Irrational Beliefs, Health Promoting Behaviors, and Pain Perception in Patients With Irritable Bowel Syndrome: The Mediating Role of Behavioral Activation and Inhibition Systems
Keywords:
Irrational beliefs, Health promoting behaviors, Pain perception, Behavioral activation system, Behavioral inhibition system, Irritable bowel syndromeAbstract
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder in which psychological factors play a significant role in symptom severity and pain perception. The present study aimed to examine the association between irrational beliefs, health promoting behaviors, and pain perception in patients with IBS, with the mediating roles of the Behavioral Activation System (BAS) and Behavioral Inhibition System (BIS). This cross sectional study was conducted among 320 patients diagnosed with IBS who were recruited using convenience sampling from a gastroenterology clinic. Participants completed the McGill Pain Questionnaire, the Health Promoting Lifestyle Profile (HPLP), the Irrational Beliefs Test, and the BIS/BAS scales. Data were analyzed using path analysis within the structural equation modeling framework in AMOS version 24. Path analysis revealed that health promoting behaviors were negatively associated with pain perception (β = −.41, p < .001), whereas irrational beliefs were positively associated with pain perception (β = .36, p < .001). Behavioral activation (BAS) showed a significant negative effect on pain perception (β = −.31, p < .001), while behavioral inhibition (BIS) demonstrated a significant positive effect (β = .35, p < .001). Health promoting behaviors were significantly related to BAS (β = −.24, p < .001) and BIS (β = .27, p < .001). Irrational beliefs were positively associated with BIS (β = .30, p < .001) but not with BAS (β = −.09, p = .106). Bootstrapping analyses indicated that BAS and BIS significantly mediated the relationship between health promoting behaviors and pain perception, whereas only BIS mediated the relationship between irrational beliefs and pain perception. The final model explained 50% of the variance in pain perception. These findings highlight the role of cognitive factors and behavioral self regulation systems in the experience of pain among patients with IBS. Interventions targeting irrational beliefs and promoting healthy behaviors may reduce pain perception by influencing motivational systems such as BAS and BIS.
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Copyright (c) 2026 Masoumeh HosseinVerdi (Author); Somayeh Keshavarz; Hasan Abdollahzadeh (Author)
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