This application proposes research development of a clinical psychologist with interests and expertise in the control of chemotherapy side effects using a biobehavioral approach. Anticipatory neusea and vomiting are significant side effects that develop in approximately 25% of patients receiving chemotherapy treatment for cancer. Converging lines of evidence from psychologic, pharmacologic and neurologic investigations suggest that anticipatory nausea/vomiting are learned or conditioned behaviors. Adequate control of chemotherapy side effects such as anticipatory nausea and vomiting is essential for maximizing cancer treatment effectiveness. Proposed research is directed toward optimizing currently available behavioral interventions for side effect control, developing a new technology for nausea assessment and an increased understanding of side effect etiology. To achieve these aims, the following career development activities designed to enhance systematic, integrated studies of side effect control are proposed: (1) randomized clinical trials to assess whether the biobehavioral treatment of systematic desensitization is as effective when done by oncologists and oncology nurses as it is when done by behavioral psychologists; (2) development and refinement of ambulatory physiologic monitoring for concomitants of patient-reported nausea; and (3) prospective studies on the etiology of anticipatory side effects to test the ability of an 8-question screening instrument given after a patient's first chemotherapy treatment to predict the development of anticipatory side effects. The research has anticipated long-term benefits in the improvement of patient compliance for both current treatment and randomized treatment research trials.
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