Validation of the Laryngeal Cognitive-Affective Tool

Amanda J. Krause, Tiffany Noel Taft, Madeline Greytak, Zoe C. Burger, Erin Walsh, Philip Weissbrod, John E. Pandolfino, Rena Yadlapati*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background & Aims: Cognitive-affective processes, including hypervigilance and symptom-specific anxiety, may contribute to chronic laryngeal symptoms and are potentially modifiable; however, a validated instrument to assess these constructs is lacking. The aims of this study were to develop and validate the Laryngeal Cognitive-Affective Tool (LCAT) instrument. Methods: This 2-phase single-center prospective study enrolled participants from November 2021 to June 2023. In the initial phase 1:1 patient cognitive interviews and multidisciplinary team consensus were conducted to develop the LCAT. In the second phase asymptomatic and symptomatic participants completed a series of questionnaires to examine psychometric properties of the LCAT. Results: A total of 268 participants were included: 8 in the initial phase and 260 in the validation phase (56 asymptomatic; 204 symptomatic). A 15-item LCAT was developed. In the validation phase, mean total LCAT and hypervigilance/anxiety subscores were significantly higher in symptomatic versus asymptomatic participants (P < .01). The LCAT had excellent internal consistency (α = 0.942) and split-half reliability (Guttman = 0.853). Using a median split, a score of 33 or greater was defined as elevated. Conclusions: The 15-item LCAT evaluates laryngeal hypervigilance and symptom-specific anxiety among patients with laryngeal symptoms. It has excellent reliability and construct validity. The LCAT highlights burdensome cognitive-affective processes that can accordingly help tailor treatments.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
StateAccepted/In press - 2024


  • Gastroesophageal Reflux
  • Laryngopharyngeal Reflux
  • Patient-Reported Outcome Measures
  • Psychosocial Functioning

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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