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rate of 74% Of the sample, 195 were excluded because of a history of psychosis or dementia, 252 were excluded because they lived in a nursing home, 236 were excluded because they had an organic medical disease or had undergone major abdominal surgery Using the Manning criteria, the authors found that 177% of their sample had IBS, while another 566% experienced some GI symptoms The sample was 41% male (144 to 1 ratio), with an average age of 53 In another landmark study of functional GI disorders, Drossman and colleagues (1993) used the US Householder Survey of Functional GI Disorders to ascertain the presence of one or more functional GI disorders in a strati ed random sample of 8,250 US householders Return rate was 658% (51% female, 96% White) Overall, 69.



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3% (3,761) respondents reported one or more functional GI disorders, with IBS being diagnosed (Rome Criteria) in 112% (606) of individuals Females outnumbered males again, 188 to 1 The survey further suggested that patients with IBS missed an average of 134 days of work or school in the past year because of their symptoms Clearly, IBS is a widespread problem that affects between 19 and 34 million Americans, costs almost $8 billion annually in medical care, and leads to more than 250 million lost work days each year Thus, it continues to be important to research this population to gain a better understanding of the IBS patient Psychological Distress While the etiology of IBS is not well understood, IBS has typically been portrayed as a psychosomatic disorder with some researchers implying that IBS patients are merely neurotics who focus on their GI symptoms (Latimer 1983).





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It , has been fairly well established in the IBS literature that the individuals who seek treatment for their IBS symptoms tend to be more psychologically distressed than the general population Folks and Kinney (1992) suggest that up to 60% of a gastroenterologist s patients have psychological complaints However, literature in this area is mixed It has not always been the case that IBS patients appear more psychologically distressed than other patients with chronic illness To better understand this issue, we must look at the psychological distress in IBS sufferers both dimensionally and categorically Dimensional Measures of Distress Several studies report that IBS patients show more distress across a variety of psychological measures when they are compared to groups with organic GI disease (Schwarz et al, 1993; Talley et al, 1990, 1991; E A Walker, Roy-Byrne, &.

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evaluation version of FACETS is just as functional as the full version, the number of observations that can be analyzed is strongly limited The WINSTEPS and FACETS programs contain a detailed user s guide (as a PDF document) WINMIRA 2001 (von Davier, 2001) is a computer program for estimating and testing a large number of discrete mixture models for categorical variables WINMIRA 2001 can be used for analyses with LCA, the Rasch model, the MRM, and hybrid models for dichotomous and polytomous data For polytomous data, WINMIRA is capable of estimating four different submodels: the partial credit model, the rating scale model, the equidistance model, and the dispersion model The CML (conditional maximum likelihood) parameter estimation method is used to estimate item parameters The advantage of such CML estimators is that they provide item parameter estimations independently of knowing the person parameters.

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