Reflective-ruminative tendencies and coping flexibility in patients with non-specific inflammatory bowel diseases

Purpose
The question concerning coping competencies among other factors that improve quality of life of the chronically ill seems to be of particular importance. The aim of the study was to examine how private self-awareness defined in terms of rumination and reflection processes is related to flexibility both in thinking and coping as pivotal elements of adaptation to chronic illness.

Methods
Participants in the study were 100 patients with non-specific inflammatory bowel diseases (Crohn’s disease and ulcerative colitis). The following instruments were used: the Rumination-Reflection Questionnaire (RRQ) by Paul D. Trapnell and Jennifer D. Campbell, the Cognitive Flexibility Questionnaire by John P. Dennis and Jillon S. Vander Wal, the Flexibility in Coping with Stress Questionnaire by Małgorzata A. Basińska and collaborators, the Short Self-Assessment of Depression and Anxiety by Andrzej Kokoszka, and a sociodemographic questionnaire developed by the present authors.

Results
Ruminative tendencies were found to correlate negatively with a single dimension of cognitive flexibility, i.e. sense of control, and with a single dimension of coping flexibility, i.e. repertoire of coping strategies. Both these relationships were strengthened by the presence of self-assessed depression symptoms (the former), and self-assessed anxiety (the latter). The significance of reflective tendencies for flexibility was limited to a simple relationship with the dimensions of alternatives, variability and reflectiveness.

Conclusions
In the work with people suffering from non-specific inflammatory bowel conditions it is important to reduce the patients’ ruminative tendencies and monitor their anxiety and depression symptoms. If such symptoms are persistent, appropriate interventions seem to be equally important.