A Biobehavioral Approach to Understand Problematic Avoidant/Restrictive Eating in Adults with Functional Dyspepsia

项目摘要/摘要 功能性消化不良(FD)是一种慢性胃肠道功能/运动障碍，影响美国高达12%的人 成年人的发病率和医疗费用很高，治疗选择有限。有害的饮食- 相关的医学后果在FD中经常发生，食物避免/限制水平符合以下标准 高达40%的成人FD患者患有回避性/限制性食物摄入障碍(ARFID)。然而，生物学上的 FD中有问题的回避性/限制性进食的机制尚未得到充分的研究，并可能导致 行为和生物干预目标。这个为期5年的以患者为中心的K23研究职业发展 该奖项通过使用创新的多学科方法来解决这一研究差距：(1) 成人FD与ARFID、FD患者胃感觉运动功能及饱腹激素的差异 (2)试点的可行性、初步效果和初步机制 对FD和ARFID患者进行基于暴露的认知行为治疗。这个项目代表着 问题回避/限制进食在功能性消化不良发病机制中的作用及其可能机制的初步探讨 使FD患者接触到更多食物量/种类的干预措施的好处。培训计划 将支持海伦·伯顿·默里博士成为一名独立的临床科学家 通过研究胃肠功能/运动的生物、心理和社会靶向机制 提供行为和生物治疗干预措施。这项研究旨在补充伯顿博士的观点 默里作为一名独立的临床和转译研究人员的目标实现了 通过四个方面的培训：胃感觉运动功能，食欲内分泌调节，行为临床 试验评估和治疗机制，以及职业发展。将落实培训目标 由Braden Kuo博士(主要导师)、Elizabeth A.Lawson博士和Jennifer J.Thomas博士(共同指导)指导 导师)；BRJánn LJótsson博士和Brian Healy博士(顾问)；以及Lukas Van Oudenhove博士，Johnathan 威廉姆斯和劳里·基弗(科学咨询委员会)。

PROJECT SUMMARY/ABSTRACT Functional dyspepsia (FD) is a chronic gastrointestinal functional/motility disorder that affects up to 12% of US adults with significant morbidity and healthcare costs and has limited treatment options. Detrimental eating- related medical consequences are frequent in FD, with a level of food avoidance/restriction meeting criteria for avoidant/restrictive food intake disorder (ARFID) in up to 40% of adults with FD. However, the biological mechanisms of problematic avoidant/restrictive eating in FD have been underexplored and could inform behavioral and biological intervention targets. This 5-year K23-Patient-Oriented Research Career Development award addresses this research gap by using an innovative, multi-disciplinary approach to examine: (1) differences in gastric sensorimotor functions and satiety hormones among adults with FD and ARFID, FD without ARFID, and healthy controls; and (2) pilot feasibility, preliminary efficacy, and preliminary mechanisms of an exposure-based cognitive-behavioral treatment in patients with FD and ARFID. This project represents the first exploration of the mechanistic role of problematic avoidant/restrictive eating in FD and the potential benefit of an intervention that exposes patients with FD to increased food volume/variety. The training plan corresponding to this project will support Dr. Helen Burton Murray in becoming an independent clinical scientist with a program of research examining biopsychosocial target mechanisms of gastrointestinal functional/motility disorders to inform behavioral and biological treatment interventions. The study aims complement Dr. Burton Murray’s objectives for her advancement as an independent clinical and translational investigator, achieved through four training areas: gastric sensorimotor functions, endocrine regulation of appetite, behavioral clinical trials evaluation and treatment mechanisms, and career development. Training goals will be implemented under the guidance of Dr. Braden Kuo (primary mentor); Drs. Elizabeth A. Lawson and Jennifer J. Thomas (co- mentors); Drs. Brjánn Ljótsson and Brian Healy (consultants); and Drs. Lukas Van Oudenhove, Johnathan Williams, and Laurie Keefer (scientific advisory committee).