience compared to healthy individuals. Clinicians should consider routine screening for these psychological factors in gastroenterology settings. Integrating psychological support and resilience-building interventions into standard treatment protocols is essential for improving the overall well-being and quality of life for patients suffering from gastrointestinal disorders.