2007 NaliboffBy: Bruce D. Naliboff, PhD

David Geffen School of Medicine, UCLA, Los Angeles, CA

Dr. Naliboff is the recipient of the 2007 IFFGD Research Award for Senior Investigator – Clinical Science. Dr. Naliboff is an innovator in human experimental studies of pain mechanisms, including his current work on visceral sensitivity in irritable bowel syndrome (IBS). He has made important contributions to our understanding of the critical role of the central nervous system in chronic visceral and somatic pain conditions and of mechanisms involved in visceral hypersensitivity, hypervigilance, and symptom specific anxiety. Other areas of interest include psychosocial moderators of symptom presentation and sex differences in pain responses.

Summary

Many studies show an increase in negative moods like anxiety or depression in those suffering from functional gastrointestinal (GI) and pain conditions. Are these psychological factors an important cause for the development and/or maintenance of symptoms in functional GI disorders? Or are they a result of maybe years of disrupted life activities and frequent periods of intolerable symptoms? As we will see, the unfolding story indicates that a better understanding of negative mood states has important implications for self-management as well as medical disease management of these disorders.

Symptom-specific Psychological Characteristics

Although increases in negative mood appear to be common in functional GI disorders and they clearly impact the quality of life of patients; our group is concerned that the standard psychiatric assessments do not capture very well the specific types of worries, fears, and thoughts that may characterize the negative moods of those with functional GI disorders. For example, individuals with IBS may not have symptoms of anxiety in general, but only in relation to GI related events or sensations (like meals, abdominal pain, or diarrhea), i.e. GI symptom-specific anxiety.

Symptom-specific Psychology and the Development of Functional GI Symptoms

One commonly asked question with regard to psychological issues in functional GI disorders is which comes first, the disturbed mood or the GI symptoms? There does not seem to be a simple answer to this question. In our research we have tried to highlight what we see as a bidirectional or interactive relationship between symptoms and psychological factors, especially symptom-specific psychological factors.

Neurobiology of Functional GI Disorders

Our view of functional GI disorders tries to understand how the big brain (in our heads) and the little brain (in our GI tract) influence each other to generate health, healing, or illness. At our Center we have been using new technologies to examine directly how the brain responds to GI sensations and conversely how the brain influences activity in the GI system. By using these novel techniques we hope to increase our understanding of these processes as well as to help to reverse the vicious cycle of emotions and GI symptoms.

Implications of a Symptom-specific Psychology for Treatment

If we accept that psychological responses, and especially symptom relevant psychological responses, play a role in the persistence and exacerbation of functional GI disorder symptoms, it would be important to try and target these responses as part of an overall treatment plan. At our Center, we have been interested in very specific ways to change symptom-specific anxiety and are currently testing even more targeted treatment approaches to help change the way the brain responds to sensations in the bowel using psychological techniques.

Find out More

View details of the studies described in this summary. Read his Report: Symptom Based Psychology for Functional Gastrointestinal Disorders

Research Awards
2013 Award Recipients
Enrico Corazziari, MD
Jan Tack, MD, PhD
Gary Mawe, PhD
Ashley Blackshaw, PhD
Carlo Di Lorenzo, MD
Niranga Manjuri Devanarayana, MD
Report from Lukas Van Oudenhove, PhD: Solving the Biopsychosocial Puzzle in Functional Dyspepsia
Muriel Larauche, PhD
2011 Award Recipients
Report from Ronnie Fass, MD: Sleep and Gastroesophageal Reflux Disease (GERD)
Million Mulugeta, PhD
Adrian Miranda, MD
Samuel Nurko, MD
Sudarshan Jadcherla, MD
Shaman Rajindrajith, MD
2009 Award Recipients
Satish Rao, MD
Emeran Mayer, MD
Javier Santos, MD
Report from Martin Storr, MD, PhD: Functional Gastrointestinal Disorders: New Insights in Enteric Regulation
Report From Miguel Saps, MD: Functional Abdominal Pain in Children and Adolescents
2007 Award Recipients
Report from Bruce D. Naliboff, PhD: Symptom Based Psychology for Functional Gastrointestinal Disorders
Report from Magnus Simrén, MD, PhD: Irritable Bowel Syndrome: Searching for Underlying Causes
Report from Brennan M. R. Spiegel, MD, MSHS: Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality
Report from Sylvie Bradesi, PhD: Role of the Central Immune System in Functional Disorders
Paul E. Hyman, MD
Report from Miranda A. L. van Tilburg, PhD: Home Based Guided Imagery to Treat Pediatric Functional Abdominal Pain
Report from Fernando Azpiroz, MD, PhD: Understanding Intestinal Gas
2005 Award Recipients
Report from Yvette Tache, PhD: Stress and Irritable Bowel Syndrome: Unraveling the Code
Report from Shaheen Hamdy, MRCP, PhD: Adult Neurogenic Dysphagia -- Disorders and Conditions that Disrupt Swallowing
Report from Michael A. Pezzone, MD, PhD: Chronic Pelvic Pain and the Overlap of Pelvic Pain Disorders
Report from Bridget R. Southwell, PhD: Research into Treatment-Resistant Constipation in Children
Report from Rachel Rosen, MD, MPH: Symptoms Arising from Non-Acid Reflux in Children
2003 Award Recipients
Report from William E. Whitehead, PhD: Summary of Clinical Research Activities
Jyoti N. Sengupta, PhD
Report from Caroline Elder Danda, PhD: Biopsychosocial Perspectives on Assessment and Treatment
Report from Terry Buchmiller-Crair, MD: Using the Fetal Gastrointestinal Tract to Overcome Neonatal Disease
Report from Dan L. Dumitrascu, MD, PhD: The Psychosocial Adjustment to Illness in Irritable Bowel Syndrome
Report from Klaus Bielefeldt, MD, PhD: Understanding Pain and Discomfort in Functional GI Disorders
Research Grants
IFFGD Competitive Grants
2014 IFFGD Idiopathic Gastroparesis Research Grants
Leo Cheng, PhD
Braden Kuo, MD, MSc
Richard McCallum, MD
2008 IFFGD Competitive Research Grants
IFFGD Noncompetitive Grants
Other Research Grant Opportunities
Funding Research
Need for Funding Research
How to Make a Difference
The State of Research at NIH & NIDDK
Clinical Trials & Studies
IBS Studies
Guide to Randomized Clinical Trials
Industry Sponsored Clinical Trials and Studies
NIH/Other Sponsored Clinical Trials and Studies

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