Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Psychology


Clinical Psychology

Content Description

1 online resource (ix, 90 pages) : illustrations (some color)

Dissertation/Thesis Chair

Leslie F Halpern

Committee Members

Raymond Cross, Sharon Danoff-Burg


coping, disease activity, HRQOL, inflammatory bowel disease, psychological distress, social constraint, Inflammatory bowel diseases, Patient compliance, Health attitudes, Health behavior

Subject Categories

Clinical Psychology


Symptoms of inflammatory bowel disease (IBD) are chronic and are characterized by periodic exacerbations followed by symptom-free intervals. Symptoms can have a detrimental impact on quality of life. Medication non-adherence in adults with IBD has been well-documented in the literature; continuous medication use is necessary to prevent flares of the disease. Therefore, the purpose of the present study was three-fold: (1) to examine associations between medication non-adherence, disease activity, and health-related quality of life (HRQOL), (2) to examine if group differences were present for patients who were high versus low in anxiety or depression in terms of their medication non-adherence, disease activity and HRQOL, and (3) to examine the contributions of coping and social constraint on disclosure to medication non-adherence, disease activity, and HRQOL. The present study was retrospective; 80 patients with IBD completed questionnaires, as part of routine care in a tertiary referral center. Results demonstrated a negative association between disease activity and HRQOL. Medication non-adherence was not associated with disease activity. In addition, patients high in anxiety or depression had diminished quality of life compared to patients low in anxiety. Regression results did not support the hypothesis that social constraint moderated the relationship between coping and HRQOL; however, the use of engagement coping approached negative significance with HRQOL. Regressions testing the mediating effects of medication non-adherence on the relations between both social constraint and coping on disease activity were not performed because results showed that medication non-adherence was not significantly related to disease activity. Results did reveal that participants who reported increased social constraint reported increased intentional and unintentional non-adherence. Also, disengagement coping significantly contributed to disease activity. In conclusion, the present study adds to the current knowledge regarding the role of both coping and social constraint in individuals with IBD. Future research is warranted to clarify the role of coping and social constraint on medication nonadherence, HRQOL, and disease activity.