Socio-cognitive processes associated with bladder and bowel incontinence anxiety: A proposed bivalent model

© 2019, Springer Science+Business Media, LLC, part of Springer Nature. The aim of this study was to examine whether the extended bivalent fear of evaluation model (extended BFOE) of Social Anxiety Disorder (SAD) could be used to explain bladder and bowel incontinence anxiety (BBIA). It was hypothesised that the relationship between dysfunctional attitudes (DAs) and BBIA would be mediated by fear of negative evaluation (FNE), fear of positive evaluation (FPE), concerns of social reprisal (CSR), and disqualification of positive social outcomes (DPSO). Three-hundred-and-seventeen undergraduate students (76.7% female; mean age = 31.07 years) completed a cross-sectional online study. A structural equation model (SEM) supported the proposed model (χ2p value =.131, CMIN/df = 1.560, CFI =.996, TLI =.990, RMSEA =.042, SRMR =.0245) with significant relationships found between DAs and FNE (p < .001), DAs and FPE (p =.002), DAs and CSR (p =.007), FNE and CSR (p <.001), FNE and DPSO (p <.001), FPE and CSR (p <.001), FPE and DPSO (p <.001), CSR and DPSO (p <.001), BBIPSS bladder and bowel with incontinence anxiety (p <.001). These results suggest that DAs, FNE, and DPSO are important contributory factors in BBIA. Given that FNE was the strongest mediator in the model, clinicians may find it advantageous to target FNE in treatment of incontinence-anxiety.