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Bowel and Bladder-Control Anxiety: A Preliminary Description of a Viscerally-Centred Phobic Syndrome

Published online by Cambridge University Press:  19 August 2013

Sunjeev K. Kamboj ,
Christine Langhoff ,
Rosanna Pajak ,
Alex Zhu ,
Agnes Chevalier  and
Sue Watson
Sunjeev K. Kamboj*
Affiliation:
University College London, UK
Christine Langhoff
Affiliation:
University College London, UK
Rosanna Pajak
Affiliation:
University College London, UK
Alex Zhu
Affiliation:
University College London, UK
Agnes Chevalier
Affiliation:
University College London, UK
Sue Watson
Affiliation:
University College London, UK
*
Reprint requests to Sunjeev Kamboj, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, UK. E-mail: sunjeev.kamboj@ucl.ac.uk
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Abstract

Background: People with anxiety disorders occasionally report fears about losing control of basic bodily functions in public. These anxieties often occur in the absence of physical disorder and have previously been recognized as “obsessive” anxieties reflecting a preoccupation with loss of bowel/bladder control. Motivated by our observations of the non-trivial occurrence of such anxieties in our clinical practice we sought to fill a gap in the current understanding of “bowel/bladder-control anxieties”. Method: Eligible participants completed an internet survey. Results: Bowel/bladder-control anxieties (n = 140) tended to emerge in the mid to late 20s and were associated with high levels of avoidance and functional impairment. There was a high prevalence of panic attacks (78%); these were especially prevalent among those with bowel-control anxiety. Of those with panic attacks, 62% indicated that their main concern was being incontinent during a panic attack. Significantly, a proportion of respondents (~16%) reported actually being incontinent during a panic attack. Seventy percent of participants reported intrusive imagery related to loss of bowel/bladder control. Intrusion-related distress was correlated with agoraphobic avoidance and general role impairment. Some differences were noted between those with predominantly bowel-, predominantly bladder- and those with both bowel and bladder-control anxieties. Conclusion: This preliminary characterization indicates that even in a non-treatment seeking community sample, bowel/bladder-control anxieties are associated with high levels of distress and impairment. Further careful characterization of these anxieties will clarify their phenomenology and help us develop or modify treatment protocols in a way that takes account of any special characteristics of such viscerally-centred phobic syndromes.

Keywords

Anxietyanxiety disordersphobiapanic disorderpanic disorder with agoraphobiavisceral sensationsbowel-control anxietybladder-control anxiety
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 2 , March 2015 , pp. 142 - 157
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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