{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:49:45Z","timestamp":1792712985694,"version":"4.5.0"},"reference-count":53,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T00:00:00Z","timestamp":1551398400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T00:00:00Z","timestamp":1551398400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100012276","name":"Tillotts Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","gastrojournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Gastroenterology"],"published-print":{"date-parts":[[2019,3]]},"DOI":"10.1053\/j.gastro.2018.11.030","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T11:45:48Z","timestamp":1542368748000},"page":"935-945.e1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":161,"title":["Acceptance and Commitment Therapy Reduces Psychological Stress in Patients With Inflammatory Bowel Diseases"],"prefix":"10.1053","volume":"156","author":[{"given":"Brona","family":"Wynne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9380-5366","authenticated-orcid":false,"given":"Wei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Keegan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Byrne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2403-7436","authenticated-orcid":false,"given":"Catherine","family":"Rowan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Hartery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Kirschbaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Doherty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garret","family":"Cullen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2139-8316","authenticated-orcid":false,"given":"Barbara","family":"Dooley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh E.","family":"Mulcahy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1053\/j.gastro.2018.11.030_bib1","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1037\/0278-6133.9.6.653","article-title":"Stress, intrusive imagery, and chronic distress","volume":"6","author":"Baum","year":"1990","journal-title":"Health Psychology"},{"key":"10.1053\/j.gastro.2018.11.030_bib3","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1080\/13548506.2017.1384554","article-title":"Magnitude and sources of distress in mid-life adults with chronic medical illness: an exploratory mixed-methods analysis","volume":"23","author":"Madva","year":"2018","journal-title":"Psychol Health Med"},{"key":"10.1053\/j.gastro.2018.11.030_bib4","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1177\/070674370505000402","article-title":"Long-term medical conditions and major depression: strength of association for specific conditions in the general population","volume":"50","author":"Patten","year":"2005","journal-title":"Can J Psychiatry"},{"key":"10.1053\/j.gastro.2018.11.030_bib5","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1136\/gut.2005.064261","article-title":"Psychological stress in IBD: new insights into pathogenic and therapeutic implications","volume":"54","author":"Mawdsley","year":"2005","journal-title":"Gut"},{"key":"10.1053\/j.gastro.2018.11.030_bib6","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1146\/annurev.clinpsy.1.102803.144141","article-title":"Stress and health: psychological, behavioral, and biological determinants","volume":"1","author":"Schneiderman","year":"2005","journal-title":"Annu Rev Clin Psychol"},{"key":"10.1053\/j.gastro.2018.11.030_bib7","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.1038\/ajg.2009.529","article-title":"Stress coping, distress, and health perceptions in inflammatory bowel disease and community controls","volume":"104","author":"Graff","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"10.1053\/j.gastro.2018.11.030_bib8","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1002\/ibd.22916","article-title":"Mood disorders in inflammatory bowel disease: relation to diagnosis, disease activity, perceived stress, and other factors","volume":"18","author":"Goodhand","year":"2012","journal-title":"Inflamm Bowel Dis"},{"key":"10.1053\/j.gastro.2018.11.030_bib9","doi-asserted-by":"crossref","first-page":"106502","DOI":"10.1155\/2012\/106502","article-title":"Psychological issues in inflammatory bowel disease: an overview","volume":"2012","author":"Sajadinejad","year":"2012","journal-title":"Gastroenterol Res Pract"},{"key":"10.1053\/j.gastro.2018.11.030_bib10","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.crohns.2008.01.002","article-title":"Reconsidering the methodology of \u201cstress\u201d research in inflammatory bowel disease","volume":"2","author":"Keefer","year":"2008","journal-title":"J\u00a0Crohns Colitis"},{"key":"10.1053\/j.gastro.2018.11.030_bib11","doi-asserted-by":"crossref","first-page":"e014315","DOI":"10.1136\/bmjopen-2016-014315","article-title":"Stress resilience and\u00a0the risk of inflammatory bowel disease: a cohort study of men living in Sweden","volume":"7","author":"Melinder","year":"2017","journal-title":"BMJ Open"},{"key":"10.1053\/j.gastro.2018.11.030_bib12","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1053\/j.gastro.2018.01.027","article-title":"Bi-directionality of brain-gut interactions in patients with inflammatory bowel disease","volume":"154","author":"Gracie","year":"2018","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2018.11.030_bib13","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.cgh.2014.02.016","article-title":"Patient-reported outcomes as primary end points in clinical trials of inflammatory bowel disease","volume":"12","author":"Williet","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2018.11.030_bib14","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1136\/gut.2010.224154","article-title":"Guidelines for the management of inflammatory bowel disease in adults","volume":"60","author":"Mowat","year":"2011","journal-title":"Gut"},{"key":"10.1053\/j.gastro.2018.11.030_bib15","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1053\/j.gastro.2018.01.045","article-title":"Best practice update: Incorporating psychogastroenterology into management of digestive disorders","volume":"154","author":"Keefer","year":"2018","journal-title":"Gastroenterology"},{"key":"10.1053\/j.gastro.2018.11.030_bib16","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S2468-1253(16)30206-0","article-title":"Effect of psychological therapy on disease activity, psychological comorbidity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis","volume":"2","author":"Gracie","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2018.11.030_bib17","doi-asserted-by":"crossref","first-page":"2704","DOI":"10.1097\/MIB.0b013e318296ae5a","article-title":"The efficacy and methodological challenges of psychotherapy for adults with inflammatory bowel disease: a review","volume":"19","author":"Knowles","year":"2013","journal-title":"Inflamm Bowel Dis"},{"key":"10.1053\/j.gastro.2018.11.030_bib18","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.beth.2009.08.002","article-title":"Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy","volume":"44","author":"Hayes","year":"2013","journal-title":"Behav Ther"},{"key":"10.1053\/j.gastro.2018.11.030_bib19","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.cpr.2016.04.009","article-title":"A\u00a0systematic review of the use of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions","volume":"46","author":"Graham","year":"2016","journal-title":"Clin Psychol Rev"},{"key":"10.1053\/j.gastro.2018.11.030_bib20","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11121-008-0099-4","article-title":"Acceptance and commitment: implications for prevention science","volume":"9","author":"Biglan","year":"2008","journal-title":"Prev Sci"},{"key":"10.1053\/j.gastro.2018.11.030_bib21","series-title":"A\u00a0practical guide to acceptance and commitment therapy","first-page":"3","article-title":"What is acceptance and commitment therapy?","author":"Hayes","year":"2004"},{"key":"10.1053\/j.gastro.2018.11.030_bib22","series-title":"The research journey of acceptance and commitment therapy (ACT)","author":"Hooper","year":"2015"},{"key":"10.1053\/j.gastro.2018.11.030_bib23","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.cpr.2016.04.009","article-title":"A\u00a0systematic review of the use of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions","volume":"46","author":"Graham","year":"2016","journal-title":"Clin Psychol Rev"},{"key":"10.1053\/j.gastro.2018.11.030_bib24","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1093\/ecco-jcc\/jjv120","article-title":"The stressometer: a simple, valid, and responsive measure of psychological stress in inflammatory bowel disease patients","volume":"9","author":"Keegan","year":"2015","journal-title":"J\u00a0Crohns Colitis"},{"key":"10.1053\/j.gastro.2018.11.030_bib25","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.crohns.2012.07.030","article-title":"The Short Health Scale: a valid and reliable measure of health related quality of life in English speaking inflammatory bowel disease patients","volume":"7","author":"McDermott","year":"2013","journal-title":"J\u00a0Crohns Colitis"},{"key":"10.1053\/j.gastro.2018.11.030_bib26","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/ibd.21400","article-title":"Short CDAI: development and validation of a shortened and simplified Crohn\u2019s Disease Activity Index","volume":"17","author":"Thia","year":"2011","journal-title":"Inflamm Bowel Dis"},{"key":"10.1053\/j.gastro.2018.11.030_bib27","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1002\/ibd.20520","article-title":"Use of the noninvasive components of the Mayo score to assess clinical response in ulcerative colitis","volume":"14","author":"Lewis","year":"2008","journal-title":"Inflamm Bowel Dis"},{"key":"10.1053\/j.gastro.2018.11.030_bib28","series-title":"Manual for the depression anxiety and stress scales","author":"Lovibond","year":"1995"},{"key":"10.1053\/j.gastro.2018.11.030_bib29","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1348\/014466505X29657","article-title":"The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample","volume":"44","author":"Henry","year":"2005","journal-title":"Br J Clin Psychol"},{"key":"10.1053\/j.gastro.2018.11.030_bib30","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1002\/pon.2045","article-title":"Refinement of the distress management problem list as the basis for a holistic therapeutic conversation among UK patients with cancer","volume":"21","author":"Brennan","year":"2012","journal-title":"Psychooncology"},{"key":"10.1053\/j.gastro.2018.11.030_bib31","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.beth.2011.03.007","article-title":"Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance","volume":"42","author":"Bond","year":"2011","journal-title":"Behav Ther"},{"key":"10.1053\/j.gastro.2018.11.030_bib32","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1080\/00365520600610618","article-title":"The SHS: a valid measure of subjective health in ulcerative colitis","volume":"41","author":"Hjortswang","year":"2006","journal-title":"Scand J Gastroenterol"},{"key":"10.1053\/j.gastro.2018.11.030_bib33","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.psyneuen.2008.08.024","article-title":"Hair as a retrospective calendar of cortisol production-increased cortisol incorporation into hair in the third trimester of pregnancy","volume":"34","author":"Kirschbaum","year":"2009","journal-title":"Psychoneuroendocrinology"},{"key":"10.1053\/j.gastro.2018.11.030_bib34","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.forsciint.2009.12.040","article-title":"An assessment of cortisol analysis in hair and its clinical applications","volume":"196","author":"Gow","year":"2010","journal-title":"Forensic Sci Int"},{"key":"10.1053\/j.gastro.2018.11.030_bib35","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.ygcen.2006.01.005","article-title":"Analysis of endogenous cortisol concentrations in the hair of rhesus macaques","volume":"147","author":"Davenport","year":"2006","journal-title":"Gen Comp Endocrinol"},{"key":"10.1053\/j.gastro.2018.11.030_bib36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jchromb.2013.03.008","article-title":"Quantitative analysis of steroid hormones in human hair using a column-switching LC-APCI-MS\/MS assay","volume":"928","author":"Gao","year":"2013","journal-title":"J\u00a0Chromatogr B Analyt Technol Biomed Life Sci"},{"key":"10.1053\/j.gastro.2018.11.030_bib37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.brat.2005.06.006","article-title":"Acceptance and commitment therapy: model, processes and outcomes","volume":"44","author":"Hayes","year":"2006","journal-title":"Behav Res Ther"},{"key":"10.1053\/j.gastro.2018.11.030_bib38","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.psyneuen.2018.03.020","article-title":"Chronic stress, hair cortisol and depression: A prospective and longitudinal study of medical internship","volume":"92","author":"Mayer","year":"2018","journal-title":"Psychoneuroendocrinology"},{"key":"10.1053\/j.gastro.2018.11.030_bib39","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/psyp.12179","article-title":"Temporal features of elevated hair cortisol among earthquake survivors","volume":"51","author":"Gao","year":"2014","journal-title":"Psychophysiology"},{"key":"10.1053\/j.gastro.2018.11.030_bib40","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.psyneuen.2016.12.017","article-title":"Stress-related and basic determinants of hair cortisol in humans: a meta-analysis","volume":"77","author":"Stalder","year":"2017","journal-title":"Psychoneuroendocrinology"},{"key":"10.1053\/j.gastro.2018.11.030_bib41","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1159\/000365764","article-title":"A\u00a0meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems","volume":"84","author":"A-Tjak","year":"2015","journal-title":"Psychotherapy and psychosomatics"},{"key":"10.1053\/j.gastro.2018.11.030_bib42","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.brat.2011.03.009","article-title":"Acceptance and commitment therapy for the treatment of stress among social workers: a randomized controlled trial","volume":"49","author":"Brinkborg","year":"2011","journal-title":"Behav Res Ther"},{"key":"10.1053\/j.gastro.2018.11.030_bib43","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.brat.2010.05.004","article-title":"A\u00a0randomised worksite comparison of acceptance and commitment therapy and stress inoculation training","volume":"48","author":"Flaxman","year":"2010","journal-title":"Behav Res Ther"},{"key":"10.1053\/j.gastro.2018.11.030_bib44","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/j.2044-8287.2011.02033.x","article-title":"A\u00a0text message programme designed to modify patients\u2019 illness and treatment beliefs improves self-reported adherence to asthma preventer medication","volume":"17","author":"Petrie","year":"2012","journal-title":"Br J Health Psychol"},{"key":"10.1053\/j.gastro.2018.11.030_bib45","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1037\/ccp0000227","article-title":"Effectiveness of cognitive-behavioral therapy on quality of life, anxiety, and depressive symptoms among patients with inflammatory bowel disease: a multicenter randomized controlled trial","volume":"85","author":"Bennebroek Evertsz","year":"2017","journal-title":"J\u00a0Consult Clin Psychol"},{"key":"10.1053\/j.gastro.2018.11.030_bib46","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1185\/03007990802215315","article-title":"Analytical approaches to reporting long-term clinical trial data","volume":"24","author":"Papp","year":"2008","journal-title":"Curr Med Res Opin"},{"key":"10.1053\/j.gastro.2018.11.030_bib47","doi-asserted-by":"crossref","first-page":"aac4716","DOI":"10.1126\/science.aac4716","article-title":"Estimating the reproducibility of psychological science","volume":"349","author":"Open Science Collaboration","year":"2015","journal-title":"Science"},{"key":"10.1053\/j.gastro.2018.11.030_bib48","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/j.2044-8260.1995.tb01489.x","article-title":"Credibility and outcome of cognitive-behavioural and psychodynamic-interpersonal psychotherapy","volume":"34","author":"Hardy","year":"1995","journal-title":"Br J Clin Psychol"},{"key":"10.1053\/j.gastro.2018.11.030_bib49","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S2215-0366(17)30153-0","article-title":"Control conditions for randomised trials of behavioural interventions in psychiatry: a decision framework","volume":"9","author":"Gold","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"10.1053\/j.gastro.2018.11.030_bib50","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.diabres.2012.04.019","article-title":"The development and feasibility of a web-based intervention with diaries and situational feedback via smartphone to support self-management in patients with diabetes type 2","volume":"97","author":"Nes","year":"2012","journal-title":"Diabetes Res Clin Pract"},{"key":"10.1053\/j.gastro.2018.11.030_bib51","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1080\/09540121.2011.579945","article-title":"Acceptance-based behavior therapy to promote HIV medication adherence","volume":"23","author":"Moitra","year":"2011","journal-title":"AIDS Care"},{"key":"10.1053\/j.gastro.2018.11.030_bib52","first-page":"308","article-title":"A\u00a0personalized approach to managing inflammatory bowel disease","volume":"12","author":"Kingsley","year":"2016","journal-title":"Gastroenterol Hepatol"},{"key":"10.1053\/j.gastro.2018.11.030_bib53","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.gtc.2017.08.013","article-title":"The practical pros and cons of complementary and alternative medicine in practice: integrating complementary and alternative medicine into clinical care","volume":"46","author":"Winter","year":"2017","journal-title":"Gastroenterol Clin North Am"},{"key":"10.1053\/j.gastro.2018.11.030_bib54","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1038\/ajg.2018.27","article-title":"ACG clinical guideline: management of Crohn\u2019s disease in adults","volume":"113","author":"Lichtenstein","year":"2018","journal-title":"Am J Gastroenterol"}],"container-title":["Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0016508518352788?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0016508518352788?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T15:20:27Z","timestamp":1758036027000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0016508518352788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":53,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["S0016508518352788"],"URL":"https:\/\/doi.org\/10.1053\/j.gastro.2018.11.030","relation":{},"ISSN":["0016-5085"],"issn-type":[{"value":"0016-5085","type":"print"}],"subject":[],"published":{"date-parts":[[2019,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Acceptance and Commitment Therapy Reduces Psychological Stress in Patients With Inflammatory Bowel Diseases","name":"articletitle","label":"Article Title"},{"value":"Gastroenterology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1053\/j.gastro.2018.11.030","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 by the AGA Institute","name":"copyright","label":"Copyright"}]}}