Gastrointestinal Biopsychosocial Research Center

描述（由申请人提供）：本R24申请要求基础设施支持，以建立胃肠道生物心理社会（身心）研究中心。研究人员在美国国立卫生研究院资助的胃肠功能紊乱的病理生理学和治疗方面有长期的记录，包括肠易激综合征、大便失禁和盆底协同障碍。这些都是常见的疾病——15%为肠易激，2-7%为大便失禁，约2%为盆底协同功能障碍——它们极大地损害了生活质量，导致每年医疗保健费用总额超过250亿美元。肠易激的病理生理学研究主题包括内脏疼痛感知的作用及其在认知和心理过程中的调节，中枢神经系统调节内脏疼痛机制的神经影像学研究，生殖激素对肠易激症状的影响，压力，虐待史和其他社会心理因素对临床结果的作用，肠易激的代际遗传和社会学习，以及肠易激与其他躯体疾病的过多合并症。临床试验研究包括评估认知行为疗法、催眠、抗抑郁药和肠易激患者教育，以及对大便失禁和便秘的生物反馈。要求对下列核心提供支持：(1)行政核心。(2)由研究协调员和专职招聘人员组成的研究核心。(3)与研究者共同开展多中心研究的机构研究网络（梅奥诊所、华盛顿大学、多伦多大学）。(4)数据技术核心，提供可扫描的纸张和互联网管理的问卷，用于数据采集的自动电话系统，以及用于跟踪注册和管理rnuticcenter研究的互联网软件。(5)生物统计学核心，提供生物统计学支持和数据管理。(6)种子基金核心，每年资助青年科研人员4个试点项目。(7)教育/传播核心，通过中心通讯和网站传播研究成果。我们还请求支持招募一名具有感染后肠易激专业知识的新教员。拟议中的中心是全校范围的，包括来自心理学、精神病学、外科（妇科）、神经放射学、牙科和公共卫生学院的研究人员。

DESCRIPTION (provided by applicant): This R24 application requests infrastructure support to establish a Gastrointestinal Biopsychosocial (mind-body) Research Center. The investigators have a longstanding record of NIH-funded research on the pathophysiology and treatment of functional GI disorders including irritable bowel syndrome, fecal incontinence, and pelvic floor dyssynergia. These are prevalent disorders-- 15% for irritable bowel, 2-7% for fecal incontinence, and approximately 2% for pelvic floor dyssynergia--that greatly impair quality of life and result in aggregate health care costs exceeding $25 billion annually. Center research themes on the pathophysiology of irritable bowel include the role of visceral pain perception and its modulation by cognitive and psychological processes, neuroimaging studies of central nervous system mechanisms modulating visceral pain, effects of reproductive hormones on irritable bowel symptoms, the role of stress, abuse history, and other psychosocial factors on clinical outcomes, intergenerational transmission of irritable bowel through heredity and social learning, and excess comorbidity of irritable bowel with other somatic disorders. Clinical trial research includes evaluation of cognitive behavior therapy, hypnosis, antidepressants, and patient education for irritable bowel, and biofeedback for fecal incontinence and constipation. Support is requested for the following cores: (1) Administrative core. (2) Research core consisting of study coordinators and full-time recruiter. (3) Research network of institutions that carry out multicenter studies jointly with the investigators (Mayo Clinic, University of Washington, University of Toronto). (4) Data technology core that provides scannable paper and internet-administered questionnaires, automated telephone systems for data acquisition, and intemet software for tracking enrollment and managing rnulticenter studies. (5) Biometry core providing biostatistical support and data management. (6) Seed grant core providing funding for 4 pilot projects by young investigators annually. (7) Education/ dissemination core to disseminate research findings through a Center newsletter and website. We also request support to recruit a new faculty member with expertise in post-infectious irritable bowel. The proposed Center is university wide and includes investigators from psychology, psychiatry, surgery (gynecology division), neuroradiology, dentistry, and the school of public health.