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.

项目摘要/摘要 喉咽反射（LPR）的广义方法，这是一种流行和异质综合征 喉症状归因于胃食管反流，导致健康状况不佳， 不当的资源利用和巨大的医疗费用。长期职业目标是发现 LPR的表型指导护理范例，侧重于不同的疾病机制。我们的初步发现 已经产生了一个核心假设，即鉴定不同的LPR表型是可行的，并且 LPR中的心理过程（例如高维护和焦虑）会影响症状负担。因此，整体 本提案中的目标是建立一种验证的方法来衡量高度维持和焦虑的水平 周围的喉症状，并了解不同的LPR表型是否报告不同的水平 过度维护和焦虑。该项目的理由是它将突出认知影响的影响 LPR症状负担的过程并产生围绕行为干预作用的假设 在LPR。因此，将追求两个具体的目标：1）验证喉过度维护和焦虑量表 [LHAS]自我报告仪器，以及2）测量不同LPR的高度维持和焦虑水平 表型。在第一个目标下，有200名有症状的患者和40名健康志愿者将完成LHA 以及一组验证的工具，以测量心理困扰和与健康相关的生活质量。 将评估LHA的心理测量特性，LHA的初步截止 决定。在第二个目标下，有200个有症状的患者将分为LPR表型 利用我们先前的模型对主组件的判别分析。喉过度维护的水平 在LPR表型以及健康的志愿者中，将测量和比较焦虑。这 拟议的研究很重要，因为预计将填补有关相互作用的关键证据差距 LPR症状负担的心理压力源。这项研究具有创新性，因为它将提供新颖的临床 评估LPR患者的认知情感过程的工具，并为框架提供了首个框架 比较评估行为干预措施的效果的ITS-BIND表型比较 进行传统的抗反复治疗，例如LPR患者的质子泵抑制剂。