A Comparison of Ego Strength, Alexithymia, and Body Image in Patients with Irritable Bowel Syndrome and Healthy Individuals

Abstract

Introduction and Aim: Irritable bowel syndrome (IBS) is not only associated with physical symptoms but also accompanied by various psychological difficulties that may negatively affect patients’ quality of life and psychological adjustment. The present study aimed to compare ego strength, alexithymia, and body image between patients with IBS and healthy individuals.

Methodology: This study employed a causal-comparative design. The statistical population consisted of patients diagnosed with IBS who were referred to gastroenterology specialty clinics in Lahijan during 2025, as well as healthy individuals. The sample included 180 participants (90 IBS patients and 90 healthy individuals) selected through purposive sampling. Research instruments included the DSM-5-TR-based Psychiatric Symptoms Screening Form, Psychological Inventory of Ego Strength (PIES), Toronto Alexithymia Scale (TAS-20), Multidimensional Body-Self Relations Questionnaire (MBSRQ), and the Frequency and Severity of Bowel Symptoms Scale. Data were analyzed using multivariate analysis of variance (MANOVA) in SPSS version 26.

Findings: The findings of multivariate analysis revealed significant differences between healthy individuals and patients with IBS in ego strength, alexithymia, and body image. Patients with IBS demonstrated lower levels of ego strength and body image, as well as higher levels of alexithymia compared to healthy individuals. The group effect was significant for ego strength (F=32.59), alexithymia (F=33.44), and body image (F=17.04) at P<0.001. Partial eta squared values also indicated that group membership explained a substantial proportion of variance in the dependent variables.

Conclusion: The results indicated that patients with IBS experience greater psychological vulnerability than healthy individuals. These findings emphasize the importance of incorporating psychological interventions focused on emotional regulation, strengthening ego functions, and improving body image into the treatment and management of IBS patients.