Restrictive Disorders Research Articles

Prevalence and determinants of restrictive lung disorder among quarry workers at the Umuoghara quarry site, Ebonyi State, Nigeria: a cross-sectional study

IntroductionRespiratory disorders pose a serious health risk for quarry workers exposed to dust, as they are a leading source of morbidity and mortality globally, often resulting in irreversible lung conditions. This study assessed the prevalence and determinants of restrictive disorder among quarry workers in Umuoghara quarry site, Ebonyi State.MethodsThis study was done on quarry workers at the Umuoghara quarry site, Ebonyi State. An analytical cross-sectional study design was adopted. Data was collected using a pre-tested semi-structured questionnaire among 300 quarry workers selected by simple random sampling method. Lung function test was performed using a spirometer- spirovit SPI schiller and data was analyzed with the use of IBM SPSS version 23.0. Pearson’s chi-square test was used to find associations between variables. Binary logistic regression (multivariate analysis) was used to find the determinants of restrictive lung disorder at p < 0.05.ResultsThe prevalence of restrictive disorder was 14.3%. Working for more than 5 years (AOR = 2.880 at 95% CI = 1.234–6.720), Working for more than 10 years (AOR = 9.645 at 95% CI = 2.601–35.766), smoking (AOR = 3.558 at 95% CI = 1.631–7.762) and non-use of protective measures (AOR = 0.114; 95% CI = 0.050–0.262) were the determinants of restrictive lung disorder in quarry workers.ConclusionThere is an increased risk of developing respiratory problems among quarry workers exposed to quarry dust. It is recommended that employees receive thorough education on the dangers of this exposure, and that employers be mandated to provide protective equipment and strictly enforce its use among workers.

Parental Attitudes and Behaviors Associated with Selective Eating in Children with Autism Spectrum Disorders

Although sometimes it appears as a natural behavior in children, selective eating can become problematic and severe, implying aliments rejection, a low range of eaten foods, the predominance of some foods in the child’s repertoire, aversion and avoidance of various food based on look, taste, texture, or smell. Consequences of selective eating can be noticed on health and development, interactions and inclusion in social settings, emotional and behavioral problems, low self-esteem, distress, and other family problems. In children with autism spectrum disorders (ASD), it can be associated with sensory processing disorder, mood disorders, and health problems, and can become severe (eg., avoidant restrictive food intake disorder). Parental attitudes and behaviors, family dynamics during mealtimes, the emotional climate of the family, social support, and cultural and social factors have a significant impact on the problem. A case example of a 13-year-old child, diagnosed with severe autism spectrum disorder and intellectual disability, with selective eating (a low variety of foods in his menu, food refusal, and behavioral interference during mealtimes) and a tendency towards overweight will show the co-occurrence of selective eating and parental problematic behaviors. The child’s sensory profile (reported by the parent) revealed no differences from the norms. Parental tendency to overly gratify the child’s behavior, excessive worrying, and excessive assistance were associated with the child’s tendency to eat selectively, as well as to his preference for unhealthy foods and refusal of healthy ones. The attachment between mother and child seems to be anxious and there is a high degree of fusion in the relationship. Intervention for the eating problems can include attachment-based therapies, systemic family therapy, cognitive-behavioral therapies, and training of parenting skills.

Ngā Māuiui Kai: creating Indigenous Māori terms for eating disorders in Aotearoa New Zealand

BackgroundMāori (the Indigenous people of Aotearoa New Zealand) report higher rates of eating disorders than non-Māori, but access treatment at lower rates. Diagnostic terms lacking in cultural relevance likely contribute to Māori exclusion in eating disorder spaces. Developing terms in te reo Māori (the Māori language) presents an opportunity to challenge eating disorder stereotypes and increase cultural safety in the eating disorder workforce.MethodologyGuided by a Māori worldview and the practice of wānanga (to meet, discuss, and think deeply about a topic), we present a Māori language glossary for eating disorders. The glossary is informed by expertise in te reo Māori, mātauranga Māori (the body of Māori knowledge), and eating disorders, and combines terms already in use with newly developed terms.ResultsWe propose an umbrella term for eating disorders (ngā māuiui kai), as well as terms for anorexia nervosa (māuiui whakatiki), bulimia nervosa (pukuruaki), binge eating disorder (māuiui kaihoro), and avoidant restrictive food intake disorder (karo kai, with three subtypes of low interest [arokore kai], sensory-based avoidance [āmaimai rongo kai], and concern about the consequences of eating [wehi-ā-kai]). We also propose terms for related concepts of body image difficulties (māuiui whakawā ata), perfectionism (māuiui kōtihitihi) and emotion dysregulation (kare-a-roto kōtitititi).ConclusionThis glossary is available for use by anyone looking for terms that come from a mana-enhancing (empowering, respectful, and strengths-based) Māori worldview. The kupu (words, terms) in this glossary are offered as possibilities for use, rather than as definitive or correct, in the hopes they will promote discussion about stigma, indigeneity, and language in the eating disorders field.

Prediction of restrictive ventilation disorders after COVID-19

Introduction. The effect of SARS-COV-2 on the lung function remains relevant at the present time.Aim. Determination of the most important predictors of the restrictive ventilation disorder after COVID-19.Materials and methods. The retrospective study included 341 patients without underlying lung diseases (median age 48 years) survivors after COVID-19 with bilateral pneumonia. The median of the greatest extent of parenchymal involvement in the acute phase of COVID-19 (CTmax) was 50%. Spirometry, body plethysmography, and diffusion test were performed. Descriptive statistics, correlation analysis, one-dimensional logistic regression analysis with an assessment of odds ratios (OR) and multivariate logistic regression analysis were applied. ROC analysis was used to assess the quality of the binary classifier model.Results. The initial model for predicting reduced total lung capacity (TLC) (criterion 1: TLC &lt; 80% predicted, criterion 2: TLC&lt;predicted-1.645SD) included predictors: CTmax, time interval from the COVID-19 onset (TI), gender, age, body mass index. Backward stepwise regression was applied and a binary classifier model that includes CTmax and TI was obtained. Applying criterion 1 for reducing TLC, the sensitivity and specificity of the model were 70,5% and 89.3%, respectively, and criterion 2 - 96.6% and 67.3%, respectively. The analysis of OR for the obtained binary classifier models showed that OR&gt;1 is observed at CTmax &gt; 70%.Conclusions. The restrictive ventilation disorder after COVID-19 is caused by CTmax and TI. The risk of reducing TLC after COVID-19 increases significantly with CTmax 70% or more. The criterion of the low level of normal of TLC affects the sensitivity and specificity of the obtained models.

Neural correlates of children with avoidant restrictive food intake disorder symptoms: large-scale neuroanatomical analysis of a paediatric population.

Avoidant restrictive food intake disorder (ARFID) is a recently recognised feeding and eating disorder and is characterised by a lack of interest and motivation to eat. Despite burgeoning research, few studies to date have explored the underlying neurobiology of ARFID. Research examining the neural underpinnings of ARFID can greatly assist in understanding different mechanisms that play disorder-specific roles. We studied a total of 1,977 10-year-old participants from the Generation R Study, a population-based Dutch cohort, to cross-sectionally examine neuroanatomical differences between those with versus without ARFID-like symptoms. Children were classified with versus without ARFID symptoms using the ARFID Index, a validated evaluative tool comprised of parent-reported and researcher-assessed measurements of picky eating, energy intake, diet quality, growth and psychosocial impact to characterise ARFID symptoms in the paediatric population. Global and regional values of surface area, cortical thickness, and volume from T1-weighted structural magnetic resonance imaging (MRI) scans in those with ARFID symptoms were compared with children not exhibiting symptoms. We identified 121 (6.1%) individuals with ARFID symptoms relative to 1,865 (93.9%) individuals without ARFID symptoms. Neuroanatomical findings identified significantly greater frontal (p = .00743; d = 0.21) and superior frontal (p = 6.56E-04; d = 0.28) cortical thickness among children with ARFID symptoms. This first large-scale study of the neural correlates of ARFID identified greater thickness of frontal cortical regions in children with ARFID symptoms, suggesting a role for executive function in the aetiology of the condition.

Confusion between avoidant restrictive food intake disorder, restricted intake self-harm, and anorexia nervosa: developing a primary care decision tree.

Confusion between avoidant restrictive food intake disorder, restricted intake self-harm, and anorexia nervosa: developing a primary care decision tree.

Eating- and Weight-Related Disorders in the Armed Forces.

Like in the general population, the prevalences of eating- and weight-related health issues in the armed forces are increasing. Relevant medical conditions include the eating disorders (EDs) anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder (ARFID), as well as body dysmorphic disorder, muscle dysmorphia, and the relative energy deficiency in sport (RED-S) syndrome. We performed a narrative literature review on eating- and weight-related disorders in the armed forces. Entry standards might exclude people with obesity, with EDs, or at high risk for EDs from entering the armed forces for military reasons and to protect the individual's health. Relevant potential risk factors of eating- and weight-related disorders in the military are the emphasis on appearance and fitness in the military, high levels of stress, military sexual trauma, post-traumatic stress disorder, deployment, relocation, long commutes, consumption of ultra-processed foods and beverages, limitations on food selection and physical exercise, and intensive combat training and field exercises. Eating- and weight-related disorders negatively impact professional military appearance and lead to problems with cardiorespiratory and neuromuscular fitness; daytime sleepiness; and a higher risk of musculoskeletal injuries, and other physical and mental health problems. Current and potential future therapeutic options include occupational health measures, psychosocial therapies, neuromodulation, and drug treatments. Even though randomized controlled trials (RCTs) have been performed to test treatments for obesity in the armed forces, RCTs for the treatment of EDs, body dysmorphic disorder, muscle dysmorphia, and RED-S syndrome are lacking in the military context.

The Effect of the Cheneau Brace on Respiratory Function in Girls with Adolescent Idiopathic Scoliosis Participating in a Schroth Exercise Program.

Objectives: The aim of this study was to evaluate the effect of brace use application and the Schroth intervention on lung ventilation and respiratory muscle strength in patients treated long-term with a Chaneau brace and the Schroth method. Methods: A total of 26 post-menarche females aged 15.7 ± 1.5 years, with a Cobb angle of 18-48° and a diagnosis of AIS in inpatient rehabilitation were examined. All participants received brace treatment for a minimum of 3 months with a dosage of 20-22 h/day. This study protocol was performed three times: 1-brace intervention-first day of the present study; 2-without the brace-second day of the present study; and 3-Schroth intervention on the same day. Results: During the period of brace use, girls treated with a long-term therapy showed significantly reduced values for VC, FVC, and FEV1 and significantly higher values for inspiratory muscle strength PImax compared to values obtained in studies without the brace and after single exercises. Expiratory muscle strength did not differ significantly. Conclusions: The majority showed restrictive lung ventilation disorders and decreased respiratory muscle strength in relation to norms. There was a significant correlation of PImax with the duration of wearing the brace and the duration of therapy.

The Effect of Added Mass on Pulmonary Function

A comparative study of the volume-velocity parameters of the human external respiration system was carried out under the influence of an additional weight load: a body armor weighing 11 kg and a backpack weighing 15 kg. The nature of changes in the main spirometric parameters under the influence of an added mass is typical for restrictive disorders of pulmonary function. A marked decrease in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) values was observed when performing the test with a protective vest. In the conditions of a combination of body armor and a backpack, these changes were more pronounced (p 0.01). At the same time, there were no significant changes in the Tiffno index values (FEV1/FVC). In addition, a significant decrease in the values of maximum voluntary ventilation (MVV) was revealed by 8.1% under the influence of body armor, and by 18.5% with a combination of a vest and a backpack relative to the control (p 0.01). A significant correlation was shown between the maximum force of contraction of the inspiratory muscles and the maximum voluntary ventilation of the lungs both in the control and with an additional weight load. It is possible that the inspiratory muscles training, aimed at increasing their strength and endurance, can be an effective strategy for minimizing the adverse effects of increased weight load when performing work with special protective equipment in various areas of human professional activity.

Neuroimaging Insights into Brain Mechanisms of Early-onset Restrictive Eating Disorders.

Early-onset restrictive eating disorders (rEO-ED) encompass a heterogeneous group of conditions, including early-onset anorexia nervosa (EO-AN) and avoidant restrictive food intake disorders (ARFID). Almost nothing is known about the consequences of rEO-ED on brain development. We performed the largest comparison of MRI-derived brain features in children and early adolescents (<13 years) with EO-AN (n=124), ARFID (n=50), and typically developing individuals (TD, n=112). Despite similar body mass index (BMI) distributions, EO-AN and ARFID showed divergent structural patterns, suggesting independent brain mechanisms. Half the regional brain measures were correlated with BMI in EO-AN and none in ARFID, indicating a partial mediation of EO-AN signal by BMI. EO-AN was associated with a widespread pattern of thinner cortex, while underweight ARFID patients exhibited smaller surface area and subcortical volumes than TD. Future studies will be required to partition the contribution of low BMI vs. ED mechanisms in neurodevelopmental disorders.

Pediatric Hospital Utilization During Medical Stabilization for Patients With Eating Disorders.

Few studies have examined pediatric hospital utilization across the spectrum of eating disorder (ED) diagnoses among hospitalized patients. We describe sociodemographic and clinical characteristics, hospital utilization, and enteral tube feeding and examine factors associated with hospital utilization among patients with EDs. Using data from the Pediatric Health Information System, we included patients aged 4 to 20 years with primary ED diagnoses hospitalized from 2018 to 2022. We examined sociodemographic factors, length of stay, costs, and enteral tube feeding by ED diagnosis. Adjusted regression models compared hospital utilization by diagnosis, adjusting for sociodemographic and clinical factors. Among N = 10 279 hospitalizations from 49 hospitals, anorexia nervosa (AN) was most common (70.9%), followed by avoidant restrictive food intake disorder (ARFID) (15.6%). Mean age was 15.1 years (SD = 2.5), and most were female (86.6%), of white non-Hispanic race (70.9%), with private insurance (70.1%), with 63.9% occurring after the coronavirus disease 2019 pandemic onset. Median (interquartile range) length of stay was 8.0 days (7.0), and hospital costs were $18 099 ($15 592). A total of 18.8% received enteral tube feeding, with significant hospital variation. In adjusted models, compared with AN, ARFID, binge disorders, and unspecified feeding and ED had shorter stays, whereas hospital costs were lower for binge disorders, and enteral feeding was more likely for ARFID. Our findings indicate long and costly hospitalizations, especially for AN, with implications for hospital and treatment capacity, highlighting the need for earlier diagnosis and treatment to prevent the need for hospitalization.

Association between Ventilation Disorder and Masticatory Dysfunction in the Korean Adult Population: A Cross-Sectional Study Using Data from the 2019 Korea National Health and Nutrition Examination Survey.

Background and Objectives: Respiratory and periodontal diseases are among the most common diseases affecting humans worldwide. Periodontal disease is a risk factor for aspiration pneumonia and other respiratory diseases. However, the evidence supporting the link between respiratory and periodontal disease is inconclusive and insufficient. Therefore, this study aimed to investigate the relationship between oral disease symptoms and respiratory diseases. Materials and Methods: Adults who underwent oral examinations and lung disease tests were recruited from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 14,956 individuals participated in the 2019 KNHANES. Among the 6846 participants who underwent oral examinations, 1320 children and adolescents were excluded. Additionally, of the 4119 adults aged ≥40 years who underwent dual lung function tests, those who did not respond to key independent confounding variables were excluded. The final sample consisted of 2988 adults. Results: Complex sample multivariate logistic regression analysis revealed that the risk of restrictive ventilation disorder was lower in individuals without chewing discomfort compared to individuals with chewing discomfort (odds ratio, 0.68; 95% confidence interval, 0.479-0.996), and the difference was statistically significant. Only one significant difference was observed between the two groups. Conclusions: Chewing discomfort is a major periodontal health-related factor associated with chronic obstructive pulmonary disease (COPD). Although the exact mechanism underlying the relationship between masticatory discomfort and COPD remains unclear, masticatory discomfort is an early symptom of oral diseases. The findings from this study provide additional basic data for the prevention of oral diseases and COPD in Korea.

21 Exploring the clinical presentation and health service utilization in autistic children and adolescents diagnosed with avoidant / restrictive food intake disorder: A descriptive study

Abstract Background Avoidant/restrictive food intake disorder (ARFID) is an eating disorder with much clinical variability, negatively impacting growth, nutrition, psychosocial functioning and overall well-being. ARFID is more frequently reported in neurotypical populations than in neurodivergent populations. Little is known about the clinical presentation and healthcare utilization of autistic individuals with ARFID. Objectives The purpose of this study was to understand the clinical presentation, laboratory abnormalities and health system utilization amongst autistic individuals diagnosed with ARFID within the community. Design/Methods We completed a comprehensive multidisciplinary assessment on autistic individuals less than18 years of age who were diagnosed with ARFID by their community physician. Recruitment period: June 2020-June 2021. Results Nineteen autistic individuals completed a comprehensive multidisciplinary assessment; of these, 42.1% (8/19) met criteria for Autism Spectrum Disorder (ASD) severity level 1. The onset of restrictive eating manifested at M(SD)= 2.5 (0.7) years, and the age of ASD diagnosis was 4.2 (3.8) years. Of these, 78.9% (15/19) had the onset of feeding difficulties either prior to or at the time of their ASD diagnosis (Figure 1). Dependence on enteral feeding or nutritional supplements (74%), psychosocial impairment (68%), and nutritional deficiencies (42%) were the criteria commonly met for ARFID. Sensory-based avoidance (100%) and lack of interest in food (89%) were the two most reported potential drivers for the dysfunctional feeding behaviour based on the Pica , ARFID, and Rumination Disorder Interview-AR-Q. Neurodevelopment disorder comorbidities included ADHD (26.3%), Anxiety (21.1%), and Intellectual Developmental Disability (15.8%). Constipation (68.4%) and nutritional deficits (63.15%) were the most common medical comorbidities recorded. Nutritional profile revealed Vitamin D deficit in 50% (8/16), Anaemia 21% (4/19), Vitamin B1 deficit 20% (2/10). Additionally, three participants (17.7%, 3/17) had deficits in Vitamin B12, Zinc, Vitamin C and low ferritin levels. Four autistic individuals (21.1%, 4/19) were hospitalized because of their restrictive eating. 68.4% (13/19) autistic individuals had involvement of at least one allied health professional (OT or SLP or BT). No participants had a prior multidisciplinary feeding assessment or intervention to address restrictive eating. Conclusion ARFID is an eating disorder observed within autistic individuals. Evidence suggests food related sensory sensitivities and lack of interest in food are potential drivers of ARFID in the context of ASD. A comprehensive multidisciplinary assessment is needed to elucidate factors driving restrictive eating to inform targeted evidence-based interventions.

Debunking the GAMLSS myth: Simplicity reigns in pulmonary function diagnostics

RationaleCurrent technical standards advocate using Generalized, Additive Models of Location, Scale, and Shape (GAMLSS) for lung function reference equations. These equations are complicated and require supplementary spline tables. Objective(1) To demonstrate that segmented (piecewise) linear regression (SLR) yields prediction accuracies similar to GAMLSS in pulmonary function diagnostics. (2) To determine the agreement between both SLR and GAMLSS. MethodsThe NHANES 2007–2012 database was utilized to construct spirometric reference equations for FEV1, FVC, and FEV1/FVC using both SLR and GAMLSS modeling techniques. K-fold cross-validation was used to provide the 95% confidence interval (CI) of the root-mean-square error (RMSE) as an indicator of prediction accuracy. Additionally, agreement was assessed between the two modeling techniques in classifying spirometric patterns (standard, airflow obstruction, restrictive, or mixed disorder) using an unweighted kappa statistic. ResultsThe RMSE values for FEV1, FVC, and FEV1/FVC and correlation coefficients between predicted values and test data were similar between the two techniques. Agreement in classifying spirometric patterns between the two techniques ranged from 0.78 to 0.80 (95 % CI). ConclusionsThe findings suggest that simple linear regression for FEV1/FVC and SLR for FEV1 and FVC offer prediction accuracies on par with GAMLSS while being more straightforward, parsimonious, and accessible to a broader audience in the field of pulmonary function diagnostics.

Script Concordance Test in Physiology: Preparation, Scoring, and Student Perceptions – A Mixed Method Study

Background: Although the curriculum has changed, assessment tools are not in alignment with the new types of teaching such as early clinical exposure (ECE) and self-directed learning. Both in summative and formative assessment most commonly used tools for assessment of cognitive domain are written formats including MCQ. However, these assessment tools such as MCQ and written essays cannot assess the higher order thinking skills and clinical reasoning skills. Materials and Methods: The present study was conducted in the department of physiology, in collaboration with medical simulation center, as a part of formative assessment for topics on pathophysiology of shock and obstructive and restrictive lung disorders taught during ECE using case scenarios. Two script concordance tests (SCTs) each on the topic of pathophysiological mechanism of different types of shock and obstructive and restrictive lung disorders each were prepared and administered to the students. Student perception to this assessment tools was obtained. Results: The Cronbach’s alpha of the 6-item SCT for respiratory and cardiovascular topic administered to the students (n = 107, 98) was 0.83 and 0.82, respectively. The inter-item correlation was respiratory and cardiovascular topic for 0.71, 0.69 suggesting that they are close and repetitive. Students were of the opinion that SCT are difficult to understand (75.8%), challenging to answer (47.2%), and it tested the clinical content better (71.4%). Conclusions: In our study, students felt though SCT tested the clinical content better when compared to conventionally used MCQ, they still find it challenging to understand and are not in favor of its use in summative and formative assessments.

Avoidant Restrictive Food Intake Disorder: A Case Series

Abstract Avoidant restrictive food intake disorder (ARFID), a recently described eating disorder categorized under DSM-5, has varied clinical presentations. The primary eating disorders have well-established practice parameters for management. However, there is no evidence-based first line of management for ARFID. There is a significant gap in this evolving construct and clinical practice. We present a case series from a tertiary care center in India, focusing on clinical management. Four adolescents with 3 girls and 1 boy between 12 and 17 years of age were included in the study. Diagnosis and management were delayed in all. Mean body mass index was 15.36 (5.26) kg/m2 at the time of diagnosis. Key drivers were dread of choking, sensory characteristics, and avoidance of unpleasant upper and lower gastrointestinal symptoms. This series supports a culturally cognizant hypothesis, an evidence based, viable management model for ARFID in low- and middle-income countries (LMIC). A combination of family-based treatment (FBT) and cognitive behavior therapy is an effective treatment model for India and other LMICs.

Eating concerns in youth with functional abdominal pain disorders.

Adolescents with functional abdominal pain (FAP) often experience pain and other gastrointestinal symptoms in the context of eating, which may place them at risk for eating disorders. This study compared disordered eating and its sequalae in adolescents with FAP to those with chronic headache. Participants in this retrospective chart review study were 270 adolescents and young adults (mean age 15.9; standard deviation [SD] = 1.63; 60% female) attending an intensive, interdisciplinary pain treatment program, including 135 youth with FAP and an age- and gender-matched control group with a primary pain diagnosis of chronic headache. Information was extracted related to eating- and weight-related symptoms. Independent t-tests and χ2 analyses found that compared with adolescents with chronic headache, patients with FAP showed significantly more eating pathology as reflected by scores on the Eating Attitudes Test-26 (EAT-26) (p < 0.001), endorsement of pain-related restrictive eating (p < 0.01), eating disorder history (p < 0.001), and avoidant restrictive food intake disorder (ARFID) diagnoses (p < 0.001). Compared to those with chronic headache, significantly more patients with FAP had lost 10 pounds or more (p < 0.01) and a higher proportion were underweight (p < 0.001). Among all participants, a history of exclusion diets used to manage symptoms significantly increased the risk for ARFID (p < 0.001). The results of this study highlight the increased risk of eating-related concerns among youth with FAP, as well as the judicious use of exclusion diets to manage symptoms in these patients.

Investigating the utility of the AQ-10 in children and adolescents assessed in an outpatient ARFID clinic.

The high co-occurrence of autism and eating disorders is well established, including for those with Avoidant Restrictive Food Intake Disorder (ARFID). It is therefore important to consider autism and identify possible autism when people present to eating disorder services to ascertain whether further assessment is indicated, to support clinical formulation and to make appropriate adaptations during interventions. This paper explores the utility of a validated autism screening measure, the AQ-10, in a population of children and adolescents who presented to an outpatient eating disorders clinic for an assessment of possible ARFID. Over 19 months, 335 young people were assessed and 246 families with children aged between 4 and 17 years completed one of three versions of the AQ-10 (Child, Adolescent, and Adult), as part of a battery of routinely administered pre-assessment questionnaires. Results indicated that 80.2% (n = 69) of those with an existing autism diagnosis scored above clinical threshold of ≥6 (M = 7.2, SD = 1.9), 43.9% (n = 43) of those queried to be autistic scored above clinical threshold (M = 5.2, SD = 2.5), and 6.5% (n = 4) of non-autistic individuals scored above clinical threshold (M = 2.8, SD = 1.8). Additionally, the AQ-10 satisfactorily discriminated between those with a known autism diagnosis and those who are not autistic across all age groups and sex. We conclude that the AQ-10, alongside a comprehensive clinical assessment and clinical judgment, is a useful screening tool that can support clinicians to identify appropriate onward referrals for autism assessments, aid clinical formulation, and consider appropriate adaptations and reasonable adjustments during ARFID interventions.

Pilot Case Series Studying a Psychoeducational and Motivational Treatment for Children With Low-Weight Avoidant Restrictive Food Intake Disorder.

Research on treatments for children with avoidant restrictive food intake disorder (ARFID) is needed. This pilot case series describes outcome data for 20 children ages 6-12 years old with a diagnosis of ARFID and who are low-weight. Participants were recruited nationwide as part of an ongoing randomized clinical trial. All participants in this study received a 14-session psychoeducational and motivational treatment (PMT) protocol. Parents completed measures of ARFID severity (the Pica, ARFID, Rumination Disorder Interview) and parental self-efficacy (Parents vs. ARFID scale). Height and weight were self-reported by parents and percent of estimated body weight (%EBW) was calculated. Assessments occurred at baseline, 1-month within treatment, 2-months within treatment, end-of-treatment (EOT), and 6-month follow-up. Twenty children (10.34 ± 1.76 years; 85% Non-Hispanic; 75% White; 70% female; 84.16 ± 4.66% EBW) with low-weight ARFID and their parents received PMT-ARFID with a clinician specializing in eating disorders. By EOT, PARDI severity scores decreased (large effect size) parental self-efficacy increased (medium effect size), but %EBW remained unchanged. Additional research evaluating PMT in adequately powered clinical trials for youth with ARFID is needed.

A tradeoff between safety and freedom: Adults’ lived experiences of ARFID

BackgroundAvoidant restrictive food intake disorder (ARFID) is characterized as a pattern of restrictive eating leading to significant medical and/or psychosocial impairment (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, American Psychiatric Association, Washington, D.C., 2013). Most existing research on ARFID utilizes quantitative methodologies to study children and adolescents. As a result, the experiences of adults with ARFID have been underrepresented in research. To fill this gap, the current study examines the lived experiences of adults with a DSM-5 diagnosis of ARFID.MethodParticipants (n = 9) included adult women aged 20–42 (M = 27, SD = 6.2) recruited from social media advertising. Open-ended, semi-structured interviews were conducted. Data were analyzed using interpretative phenomenological analysis (IPA).ResultsOne of three overarching themes identified by IPA will be discussed in this study: “A tradeoff between safety and freedom,” which consists of two subthemes: (a) Ensuring safety from food unknowns and (c) Longing for Freedom. This overarching theme explores the influence of ARFID on an individual’s sense of safety and freedom.DiscussionThis study is one of few to qualitatively examine ARFID, and the only to do so using IPA. Findings offer novel insights relevant to researchers and clinicians who treat adults with ARFID and who wish to increase consideration and understanding of patient lived experience in their work.