Early-onset restrictive eating disturbances in primary school boys and girls.

Susanne Kurz,Simone Munsch,Daniela Dremmel,Zoé Van Dyck,Anja Hilbert

doi:10.1007/s00787-014-0622-z

Abstract

This study sought to determine the distribution of early-onset restrictive eating disturbances characteristic of the new DSM-5 diagnosis, avoidant/restrictive food intake disorder (ARFID) in middle childhood, as well as to evaluate the screening instrument, Eating Disturbances in Youth-Questionnaire (EDY-Q). A total of 1,444 8- to 13-year-old children were screened in regular schools (3rd to 6th grade) in Switzerland using the self-report measure EDY-Q, consisting of 12 items based on the DSM-5 criteria for ARFID. 46 children (3.2 %) reported features of ARFID in the self-rating. Group differences were found for body mass index, with underweight children reporting features of ARFID more often than normal and overweight children. The EDY-Q revealed good psychometric properties, including adequate discriminant and convergent validity. Early-onset restrictive eating disturbances are commonly reported in middle childhood. Because of possible negative short- and long-term impact, early detection is essential. Further studies with structured interviews and parent reports are needed to confirm this study’s findings.

Highlights

Eating disturbances in middle childhood are common; their assessment and presentation remain under debate
This study sought to determine the distribution of early-onset restrictive eating disturbances characteristic of the new DSM-5 diagnosis, avoidant/restrictive food intake disorder (ARFID) in middle childhood, as well as to evaluate the screening instrument, Eating Disturbances in Youth-Questionnaire (EDY-Q)
Additional analyses of the differences between German versus French language showed similar results on the psychometric properties and distribution. This is the first investigation on the prevalence of early-onset restrictive eating disturbances characteristic of the new DSM-5 category ARFID in a nonclinical middle childhood population sample

Summary

Introduction

Eating disturbances in middle childhood are common; their assessment and presentation remain under debate. ARFID is defined as a feeding or eating disturbance associated with significant clinical and/or psychosocial impairment, which can be present across the lifespan [7] It serves as a replacement for the DSM-IV-TR diagnosis of feeding disorder of infancy and early childhood. ARFID includes several presentations described in middle childhood which do not fit any previous eating disorder diagnosis [10] They can be characterized in terms of a lack of interest in eating or food, eating a very limited amount of food connected to sensory or other properties of the food (colour, texture, taste, brand), and the avoidance of food based on specific fears, such as choking or vomiting. There is an abundance of terms describing these presentations

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