Journal Articles

Published Research

The following is a summary of journal publications by Associate Professor Knowles. Click on the references below for further details.

Journal Articles


Neilson, K., Ftanou, M., Monshat, K., Salzberg, M., Bell, S., Kamm, MA., Connell, W., Knowles, S.R., Sevar, K., Mancuso, S.G., and Castle, D. (2015). A controlled study of a group mindfulness intervention for individuals living with inflammatory bowel disease. Inflammatory Bowel Diseases, 22(3): 694 – 701.

Background: This study aimed to evaluate the feasibility, acceptability, and effectiveness of a mindfulness-based intervention for patients with inflammatory bowel disease (MI-IBD).

Design: Treatment-as-usual control versus mindfulness-based stress reduction intervention.

Methods: Sixty patients participated in either the MI-IBD (n = 33) or treatment-as-usual group (n = 27) conditions. The MI-IBD consisted of an 8-week mindfulness-based stress reduction training group. Outcome measures were administered at baseline (before intervention), immediately after intervention, and 6 months after intervention. Primary outcomes included measures of quality of life, psychological distress (depression and anxiety), and mindfulness. Data for MI-IBD group participants also included weekly attendance, daily minutes meditated, and satisfaction with the program.

Results: There were no baseline differences between intervention and control groups on demographic variables or inflammatory bowel disease severity. Compared with the control group, the MI-IBD group reported significantly greater improvements in anxiety, quality of life, and mindfulness at after intervention, with reduction in depression and improvements in quality of life and mindfulness maintained at 6 months after intervention.

Conclusions: Results demonstrate the feasibility, acceptability, and efficacy of a mindfulness intervention for patients with inflammatory bowel disease, with medium-to-large effects on psychological distress, quality of life, and mindfulness.


Tribbick, D., Salzberg, M., Ftanou, M., Connell, W.R., Macrae, F., Kamm, M.A., Bates, G., Cunningham, G., Austin, D., & Knowles, S. R. (2015). Prevalence of Mental Health Disorders in Inflammatory Bowel Disease: An Australian Outpatients Cohort. Clinical and Experimental Gastroenterology, 8:197-204. doi: 10.2147/CEG.S77567.

Background: This study aimed to characterize prevalence of anxiety and depressive conditions and uptake of mental health services in an Australian inflammatory bowel disease (IBD) outpatient setting.

Methods: Eighty-one IBD patients (39 males, mean age 35 years) attending a tertiary hospital IBD outpatient clinic participated in this study. Disease severity was evaluated according to the Manitoba Index. Diagnosis of an anxiety or depressive condition was based upon the Mini-International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale.

Results: Based on Hospital Anxiety and Depression Scale subscale scores >8 and meeting Mini-International Neuropsychiatric Interview criteria, 16 (19.8%) participants had at least one anxiety condition, while nine (11.1%) had a depressive disorder present. Active IBD status was associated with higher prevalence rates across all anxiety and depressive conditions. Generalized anxiety was the most common (12 participants, 14.8%) anxiety condition, and major depressive disorder (recurrent) was the most common depressive condition reported (five participants, 6.2%). Seventeen participants (21%) reported currently seeking help for mental health issues while 12.4% were identified has having at least one psychological condition but not seeking treatment.

Conclusion: We conclude that rates of anxiety and depression are high in this cohort, and that IBD-focused psychological services should be a key component of any holistic IBD service, especially for those identified as having active IBD.