Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

Brigham, Kathryn S.; Manzo, Laurie D.; Eddy, Kamryn T.; Thomas, Jennifer J.

doi:10.1007/s40124-018-0162-y

Cited by 91 publications

(132 citation statements)

References 28 publications

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“…Mirroring these restrictions in food intake, children with versus without ARFID reported lower intakes of important micronutrients such as calcium or phosphate, which is in line with recent evidence on electrolyte abnormalities in adolescents with ARFID (Strandjord, Dieke, Richmond, & Rome, 2015) and may be related to a range of adverse physical symptoms (Brigham, Manzo, Eddy, & Thomas, 2018). Strikingly, child-and parent-reports on children's food intake were highly associated indicating that child-report of food intake may provide reliable nutritional information.…”

Section: Discussionsupporting

confidence: 84%

“…As the results on the ARFID module's convergent validity showed, children with ARFID consumed about 62%–68% of the recommended daily energy intake based on parent‐ and child‐report, respectively, thus reflecting the diagnosis' main definitional feature (APA, ). Mirroring these restrictions in food intake, children with versus without ARFID reported lower intakes of important micronutrients such as calcium or phosphate, which is in line with recent evidence on electrolyte abnormalities in adolescents with ARFID (Strandjord, Dieke, Richmond, & Rome, ) and may be related to a range of adverse physical symptoms (Brigham, Manzo, Eddy, & Thomas, ). Strikingly, child‐ and parent‐reports on children's food intake were highly associated indicating that child‐report of food intake may provide reliable nutritional information.…”

Section: Discussionsupporting

confidence: 84%

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Interview‐based assessment of avoidant/restrictive food intake disorder (ARFID): A pilot study evaluating an ARFID module for the Eating Disorder Examination

Schmidt

Kirsten

Hiemisch

et al. 2019

Intl J Eating Disorders

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Objective Although avoidant/restrictive food intake disorder (ARFID) has been included as a new diagnostic entity of childhood feeding and eating disorders, there is a lack of measures to reliably and validly assess ARFID. In addition, virtually nothing is known about clinical characteristics of ARFID in nonclinical samples. Method The present study presents the development and validation of an ARFID module for the child and parent version of the Eating Disorder Examination (EDE) in a nonclinical sample of N = 39 children between 8 and 13 years with underweight and/or restrictive eating behaviors. For evaluating the ARFID module's reliability, the convergence of diagnoses between two independent raters and between the child and parent module was determined. The module's validity was evaluated based on the full‐length child version of the EDE, a 24 h food record, parent‐reported psychosocial functioning and self‐reported quality of life, and objective anthropometric measures. Results In total, n = 7 children received an ARFID diagnosis. The ARFID module showed high interrater reliability, especially for the parent version, and high convergence between child and parent report. Evidence for the module's convergent, divergent, and discriminant validity was provided. Specifically, children with versus without ARFID reported significantly less macro‐ and micronutrient intake and were more likely to be underweight. Discussion This pilot study indicates the child and parent version of the EDE ARFID module to be promising for diagnosing ARFID in a structured way but still necessitates a validation in a larger clinical and community‐based sample.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 84%

Interview‐based assessment of avoidant/restrictive food intake disorder (ARFID): A pilot study evaluating an ARFID module for the Eating Disorder Examination

Schmidt

Kirsten

Hiemisch

et al. 2019

Intl J Eating Disorders

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“…Individuals with other eating disorders may also be more likely to be admitted to outpatient services. For example, those with a diagnosis of ARFID are less likely than those with AN to present with low heart rate and hypotension [ 34 ]. The current study therefore set out to examine diagnostic differences across males who were treated in outpatient versus intensive (day treatment/inpatient) services.…”

Section: Introductionmentioning

confidence: 99%

Eating disorders in biological males: clinical presentation and consideration of sex differences in a pediatric sample

et al. 2018

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BackgroundThe growing body of research on eating disorders among male adolescents reveals some sex differences in clinical presentation. The current study set out to replicate and extend recent research on the clinical and medical characteristics of male youth with eating disorders, and examine sex differences between biological males and females in a tertiary pediatric eating disorder treatment setting.MethodsA retrospective chart review was conducted with all biological males who were admitted to the Eating Disorders Programs at British Columbia Children’s Hospital (2003–2015) or the Looking Glass Residence (2011–2015). Clinical data, including demographics, percentage of median body mass index (% mBMI), and psychiatric diagnoses, were recorded along with medical data (i.e., vital signs, basic biochemistry investigations, and bone mineral density). A comparison group of females with eating disorders who received treatment at British Columbia Children’s Hospital in the inpatient or outpatient streams (2010–2015) were included, to examine sex differences with males who were admitted during the same period.ResultsA total of 71 male youth were included in the chart review. Males had significant medical complications, with 26.5% of the sample presenting with a heart rate of less than 50 beats per minute and 31.4% presenting with a bone mineral density z-score for the lumbar spine ≤ − 1. Sex differences between the subset of males who were treated between 2010 and 2015 (n = 41) and the females (n = 251) were examined. Females were more likely than were males to have a diagnosis of anorexia nervosa or bulimia nervosa, and to be underweight (< 95% mBMI) at admission. Males were younger than females, but no differences emerged in the duration of the eating disorder symptoms. No sex differences emerged relating to medical instability (e.g., bradycardia).ConclusionsA large proportion of male children and youth with eating disorders are medically compromised at admission. Males were younger than females, and were less likely than females to have a diagnosis of anorexia nervosa or bulimia nervosa. Males who were underweight at admission had also lost a lower percentage of body weight in comparison to females. The current study replicates previous sex differences reported in pediatric samples.

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“…83 As the disorder is increasingly recognized, guidelines for diagnostic and treatment approaches are being developed, including recommended workup. 84 Moreover, a thorough assessment of the patient's attitude toward weight and body image is vital to verify the ARFID diagnosis and to rule out other eating disorders. 84 Screening tools, such as the Pica ARFID and Rumination Disorder Interview, Eating Disorders in Youth Questionnaire, and Nine-Item ARFID Screen can also be useful in making the diagnosis and tracking symptoms over time.…”

Section: Avoidant/restrictive Food Intake Disordermentioning

confidence: 99%

“…84 Moreover, a thorough assessment of the patient's attitude toward weight and body image is vital to verify the ARFID diagnosis and to rule out other eating disorders. 84 Screening tools, such as the Pica ARFID and Rumination Disorder Interview, Eating Disorders in Youth Questionnaire, and Nine-Item ARFID Screen can also be useful in making the diagnosis and tracking symptoms over time. 84 Once the diagnosis has been made, the treatment for ARFID requires a multidisciplinary approach to achieve weight restoration and address disordered eating behaviors.…”

Section: Avoidant/restrictive Food Intake Disordermentioning

confidence: 99%

Pediatric Consultation-Liaison Psychiatry: An Update and Review

2020

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Background: In recent years, there has been an increasing burden of child and adolescent mental illness recognized in the United States, and the need for pediatric mental health care is growing. Pediatric consultation-liaison (C-L) psychiatrists are increasingly playing a role in the management of medical and psychiatric disease for pediatric patients. The field is a fast-moving one, with understanding of new neuropsychiatric disease entities; reformulation of prior disease entities; and new interdisciplinary treatments and models of care. Methods: In this study, we aim to review recent advances in the field of pediatric C-L psychiatry, including new diagnostic entities, updated management of frequently encountered clinical presentations, and developments in systems of care. Conclusion: The advances in pediatric C-L psychiatry are broad and serve to promote more streamlined, evidence-based care for the vulnerable population of psychiatrically ill pediatric medical patients. More work remains to determine the most effective interventions for the wide array of presentations seen by pediatric C-L psychiatrists.

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Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

Cited by 91 publications

References 28 publications

Interview‐based assessment of avoidant/restrictive food intake disorder (ARFID): A pilot study evaluating an ARFID module for the Eating Disorder Examination

Interview‐based assessment of avoidant/restrictive food intake disorder (ARFID): A pilot study evaluating an ARFID module for the Eating Disorder Examination

Eating disorders in biological males: clinical presentation and consideration of sex differences in a pediatric sample

Pediatric Consultation-Liaison Psychiatry: An Update and Review

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