# Role of Psychological Processes on Symptom Burden in Laryngopharyngeal Reflux

> **NIH NIH R03** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2024 · $120,262

## Abstract

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.

## Key facts

- **NIH application ID:** 10823349
- **Project number:** 5R03DK135513-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Rena Hiren Yadlapati
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $120,262
- **Award type:** 5
- **Project period:** 2023-04-15 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10823349

## Citation

> US National Institutes of Health, RePORTER application 10823349, Role of Psychological Processes on Symptom Burden in Laryngopharyngeal Reflux (5R03DK135513-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10823349. Licensed CC0.

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