Project Summary/Abstract
This K23 Career Development Award application is designed to prepare the PI for her long-term career goal of
becoming an independent clinical scientist with lines of research focused on the brain-gut axis as it relates to
disease, emotional, and behavioral functioning in pediatric patients diagnosed with inflammatory bowel disease
(IBD). Consistent with this goal, the proposed research and career development plan will build upon pilot data
collected during the applicant's KL2 Award demonstrating a positive and significant relationship between high
stress reactivity in response to a standardized laboratory stressor and greater mental health symptoms in youth
newly diagnosed with IBD. These preliminary data suggest that stress reactivity (as measured via skin
conductance, a reliable indicator of autonomic nervous system (ANS) activity) in response to a stress challenge,
may serve as a biomarker of psychosocial functioning that could then be used to risk stratify youth who would
benefit from coping skills interventions. Thus, the goals of the current study are to conduct a longitudinal
observational study to (1) compare relationships between stress reactivity and mental health symptoms in
patients with IBD and healthy controls and (2) examine indices of stress reactivity as novel predictors of mental
and physical health outcomes in youth with IBD. To this end, we propose to recruit an observational, longitudinal
cohort of youth newly diagnosed with IBD (N=60) to be compared to age and sex-matched healthy controls
(N=60) at baseline and then followed at six assessment points across 24-months. Indices of stress processing
to be assessed include skin conductance and heart rate variability, both validated psychophysiological measures
of stress processing. Further, this project will develop a biofeedback enhanced coping skills training program
using a treatment group (n=20) and wait-list control group (n=20) to which patients with IBD who screen positive
for symptoms of anxiety and/or depression will be randomized. We will evaluate the treatment's feasibility,
acceptability, and preliminary outcomes on psychological symptoms, autonomic reactivity, and IBD symptoms.
Career development activities will take place under the mentorship of an interdisciplinary mentoring team to
provide advanced training in 1) clinical and translational research, 2) longitudinal data analysis and RCT
methodology to support intervention development, 3) brain-gut processes and clinical management relevant to
pediatric IBD, and 4) scholarly productivity and grant writing. Findings from this K23 proposal will be instrumental
in demonstrating longitudinal trajectories of disease and psychosocial functioning in newly diagnosed youth with
IBD and determining whether indices of stress processing can serve as objective biomarkers of risk. Findings
will be used to inform refined iterations of our biofeedback enhanced coping skills treatment protocol with focus
on determining mechanisms of treatment effect, implementation to minimize burden on families, and a future
randomized clinical trial.