Anticipatory nausea and vomiting occurred in 25 percent of 568 consecutive chemotherapy outpatients previously studied for anticipatory side effects. Converging lines of evidence from psychologic, pharmacologic and neurologic investigations support the view that anticipatory nausea/vomiting is a learned or conditioned bahavior. Systematic Desensitization has been established experimentally as both a precise and effective treatment for maladaptive learned behaviors. A randomized clinical trial showed the antiemetic effectiveness of Systematic Desensitization when administered by an experienced behavioral psychologist for the control of anticiapatory nausea/vomiting (ANV). Research proposed in this continuation application systematically expands previous promising findings through two specific studies: The first investigates through a randomized comparative clinical trial, the degree to which Systematic Desensitization is effective when used by oncology clinical personnel for control of patients' ANV. The second tests the ability of a 7 question clinical profile to predict which chemotherapy patients will develop anticipatory side effects. Over 300 new patients a year enter chemotherapy research trials at the University of Rochester Cancer Research Center. All will be screened with the predictive clinical profile at their second treatment cycle. Anticipatory nausea/vomiting and other criteria for entry into the clinical trial will be assessed at the fourth cycle. A sample size of 90 patients randomized to two experimental and one control arm of the clinical trial will assure conventionally assumed levels of protection for type 1 (Alpha = .05) and type 2 (power = 0.80) experimental errors. The proposed study has the anticipated long-term benefit of improving patient compliance in both best current treatment (Phase IV) and randomized (Phase III) treatment research trials.
