2.39 Developing a Biopsychosocial Schematic to Aid in Evaluation of Avoidant/Restrictive Food Intake Disorder

Abstract

ObjectivesThe objectives of this study are: 1) to develop a clinical tool supporting the assessment of developmental, psychiatric, medical, and family contributors in avoidant/restrictive food intake disorder (ARFID); 2) to gather survey feedback from physicians regarding the utility of this tool in guiding assessment of ARFID, improving understanding of ARFID, and informing treatment planning of ARFID; and 3) to determine the odds of providers using the tool in clinical practice.MethodsChild and adolescent psychiatrists were asked to review an ARFID clinical assessment tool developed by the authors. Participants completed an electronic survey regarding the tool asking: 1) utility in guiding assessment; 2) utility in treatment planning; 3) effectiveness in improving understanding of ARFID; and 4) odds of using in clinical practice. Responses were based on a Likert scale, with an option for free text comments.ResultsRespondents (N = 16) replied as follows: 1) guiding assessment: N = 6 (37.5%) extremely helpful; N = 8 (50.0%) very helpful; N = 2 (12.5%) somewhat helpful; and N = 0 for “not so helpful” or “not helpful at all;” 2) treatment planning: N = 1 (6.25%) extremely helpful; N = 7 (43.75%) very helpful; N = 5 (31.25%) somewhat helpful; N = 2 (12.5%) not so helpful; and N = 1 (6.25%) not at all helpful; 3) improving understanding of ARFID: N = 6 (37.5%) extremely effective; N = 5 (31.25%) very effective; N = 4 (25.0%) effective; N = 2 (6.25%) not so effective; and N = 0 not at all effective; and 4) likeliness to use in clinical practice: N = 6 (37.5%) very likely; N = 6 (37.5%) likely; N = 2 (12.5%) neither likely nor unlikely; N = 1 (6.25%) unlikely; N = 1 (12.5%) very unlikely. Most respondents (N = 13; 81.25%) included comments; 30.76% (n = 4) indicated an interest in expansion of the tool to guide treatment.ConclusionsARFID is a heterogeneous illness with a dearth of available clinical tools. Survey responses indicate that users found this tool helpful in guiding assessment and improving understanding of this complex illness, but less helpful in treatment planning. The majority were at least likely to use in clinical practice. Limitations include our small sample size, and the fact that the survey targeted providers already familiar with ARFID. Future directions will focus on expanding the tool to guide treatment planning, and considering modifications for use by a broader clinical audience.DIAG, EA ObjectivesThe objectives of this study are: 1) to develop a clinical tool supporting the assessment of developmental, psychiatric, medical, and family contributors in avoidant/restrictive food intake disorder (ARFID); 2) to gather survey feedback from physicians regarding the utility of this tool in guiding assessment of ARFID, improving understanding of ARFID, and informing treatment planning of ARFID; and 3) to determine the odds of providers using the tool in clinical practice. The objectives of this study are: 1) to develop a clinical tool supporting the assessment of developmental, psychiatric, medical, and family contributors in avoidant/restrictive food intake disorder (ARFID); 2) to gather survey feedback from physicians regarding the utility of this tool in guiding assessment of ARFID, improving understanding of ARFID, and informing treatment planning of ARFID; and 3) to determine the odds of providers using the tool in clinical practice. MethodsChild and adolescent psychiatrists were asked to review an ARFID clinical assessment tool developed by the authors. Participants completed an electronic survey regarding the tool asking: 1) utility in guiding assessment; 2) utility in treatment planning; 3) effectiveness in improving understanding of ARFID; and 4) odds of using in clinical practice. Responses were based on a Likert scale, with an option for free text comments. Child and adolescent psychiatrists were asked to review an ARFID clinical assessment tool developed by the authors. Participants completed an electronic survey regarding the tool asking: 1) utility in guiding assessment; 2) utility in treatment planning; 3) effectiveness in improving understanding of ARFID; and 4) odds of using in clinical practice. Responses were based on a Likert scale, with an option for free text comments. ResultsRespondents (N = 16) replied as follows: 1) guiding assessment: N = 6 (37.5%) extremely helpful; N = 8 (50.0%) very helpful; N = 2 (12.5%) somewhat helpful; and N = 0 for “not so helpful” or “not helpful at all;” 2) treatment planning: N = 1 (6.25%) extremely helpful; N = 7 (43.75%) very helpful; N = 5 (31.25%) somewhat helpful; N = 2 (12.5%) not so helpful; and N = 1 (6.25%) not at all helpful; 3) improving understanding of ARFID: N = 6 (37.5%) extremely effective; N = 5 (31.25%) very effective; N = 4 (25.0%) effective; N = 2 (6.25%) not so effective; and N = 0 not at all effective; and 4) likeliness to use in clinical practice: N = 6 (37.5%) very likely; N = 6 (37.5%) likely; N = 2 (12.5%) neither likely nor unlikely; N = 1 (6.25%) unlikely; N = 1 (12.5%) very unlikely. Most respondents (N = 13; 81.25%) included comments; 30.76% (n = 4) indicated an interest in expansion of the tool to guide treatment. Respondents (N = 16) replied as follows: 1) guiding assessment: N = 6 (37.5%) extremely helpful; N = 8 (50.0%) very helpful; N = 2 (12.5%) somewhat helpful; and N = 0 for “not so helpful” or “not helpful at all;” 2) treatment planning: N = 1 (6.25%) extremely helpful; N = 7 (43.75%) very helpful; N = 5 (31.25%) somewhat helpful; N = 2 (12.5%) not so helpful; and N = 1 (6.25%) not at all helpful; 3) improving understanding of ARFID: N = 6 (37.5%) extremely effective; N = 5 (31.25%) very effective; N = 4 (25.0%) effective; N = 2 (6.25%) not so effective; and N = 0 not at all effective; and 4) likeliness to use in clinical practice: N = 6 (37.5%) very likely; N = 6 (37.5%) likely; N = 2 (12.5%) neither likely nor unlikely; N = 1 (6.25%) unlikely; N = 1 (12.5%) very unlikely. Most respondents (N = 13; 81.25%) included comments; 30.76% (n = 4) indicated an interest in expansion of the tool to guide treatment. ConclusionsARFID is a heterogeneous illness with a dearth of available clinical tools. Survey responses indicate that users found this tool helpful in guiding assessment and improving understanding of this complex illness, but less helpful in treatment planning. The majority were at least likely to use in clinical practice. Limitations include our small sample size, and the fact that the survey targeted providers already familiar with ARFID. Future directions will focus on expanding the tool to guide treatment planning, and considering modifications for use by a broader clinical audience.DIAG, EA ARFID is a heterogeneous illness with a dearth of available clinical tools. Survey responses indicate that users found this tool helpful in guiding assessment and improving understanding of this complex illness, but less helpful in treatment planning. The majority were at least likely to use in clinical practice. Limitations include our small sample size, and the fact that the survey targeted providers already familiar with ARFID. Future directions will focus on expanding the tool to guide treatment planning, and considering modifications for use by a broader clinical audience.