{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:54:52Z","timestamp":1792043692553,"version":"4.4.0"},"reference-count":47,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011684","name":"Crohn&apos;s &amp; Colitis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2023,3]]},"DOI":"10.1016\/j.cgh.2022.07.025","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T03:55:14Z","timestamp":1659930914000},"page":"741-749.e3","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":47,"title":["High Perceived Stress is Associated With Increased Risk of Ulcerative Colitis Clinical Flares"],"prefix":"10.1016","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6731-8193","authenticated-orcid":false,"given":"Jenny S.","family":"Sauk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Jin","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Labus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariela","family":"Khandadash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron I.","family":"Ahdoot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venu","family":"Lagishetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Katzka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Naliboff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3923-3349","authenticated-orcid":false,"given":"Emeran A.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.cgh.2022.07.025_bib1","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.15585\/mmwr.mm6542a3","article-title":"Prevalence of inflammatory bowel disease among adults aged >\/=18 years - United States, 2015","volume":"65","author":"Dahlhamer","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.cgh.2022.07.025_bib2","doi-asserted-by":"crossref","first-page":"6296","DOI":"10.3748\/wjg.v22.i27.6296","article-title":"Environmental risk factors for inflammatory bowel diseases: evidence-based literature review","volume":"22","author":"Abegunde","year":"2016","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib3","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1111\/j.1572-0241.2008.01980.x","article-title":"The Manitoba IBD Cohort Study: a population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders","volume":"103","author":"Walker","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib4","first-page":"2209","article-title":"Impaired parasympathetic function increases susceptibility to inflammatory bowel disease in a mouse model of depression","volume":"118","author":"Ghia","year":"2008","journal-title":"J\u00a0Clin Invest"},{"key":"10.1016\/j.cgh.2022.07.025_bib5","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1053\/j.gastro.2006.02.007","article-title":"Antidepressants attenuate increased susceptibility to colitis in a murine model of depression","volume":"130","author":"Varghese","year":"2006","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2022.07.025_bib6","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1038\/ajg.2010.140","article-title":"A\u00a0prospective population-based study of triggers of symptomatic flares in IBD","volume":"105","author":"Bernstein","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib7","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1053\/j.gastro.2018.01.027","article-title":"Bi-directionality of brain\u2013gut interactions in patients with inflammatory bowel disease","volume":"154","author":"Gracie","year":"2018","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2022.07.025_bib8","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1136\/gutjnl-2018-317182","article-title":"Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression","volume":"68","author":"Frolkis","year":"2019","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2022.07.025_bib9","doi-asserted-by":"crossref","DOI":"10.1016\/j.psyneuen.2019.104501","article-title":"Stress and the brain-gut axis in functional and chronic-inflammatory gastrointestinal diseases: a transdisciplinary challenge","volume":"111","author":"Labanski","year":"2020","journal-title":"Psychoneuroendocrinology"},{"key":"10.1016\/j.cgh.2022.07.025_bib10","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jcmgh.2018.04.003","article-title":"The brain-gut-microbiome axis","volume":"6","author":"Martin","year":"2018","journal-title":"Cell Mol Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2022.07.025_bib11","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/01.MIB.0000160771.71328.6c","article-title":"Amount of systemic steroid medication is a strong predictor for the use of complementary and alternative medicine in patients with inflammatory bowel disease: results from a German National Survey","volume":"11","author":"Langhorst","year":"2005","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib12","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1038\/ajg.2009.15","article-title":"Do NSAIDs, antibiotics, infections, or stress trigger flares in IBD?","volume":"104","author":"Singh","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib13","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1097\/MIB.0b013e3182a192ba","article-title":"Short-term stress, but not mucosal healing nor depression was predictive for the risk of relapse in patients with ulcerative colitis: a prospective 12-month follow-up study","volume":"19","author":"Langhorst","year":"2013","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib14","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1111\/j.1572-0241.2000.02012.x","article-title":"Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission","volume":"95","author":"Levenstein","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1159\/000442929","article-title":"Psychological stress and depression: risk factors for IBD?","volume":"34","author":"Bernstein","year":"2016","journal-title":"Dig Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib16","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1038\/ajg.2015.147","article-title":"The relationship among perceived stress, symptoms, and inflammation in persons with inflammatory bowel disease","volume":"110","author":"Targownik","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib17","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/MIB.0000000000001040","article-title":"Evidence of bidirectional associations between perceived stress and symptom activity: a prospective longitudinal investigation in inflammatory bowel disease","volume":"23","author":"Sexton","year":"2017","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib18","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1097\/01.MIB.0000161919.42878.a0","article-title":"Evidence that stress contributes to inflammatory bowel disease: evaluation, synthesis, and future directions","volume":"11","author":"Maunder","year":"2005","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib19","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/gut.43.1.29","article-title":"A\u00a0simple clinical colitis activity index","volume":"43","author":"Walmsley","year":"1998","journal-title":"Gut"},{"issue":"Suppl 20","key":"10.1016\/j.cgh.2022.07.025_bib20","first-page":"22","article-title":"The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"J\u00a0Clin Psychiatry"},{"key":"10.1016\/j.cgh.2022.07.025_bib21","first-page":"1070","article-title":"An optimized patient-reported ulcerative colitis disease activity measure derived from the Mayo score and the simple clinical colitis activity index","volume":"20","author":"Bewtra","year":"2014","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib22","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/apt.15808","article-title":"Therapeutic thresholds for golimumab serum concentrations during induction and maintenance therapy in ulcerative colitis: results from the GO-LEVEL study","volume":"52","author":"Samaan","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.cgh.2022.07.025_bib23","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/ibd.20049","article-title":"Does colonoscopy cause increased ulcerative colitis symptoms?","volume":"13","author":"Menees","year":"2007","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib24","doi-asserted-by":"crossref","first-page":"2779","DOI":"10.1016\/S0140-6736(17)32641-7","article-title":"Effect of tight control management on Crohn\u2019s disease (CALM): a multicentre, randomised, controlled phase 3 trial","volume":"390","author":"Colombel","year":"2017","journal-title":"Lancet"},{"key":"10.1016\/j.cgh.2022.07.025_bib25","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1002\/ibd.22917","article-title":"Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease","volume":"18","author":"D\u2019Haens","year":"2012","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib26","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/00006842-199103000-00002","article-title":"Immunological changes in young and old adults during brief laboratory stress","volume":"53","author":"Naliboff","year":"1991","journal-title":"Psychosom Med"},{"key":"10.1016\/j.cgh.2022.07.025_bib27","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.neubiorev.2011.11.009","article-title":"A\u00a0meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health","volume":"36","author":"Thayer","year":"2012","journal-title":"Neurosci Biobehav Rev"},{"key":"10.1016\/j.cgh.2022.07.025_bib28","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3389\/fpubh.2017.00258","article-title":"An overview of heart rate variability metrics and norms","volume":"5","author":"Shaffer","year":"2017","journal-title":"Front Public Health"},{"key":"10.1016\/j.cgh.2022.07.025_bib29","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1159\/000104861","article-title":"The role of psychological stress in inflammatory bowel disease","volume":"13","author":"Mawdsley","year":"2006","journal-title":"Neuroimmunomodulation"},{"key":"10.1016\/j.cgh.2022.07.025_bib30","series-title":"Encyclopedia of Behavioral Medicine","first-page":"666","article-title":"Electrodermal activity (EDA)","author":"Critchley","year":"2013"},{"key":"10.1016\/j.cgh.2022.07.025_bib31","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1007\/s10620-020-06493-y","article-title":"Wearable devices are well accepted by patients in the study and management of inflammatory bowel disease: a survey study","volume":"66","author":"Hirten","year":"2021","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.cgh.2022.07.025_bib32","first-page":"552","article-title":"Computerised biofeedback games: a new method for teaching stress management and its use in irritable bowel syndrome","volume":"32","author":"Leahy","year":"1998","journal-title":"J\u00a0R Coll Physicians Lond"},{"key":"10.1016\/j.cgh.2022.07.025_bib33","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1093\/ibd\/izaa323","article-title":"Longitudinal autonomic nervous system measures correlate with stress and ulcerative colitis disease activity and predict flare","volume":"27","author":"Hirten","year":"2021","journal-title":"Inflamm Bowel Dis"},{"key":"10.1016\/j.cgh.2022.07.025_bib34","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1111\/nmo.12865","article-title":"Autonomic nervous system function predicts the inflammatory response over three years in newly diagnosed ulcerative colitis patients","volume":"28","author":"Gunterberg","year":"2016","journal-title":"Neurogastroenterol Motil"},{"key":"10.1016\/j.cgh.2022.07.025_bib35","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1038\/ajg.2015.147","article-title":"The relationship among perceived stress, symptoms, and inflammation in persons with inflammatory bowel disease","volume":"110","author":"Targownik","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib36","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/0277-9536(88)90397-8","article-title":"Disclosure of traumas and psychosomatic processes","volume":"26","author":"Pennebaker","year":"1988","journal-title":"Soc Sci Med"},{"key":"10.1016\/j.cgh.2022.07.025_bib37","doi-asserted-by":"crossref","first-page":"808","DOI":"10.3389\/fpsyt.2019.00808","article-title":"Epigenetic modifications in stress response genes associated with childhood trauma","volume":"10","author":"Jiang","year":"2019","journal-title":"Front Psychiatry"},{"key":"10.1016\/j.cgh.2022.07.025_bib38","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/0304-3959(94)90006-X","article-title":"The factor structure of the Coping Strategies Questionnaire","volume":"57","author":"Swartzman","year":"1994","journal-title":"Pain"},{"key":"10.1016\/j.cgh.2022.07.025_bib39","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1080\/10705500802222972","article-title":"The Brief Resilience Scale: assessing the ability to bounce back","volume":"15","author":"Smith","year":"2008","journal-title":"Int J Behav Med"},{"key":"10.1016\/j.cgh.2022.07.025_bib40","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jrp.2005.08.007","article-title":"The international personality item pool and the future of public-domain personality measures","volume":"40","author":"Goldberg","year":"2006","journal-title":"J\u00a0Res Personality"},{"key":"10.1016\/j.cgh.2022.07.025_bib41","first-page":"1571","article-title":"The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial","volume":"91","author":"Irvine","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2022.07.025_bib42","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"10.1016\/j.cgh.2022.07.025_bib43","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1093\/sleep\/33.6.781","article-title":"Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments","volume":"33","author":"Buysse","year":"2010","journal-title":"Sleep"},{"key":"10.1016\/j.cgh.2022.07.025_bib44","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.crohns.2014.01.028","article-title":"EpiCom-group. Health-related quality of life improves during one year of medical and surgical treatment in a European population-based inception cohort of patients with inflammatory bowel disease--an ECCO-EpiCom study","volume":"8","author":"Burisch","year":"2014","journal-title":"J\u00a0Crohns Colitis"},{"key":"10.1016\/j.cgh.2022.07.025_bib45","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/01688639408402620","article-title":"Development and validation of a Multiple Ability Self-Report Questionnaire","volume":"16","author":"Seidenberg","year":"1994","journal-title":"J\u00a0Clin Exp Neuropsychol"},{"key":"10.1016\/j.cgh.2022.07.025_bib46","first-page":"449","article-title":"Heart rate variability as a biomarker for autonomic nervous system response differences between children with chronic pain and healthy control children","author":"Evans","year":"2013","journal-title":"J\u00a0Pain Res"},{"key":"10.1016\/j.cgh.2022.07.025_bib47","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3389\/fpsyg.2017.00213","article-title":"Heart rate variability and cardiac vagal tone in psychophysiological research \u2013 recommendations for experiment planning, data analysis, and data reporting","volume":"08","author":"Laborde","year":"2017","journal-title":"Front Psychol"}],"container-title":["Clinical Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356522007212?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356522007212?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T05:41:58Z","timestamp":1761543718000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542356522007212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":47,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["S1542356522007212"],"URL":"https:\/\/doi.org\/10.1016\/j.cgh.2022.07.025","relation":{},"ISSN":["1542-3565"],"issn-type":[{"value":"1542-3565","type":"print"}],"subject":[],"published":{"date-parts":[[2023,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"High Perceived Stress is Associated With Increased Risk of Ulcerative Colitis Clinical Flares","name":"articletitle","label":"Article Title"},{"value":"Clinical Gastroenterology and Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cgh.2022.07.025","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 by the AGA Institute. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}