Background and Objectives: Excessive use of defense styles, attentional styles, and pain coping strategies may contribute to the development of psychosomatic disorders such as gastrointestinal problems. Among these, irritable bowel syndrome is considered as one of the most common and disabling conditions. This study aimed to determine the relationship between defense mechanisms, attentional styles, and pain coping strategies and visceral sensitivity in patients with irritable bowel syndrome.
Materials and Methods: This descriptive-correlational study was conducted on 193 patients with irritable bowel syndrome in Isfahan, who were selected through convenience sampling. Data were collected using the Pain Coping Strategies Questionnaire (Rosenstiel & Keefe, 1983), the Defense Style Questionnaire (Andrews et al., 1993), the Attention Style Questionnaire (Van Calster et al., 2018), and the Visceral Sensitivity Index (Labus et al., 2004), and were analyzed using stepwise multiple linear regression.
Results: The findings showed significant relationships between visceral sensitivity and immature defense style (b=–0.114, p=0.001), mature defense style (b=0.343, p<0.001), attentional focus style (b=-0.488, p=0.013), distraction/cognitive avoidance style (b=0.994, p<0.001), the pain coping subscales of pain denial (b=0.550, p=0.001), and self-talk (b=–0.502, p=0.005). Collectively, these variables explained 28.7% of the variance in visceral sensitivity.
Conclusion: The results indicated that defense styles, attentional styles, and pain coping strategies are predictors of visceral sensitivity. Therefore, it is recommended that counselors and therapists pay attention to these psychological factors in treatment planning.
Keywords: Defense styles, Attentional styles, Pain coping strategies, Visceral sensitivity, Irritable bowel syndrome

Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of Islamic Azad University, Isfahan Branch, approved the study (IR.IAU.KHUISF.REC.1403.061).
Authors’ contributions:
- Conceptualization: Nastaran Igder
- Methodology: Nastaran Igder
- Data collection: Nastaran Igder
- Formal analysis: Nastaran Igder
- Supervision: Hajar Torkan
- Project administration: Nastaran Igder
- Writing – original draft: Nastaran Igder
- Writing – review & editing: Nastaran Igder, Hajar Torkan, Mohammad Jafari