Feeding, Eating, and Emotional Disturbances in Children with Avoidant/Restrictive Food Intake Disorder (ARFID).

Sharon Iron-Segev,Daniel Stein,Shani Arad-Rubinstein,Danielle Best,Hadar Dickstein,Martin Efron,Yaffa Serur

doi:10.3390/nu12113385

Abstract

Avoidant/restrictive food intake disorder (ARFID) is a relatively new diagnostic category. We sought to determine whether the Stanford Feeding Questionnaire (SFQ), an instrument for assessing picky eating, can differentiate children with ARFID from control children, and whether children with ARFID would show more nonfeeding/eating emotional problems than controls. Fifty children with ARFID were compared to 98 controls. Parents completed the SFQ, Screen for Child Anxiety Related Emotional Disorders (SCARED), Strength and Difficulties Questionnaire (SDQ), and Sensory Responsiveness Questionnaire (SRQ). On the SFQ, 12 items represented child ARFID behaviors (SFQ-ARFID Scale), and another 15 items represented parental feeding problems (SFQ-PFP Scale). We found that the SFQ-ARFID and SFQ-PFP Scale scores were significantly higher in children with ARFID vs. controls. Children with ARFID demonstrated higher SDQ-Total-Difficulties, higher SDQ-Internalizing-Difficulties and lower SRQ-Hedonic scores compared with controls. Of all parameters, the SFQ-ARFID Scale best differentiated children with ARFID from control children (area under receiver operating characteristics curve = 0.939, 95% CI, 0.895–0.983, p < 0.001). These findings suggest that parental reports show more eating problems and emotional disturbances in children with ARFID vs. controls, and more parental feeding problems. Further research is required to determine whether the SFQ-ARFID Scale may serve as an effective screening tool for the identification of ARFID.

Highlights

Avoidant/restrictive food intake disorder (ARFID) is a relatively new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1] and the International Classification of Diseases11th Revision (ICD-11) [2]
The findings of this study showed that the score of the proposed Stanford Feeding Questionnaire (SFQ)-ARFID Scale, based on 12 selected items from the SFQ describing maladaptive eating-related behaviors, was significantly higher for children with ARFID as diagnosed in the psychiatric evaluation [Mean (SD) 4.46 (1.01)
The primary aim of the present study was to determine if the SFQ could distinguish between children diagnosed with ARFID using the DSM-5 criteria [1] from control children

Summary

Introduction

Avoidant/restrictive food intake disorder (ARFID) is a relatively new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1] and the International Classification of Diseases11th Revision (ICD-11) [2]. ARFID captures a varied presentation of feeding and eating disturbances leading to nutritional deficiencies, failure to meet nutritional and/or energy needs, and related psychosocial functioning imbalances [1]. In this new version of the diagnosis, symptoms of avoidance and restrictive eating are recognized as unrelated. At present, limited data is available about the incidence and prevalence of ARFID in the general population [5,6] This is because, as a relatively new defined disorder, it has not yet been assessed sufficiently in large-scale population-based epidemiological studies [4]. A study conducted in pediatric gastrointestinal clinics in the Boston area reported a much lower ARFID prevalence of only 1.5% [14]

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