Role of Psychological Processes on Symptom Burden in Laryngopharyngeal Reflux

心理过程对咽喉反流症状负担的作用

• 批准号: 10640761
• 负责人: Rena Hiren Yadlapati
• 金额: $ 12.51万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10640761
• 关键词: Accounting; Adult; Affective; Anxiety; Behavior; Behavior Therapy; Caring; Categories; Chronic; Classification; Clinical; Clinical Trials Design; Cognition; Cognitive; Cognitive Therapy; Combined Modality Therapy; Consultations; Coughing; Data; Diagnosis; Diagnostic tests; Discriminant Analysis; Disease; Dysphonia; Esophagus; Fundoplication; Future; Gastroesophageal reflux disease; General Population; Goals; Health Care Costs; Heartburn; Interview; Larynx; Measures; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Methods; Modeling; Operative Surgical Procedures; Patient Self-Report; Patients; Phenotype; Physiological; Principal Component Analysis; Process; Property; Prospective Studies; Proton Pump Inhibitors; Psychometrics; Quality of life; Questionnaires; Randomized, Controlled Trials; Reflux; Reporting; Research; Research Proposals; Resources; Role; Severities; Sore Throat; Speech; Symptoms; Syndrome; Treatment outcome; United States National Institutes of Health; Work; career; clinical practice; comparison intervention; efficacy evaluation; experience; health related quality of life; healthy volunteer; inhibitor therapy; innovation; instrument; laryngopharyngeal reflux; novel; poor health outcome; programs; psychologic; psychological distress; psychological stressor; psychosocial; success; symptomatic improvement; targeted treatment; therapeutic target; tool; treatment response

PROJECT SUMMARY/ABSTRACT Generalized approaches for laryngopharyngeal reflux (LPR), a prevalent and heterogeneous syndrome in which laryngeal symptoms are attributed to gastroesophageal reflux, have led to poor health outcomes, inappropriate resource utilization, and tremendous healthcare costs. The long-term career goal is to discover phenotype guided care paradigms for LPR, focused on distinct disease mechanism. Our preliminary findings have generated the central hypothesis that identification of distinct LPR phenotypes is feasible and that psychological processes such as hypervigilance and anxiety impact symptom burden in LPR. Thus, the overall objectives in this proposal are to establish a validated method to measure levels of hypervigilance and anxiety surrounding laryngeal symptoms and understand whether distinct LPR phenotypes report differing levels of hypervigilance and anxiety. The rationale for this project is that it will highlight the impact of cognitive-affective processes on LPR symptom burden and generate hypotheses surrounding the role of behavioral interventions in LPR. Thus, two specific aims will be pursued: 1) validate the laryngeal hypervigilance and anxiety scale [LHAS] self-report instrument, and 2) measure levels of hypervigilance and anxiety across distinct LPR phenotypes. Under the first aim, 200 symptomatic patients and 40 healthy volunteers will complete the LHAS and a set of validated instruments measuring psychological distress and health related quality of life. Psychometric properties of the LHAS will be assessed and a preliminary cutoff for the LHAS will be determined. Under the second aim, the 200 symptomatic patients will be categorized into LPR phenotypes utilizing our prior model from discriminant analysis of principal components. Levels of laryngeal hypervigilance and anxiety will be measured and compared across LPR phenotypes, as well as the healthy volunteers. The proposed research is significant as it is expected to fill a key evidence gap about the interplay of psychological stressors on LPR symptom burden. This research is innovative as it will provide a novel clinical tool to evaluate cognitive affective processes in patients with LPR as well as inform the framework of a first-of- its-kind phenotype stratified randomized controlled trial to assess efficacy of behavioral interventions compared to traditional anti-reflux therapy such as proton pump inhibitors in patients with LPR.

项目总结/摘要 咽喉反流（LPR）的一般方法，这是一种流行的异质性综合征， 其喉部症状归因于胃食管反流，导致不良的健康结果， 不适当的资源利用和巨大的医疗成本。长期的职业目标是发现 表型引导护理模式的LPR，侧重于不同的疾病机制。我们的初步研究结果 已经产生了中心假设，即识别不同的LPR表型是可行的， 心理过程如过度警觉和焦虑影响LPR的症状负担。因此， 本提案的目标是建立一种有效的方法来测量过度警觉和焦虑的水平 并了解不同的LPR表型是否报告不同水平的 高度警惕和焦虑这个项目的基本原理是，它将突出认知情感的影响， LPR症状负担的过程，并围绕行为干预的作用产生假设 在LPR。因此，本研究的两个具体目标是：1）验证喉部过度警觉和焦虑量表 [LHAS]自我报告工具，以及2）测量不同LPR的过度警惕和焦虑水平 表型在第一个目标下，200名有症状的患者和40名健康志愿者将完成LHAS 以及一套经验证的测量心理困扰和健康相关生活质量的工具。 将对LHAS的心理测量特性进行评估，并确定LHAS的初步截止值。 测定根据第二个目标，200名有症状的患者将被分类为LPR表型 利用主成分判别分析的先验模型。喉警觉水平 和焦虑将在LPR表型中进行测量和比较，以及健康志愿者。的 拟议的研究是重要的，因为它预计将填补一个关键的证据差距， 心理应激源对LPR症状负担的影响。这项研究是创新的，因为它将提供一个新的临床 评估LPR患者认知情感过程的工具，并告知第一个框架， 其类表型分层随机对照试验，以评估行为干预措施的疗效比较 传统的抗反流治疗，如质子泵抑制剂在LPR患者。