This project is one of a number that are in competition for funding from the ‘GW4 BioMed MRC Doctoral Training Partnership’ which is offering up to 18 studentships for entry in September 2020.
The DTP brings together the Universities of Bath, Bristol, Cardiff and Exeter to develop the next generation of biomedical researchers. Students will have access to the combined research strengths, training expertise and resources of the four research-intensive universities.
Lead supervisor: Dr Ben Ainsworth, Department of Psychology, University of Bath
Co-supervisors: Dr Abby Tabor (Bath), Dr James Dodd (Bristol) and Prof Kyle Pattinson (Oxford)
Chronic breathlessness is the defining symptom of asthma and COPD, which have a combined cost the NHS of £5 billion annually, affecting up to 9% of the UK. Research consistently shows that physiological impairment markers (ie. lung function – usually used to appraise disease state) poorly predict quality of life or symptom severity. Instead, a model including psychological and social disease aspects is needed for breathlessness, as highlighted by a recent EU working group as a currently unmet need.
Cutting-edge cognitive neuroscience theory has focused on the ‘Bayesian Brain’: our perceptual experience of our body and the world are continually updated based on previous experiences and current contextual information. The experience of breathlessness reflects previous encounters (eg. past asthma attacks) and relevant immediate stimuli (environmental triggers) as well as ‘interoceptive’ stimuli (tightness in chest, heart rate). Biased psychological or social functioning (eg. anxiety about future asthma attacks) in this predictive process may cause maladaptive behaviours that actually worsen asthma outcomes and reduce quality of life.
This novel project will build on state-of-the-art research at the University of Bath to establish a predictive model of breathlessness, experimentally manipulating external and internal stimuli in healthy volunteers. We will then translate findings to a clinical population. In a coherent programme of three studies, we will focus on anxiety-related psychological dysfunctions (negative affective state, negative mood) frequently associated with worse respiratory symptoms.
Study 1: A systematic review and meta-analysis will examine interoceptive biases in chronic diseases associated with breathlessness (such as asthma, COPD and pain), and their association with psychological dysfunction, to inform studies 2 and 3.
Study 2: In a novel experimental model we will induce respiratory loading in healthy volunteers, simulating symptoms experienced by people with asthma (N=80 based on pilot data from BA). We will examine how subjective experience and psychological perceptions relate to individual interoceptive thresholds (ie. sensitivity to breathlessness) and neurocognitive task performance.
Study 3: We will develop this model in people with breathlessness (asthma/COPD) and examine whether psychological interventions targeting maladaptive interoceptive processes (eg. mindfulness) can modify them. An experimental study will randomise 60 patients with breathlessness (asthma/COPD) to a brief psychological intervention (or control). Before/after measures of anxiety, asthma and interoception will be used to test whether changes in interoception predict changes in asthma and anxiety.
Findings will rapidly translate to patient benefit including informing guidelines and treatment for breathlessness/asthma/COPD through established supervisory networks.
Applicants for a studentship must have obtained, or be about to obtain, a First or Upper Second Class UK Honours degree, or the equivalent qualifications gained outside the UK, in an area appropriate to the skills requirements of the project.
IMPORTANT: In order to apply for this project, you should apply using the DTP’s online application form: https://cardiff.onlinesurveys.ac.uk/gw4-biomed-mrc-doctoral-training-partnership-student-appl
You do NOT need to apply to the University of Bath at this stage – only those applicants who are successful in obtaining an offer of funding form the DTP will be required to submit an application to study at Bath.
More information on the application process may be found here: https://www.gw4biomed.ac.uk/doctoral-students/
APPLICATIONS CLOSE AT 17:00 ON 25 NOVEMBER 2019.