A Comparative Study of Perceived Stress, Personality Traits, and Resilience in Patients with Gastrointestinal Disorders and Healthy Controls

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Methods A causal-comparative design was employed. The sample consisted of 100 participants, divided into 50 patients with Irritable Bowel Syndrome (IBS) referred to the Valiasr International Hospital Gastroenterology Clinic in Tabriz, and 50 healthy matched controls (patient companions). Participants were selected via purposive sampling. Data were collected using three standardized questionnaires: the Perceived Stress Scale (PSS) [5], the NEO Five-Factor Inventory (NEO-FFI) [9], and the Connor-Davidson Resilience Scale (CD-RISC) [12]. Data were analyzed using both univariate (ANOVA) and multivariate analysis of variance (MANOVA). Results The results indicated a significant difference between the two groups across all measured variables (p < 0.05). Patients with GI disorders reported significantly higher levels of perceived stress and neuroticism. Conversely, healthy controls scored significantly higher on the other four personality traits: extraversion, openness to experience, agreeableness, and conscientiousness as well as on all components of resilience (personal competence, trust in instincts, tolerance of negative affect, positive acceptance of change, and spiritual influences). Conclusion The findings suggest that psychological factors, including specific personality traits and lower resilience, are significantly associated with GI disorders. Integrating psychological assessments and interventions, such as stress management and resilience training, into the standard care for patients with GI conditions is strongly recommended. 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F1000Research 2025, 14 :1029 ( https://doi.org/10.12688/f1000research.170655.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article A Comparative Study of Perceived Stress, Personality Traits, and Resilience in Patients with Gastrointestinal Disorders and Healthy Controls [version 1; peer review: awaiting peer review] Shima Maserrat https://orcid.org/0009-0005-4081-1080 Shima Maserrat https://orcid.org/0009-0005-4081-1080 PUBLISHED 02 Oct 2025 Author details Author details Islamic Azad University Tabriz Branch, Tabriz, East Azerbaijan Province, Iran Shima Maserrat Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract This study aimed to compare perceived stress, personality traits, and resilience in patients with gastrointestinal (GI) disorders and healthy counterparts. Methods A causal-comparative design was employed. The sample consisted of 100 participants, divided into 50 patients with Irritable Bowel Syndrome (IBS) referred to the Valiasr International Hospital Gastroenterology Clinic in Tabriz, and 50 healthy matched controls (patient companions). Participants were selected via purposive sampling. Data were collected using three standardized questionnaires: the Perceived Stress Scale (PSS) [5], the NEO Five-Factor Inventory (NEO-FFI) [9], and the Connor-Davidson Resilience Scale (CD-RISC) [12]. Data were analyzed using both univariate (ANOVA) and multivariate analysis of variance (MANOVA). Results The results indicated a significant difference between the two groups across all measured variables (p < 0.05). Patients with GI disorders reported significantly higher levels of perceived stress and neuroticism. Conversely, healthy controls scored significantly higher on the other four personality traits: extraversion, openness to experience, agreeableness, and conscientiousness as well as on all components of resilience (personal competence, trust in instincts, tolerance of negative affect, positive acceptance of change, and spiritual influences). Conclusion The findings suggest that psychological factors, including specific personality traits and lower resilience, are significantly associated with GI disorders. Integrating psychological assessments and interventions, such as stress management and resilience training, into the standard care for patients with GI conditions is strongly recommended. READ ALL READ LESS Keywords Perceived Stress, Personality Traits, Resilience, Gastrointestinal Disorders, Irritable Bowel Syndrome (IBS), NEO-FFI Corresponding Author(s) Shima Maserrat ( [email protected] ) Close Corresponding author: Shima Maserrat Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Maserrat S. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Maserrat S. A Comparative Study of Perceived Stress, Personality Traits, and Resilience in Patients with Gastrointestinal Disorders and Healthy Controls [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :1029 ( https://doi.org/10.12688/f1000research.170655.1 ) First published: 02 Oct 2025, 14 :1029 ( https://doi.org/10.12688/f1000research.170655.1 ) Latest published: 02 Oct 2025, 14 :1029 ( https://doi.org/10.12688/f1000research.170655.1 ) Introduction Gastrointestinal (GI) disorders represent a significant portion of the global burden of non-communicable diseases, imposing considerable economic and psychological strain on individuals and healthcare systems. 1 Notably, functional GI disorders like Irritable Bowel Syndrome (IBS) are highly prevalent and are frequently accompanied by co-morbid psychological distress. 2 , 3 These disorders are characterized by chronic symptoms without a clear structural cause, often leading to a reduced quality of life. 4 The biopsychosocial model is crucial for understanding GI disorders. Psychological constructs such as perceived stress, defined as an individual’s cognitive appraisal of their ability to cope with life demands, 5 are strongly implicated. Research indicates that up to 75% of physical illnesses are linked to stress, which is a known risk factor for numerous conditions. 6 , 7 Patients with IBS often report higher perceived stress, which is correlated with a lower quality of life. 8 Personality traits, as outlined in the Five-Factor Model (neuroticism, extraversion, openness, agreeableness, conscientiousness), represent enduring patterns of thoughts, feelings, and behaviors that can influence an individual’s reaction to stress and susceptibility to illness. 9 Studies have shown that patients with IBS tend to score higher on neuroticism-a trait associated with negative emotionality-and lower on traits like extraversion and conscientiousness compared to healthy individuals. 10 , 11 Resilience, the capacity to adapt successfully in the face of adversity, is another critical protective factor. 12 It enables individuals to utilize adaptive coping strategies, buffering against the development and exacerbation of psychosomatic illnesses. Lower levels of resilience have been documented in patients with IBS, making them more vulnerable to psychological distress and its physical manifestations. 13 , 14 Given the high comorbidity between GI symptoms and psychological factors, this study seeks to comprehensively compare perceived stress, personality traits (based on the Five-Factor Model), and resilience in patients diagnosed with GI disorders and a matched sample of healthy controls. Methods Participants and Procedure This study utilized a causal-comparative design. The sample comprised 100 individuals: 50 patients with a confirmed medical diagnosis of IBS (the clinical group) and 50 healthy controls selected from patient companions at the Valiasr International Hospital Gastroenterology Clinic in Tabriz, Iran. Participants were selected via purposive sampling based on the following inclusion criteria: (a) age between 25 and 45 years, (b) a minimum education of a high school diploma, and (c) for the clinical group, a confirmed medical record of IBS. Exclusion criteria included a diagnosis of other major physical (e.g., hypertension, heart disease) or psychological disorders. This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Research Ethics Committee of Islamic Azad University, Tabriz Medical Sciences Branch (Reference Number: IR.IAU.TABRIZ.REC.1402.045). All participants were provided with a detailed information sheet explaining the study’s purpose, procedures, and their rights. Written informed consent was obtained from every participant prior to their inclusion in the study. Instruments 1. Perceived Stress Scale (PSS): Developed by Cohen, Kamarck, and Mermelstein (1983), 5 this 14-item scale measures the degree to which situations in one’s life are appraised as stressful. Items are rated on a 5-point Likert scale. Higher scores indicate greater perceived stress. Cronbach’s alpha in this study was 0.90. 2. NEO Five-Factor Inventory (NEO-FFI): This 60-item questionnaire by Costa and McCrae 9 assesses the five major personality domains: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. Each domain is measured with 12 items rated on a 5-point Likert scale. Cronbach’s alpha for the subscales in this study ranged from 0.85 to 0.91. 3. Connor-Davidson Resilience Scale (CD-RISC): This 25-item scale by Connor and Davidson 12 measures the ability to cope with adversity. It encompasses five components: personal competence, trust in one’s instincts, tolerance of negative affect, positive acceptance of change, and spiritual influences. Items are rated on a 5-point scale, with higher scores indicating greater resilience. Cronbach’s alpha in this study was 0.88. Data analysis Data were analyzed using SPSS software version 25. Descriptive statistics (mean, standard deviation) were used to characterize the sample. To test the hypotheses, Univariate Analysis of Variance (ANOVA) was used for the single variable of perceived stress. Multivariate Analysis of Variance (MANOVA) was employed to examine group differences across the five personality traits and the five resilience components simultaneously, followed by ANOVA for each individual variable. Assumptions of homogeneity of variance (Levene’s test) and covariance (Box’s M test) were checked and met. Results Descriptive findings The demographic analysis showed that the sample consisted of 32% males and 68% females. The mean age and education level were comparable between the two groups, ensuring effective matching. Hypothesis testing 1. Perceived Stress: A one-way ANOVA revealed a significant difference in perceived stress between the two groups (F(1, 98) = 41.82, p < 0.001, η 2 = 0.30). Patients with GI disorders (M = 36.92, SD = 6.48) reported significantly higher levels of perceived stress than healthy controls (M = 21.06, SD = 9.32). 2. Personality Traits: MANOVA results indicated a significant overall difference between the groups on the combined personality traits (Wilks’ λ = 0.77, F(5, 94) = 5.55, p < 0.001). Subsequent ANOVAs showed that: Neuroticism was significantly higher in the clinical group (F(1, 98) = 10.72, p = 0.001, η 2 = 0.10). Extraversion (F(1, 98) = 6.69, p = 0.01, η 2 = 0.06), Openness to Experience (F(1, 98) = 10.06, p = 0.002, η 2 = 0.09), Agreeableness (F(1, 98) = 9.09, p = 0.003, η 2 = 0.09), and Conscientiousness (F(1, 98) = 5.19, p = 0.025, η 2 = 0.05) were all significantly higher in the healthy control group. 3. Resilience Components: MANOVA revealed a significant overall difference for resilience components (Wilks’ λ = 0.51, F(5, 94) = 17.89, p < 0.001). Follow-up ANOVAs confirmed that healthy controls scored significantly higher (p < 0.05) on all five subscales: Personal Competence, Trust in Instincts, Tolerance of Negative Affect, Positive Acceptance, and Spiritual Influences. Discussion The present study found significant psychological differences between patients with GI disorders and healthy controls. As hypothesized, patients reported markedly higher levels of perceived stress. This aligns with previous research 6 , 8 , 15 suggesting that the chronic and unpredictable nature of GI symptoms acts as a persistent stressor, while a heightened stress response may also exacerbate gut sensitivity and symptom severity through the gut-brain axis. 3 The personality profile of the clinical group was characterized by significantly higher neuroticism and lower scores on the other four traits. High neuroticism, a well-established risk factor for internalizing disorders, is linked to a tendency to experience negative emotions, anxiety, and poor coping strategies, 9 , 16 which can intensify the perception of physical symptoms. Conversely, lower levels of extraversion, agreeableness, conscientiousness, and openness suggest a potential deficit in social engagement, adaptive coping, goal-directed behavior, and cognitive flexibility, all of which are resources for managing chronic illness. 10 , 11 , 17 Furthermore, patients with GI disorders demonstrated lower resilience across all measured components. Resilience enables individuals to bounce back from adversity, utilize social support, and maintain emotional regulation. 12 , 13 A deficit in this capacity likely leaves individuals less equipped to manage the daily challenges of a chronic condition, leading to a greater psychological and physical burden. 14 These findings underscore the profound interconnection between psychological factors and GI health. They support a holistic, biopsychosocial approach to treating disorders like IBS, where psychological intervention is not an adjunct but a core component of care. Limitations and suggestions The sample was recruited from a single clinic, which may affect generalizability. The use of self-report measures is susceptible to bias. Furthermore, the cross-sectional design cannot establish causality. Future research should employ longitudinal designs to explore causal pathways, include objective physiological measures of stress, and investigate the efficacy of psychological interventions (e.g., cognitive-behavioral therapy, mindfulness-based stress reduction, resilience training) tailored for patients with GI disorders. Conclusion This study provides robust evidence that patients with GI disorders exhibit a distinct psychological profile characterized by elevated perceived stress, a specific pattern of personality traits (high neuroticism, low extraversion, openness, agreeableness, and conscientiousness), and diminished resilience compared to healthy individuals. Clinicians should consider routine screening for these psychological factors in gastroenterology settings. Integrating psychological support and resilience-building interventions into standard treatment protocols is essential for improving the overall well-being and quality of life for patients suffering from gastrointestinal disorders. Data availability The datasets generated and analyzed during the current study are not publicly available due to ethical reasons and restrictions imposed by the Research Ethics Committee of Islamic Azad University, Tabriz Medical Sciences Branch. The ethical approval for this study stipulates that the raw participant data, which includes potentially identifiable information, must remain confidential. However, anonymized data that support the main findings are available from the corresponding author ( [email protected] ) upon reasonable request and with permission from the aforementioned ethics committee. References 1. 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Farnam A, Somi MH, Sarami F, et al. : Five personality dimensions in patients with irritable bowel syndrome. Neuropsychiatr. Dis. Treat. 2008; 4 (5): 959–962. PubMed Abstract 11. Ranasinghe N, Devanarayana NM, Benninga MA, et al. : Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life. BMC Gastroenterol. 2018; 18 (1): 33. PubMed Abstract | Publisher Full Text | Free Full Text 12. Connor KM, Davidson JR: Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress. Anxiety. 2003; 18 (2): 76–82. Publisher Full Text 13. Masten AS, Lucke CM, Nelson KM, et al. : Resilience in development and psychopathology: Multisystem perspectives. Annu. Rev. Clin. Psychol. 2021; 17 : 521–549. PubMed Abstract | Publisher Full Text 14. Thrasher S: Effects of Resilience and Psychological Defenses on the Relationship Between Emotional Distress & Gastrointestinal Health [PhD dissertation]. 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 02 Oct 2025 ADD YOUR COMMENT Comment Author details Author details Islamic Azad University Tabriz Branch, Tabriz, East Azerbaijan Province, Iran Shima Maserrat Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 02 Oct 2025, 14:1029 https://doi.org/10.12688/f1000research.170655.1 Copyright © 2025 Maserrat S. 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