“If I could survive without eating, it would be a huge relief”: Development and initial validation of the Fear of Food Questionnaire

Zickgraf, Hana F.; Loftus, Paddy; Gibbons, Benjamin; Cohen, Lauren; Hunt, Melissa G.

doi:10.1016/j.appet.2021.105808

Cited by 14 publications

(14 citation statements)

References 51 publications

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“…The Patient Assessment of Upper Gastrointestinal Disorders Quality of Life (PAGI‐QOL) is a 20‐item measure of upper gastrointestinal‐related quality of life averaged into five subscales (daily activities, clothing, diet and food habits, relationship, and psychological well‐being and distress) and a total score (each range = 0–5), with lower scores indicating greater quality of life (De La Loge et al, 2004). The Fear of Food Questionnaire (FFQ) is an 18‐item measure of food‐related fears averaged into five subscales (GI fears, food fears, food avoidance, social impairment, and distress/loss of pleasure) and a total score (each range = 0–5), with higher scores indicating greater food‐related fears (Zickgraf et al, 2022). The Food Neophobia Scale (FNS) is a 10‐item measure of food neophobia summed into a total score (range = 10–70), with higher scores indicating less willingness to try new foods (Pliner & Hobden, 1992).…”

Section: Methodsmentioning

confidence: 99%

“…, 2004). The Fear of Food Questionnaire (FFQ) is an 18-item measure of foodrelated fears averaged into five subscales (GI fears, food fears, food avoidance, social impairment, and distress/loss of pleasure) and a total score (each range = 0-5), with higher scores indicating greater foodrelated fears (Zickgraf et al, 2022). The Food Neophobia Scale (FNS) is a 10-item measure of food neophobia summed into a total score (range = 10-70), with higher scores indicating less willingness to try new foods (Pliner & Hobden, 1992).…”

Section: Quantitative Measuresmentioning

confidence: 99%

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Development of a brief cognitive‐behavioral treatment for avoidant/restrictive food intake disorder in the context of disorders of gut–brain interaction: Initial feasibility, acceptability, and clinical outcomes

Murray

Weeks

Becker

et al. 2022

Intl J Eating Disorders

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Background: Avoidant/restrictive food intake disorder (ARFID) symptoms are common (up to 40%) among adults with disorders of gut-brain interaction (DGBI), but treatments for this population (DGBI + ARFID) have yet to be evaluated.We aimed to identify initial feasibility, acceptability, and clinical effects of an exposure-based cognitive-behavioral treatment (CBT) for adults with DGBI + ARFID. Methods: Patients (N = 14) received CBT as part of routine care in an outpatient gastroenterology clinic. A two-part investigation of the CBT included a retrospective evaluation of patients who were offered a flexible (8-10) session length and an observational prospective study of patients who were offered eight sessions. Feasibility benchmarks were ≥75% completion of sessions, quantitative measures (for treatment completers), and qualitative interviews. Acceptability was assessed with a benchmark of ≥70% patients reporting a posttreatment satisfaction scores ≥3 on 1-4 scale and with posttreatment qualitative interviews. Mixed model analysis explored signals of improvement in clinical outcomes.Results: All feasibility and acceptability benchmarks were achieved (and qualitative feedback revealed high satisfaction with the treatment and outcomes). There were improvements in clinical outcomes across treatment (all p's < .0001) with large effects for ARFID fear (À52%; Hedge's g = 1.5; 95% CI = 0.6, 2.5) and gastrointestinal-specific anxiety (À42%; Hedge's g = 1.0; 95% CI = 0.5, 16). Among those who needed to gain weight (n = 10), 94%-103% of expected weight gain goals were achieved.Discussion: Initial development and testing of a brief 8-session CBT protocol for DGBI + ARFID showed high feasibility, acceptability, and promising clinical improvements. Findings will inform an NIH Stage 1B randomized control trial.

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Section: Methodsmentioning

confidence: 99%

Section: Quantitative Measuresmentioning

confidence: 99%

Development of a brief cognitive‐behavioral treatment for avoidant/restrictive food intake disorder in the context of disorders of gut–brain interaction: Initial feasibility, acceptability, and clinical outcomes

Murray

Weeks

Becker

et al. 2022

Intl J Eating Disorders

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“…It has excellent internal consistency reliability with Cronbach’s α=0.96 and strong 2-week test–retest reliability at r=0.93, p<0.001. 35 It also shows good criterion and known-groups validity. Qualitative score ranges are 0–15 (minimal), 16–30 (mild), 31–45 (moderate) and 46–90 (severe).…”

Section: Methodsmentioning

confidence: 91%

“…Items are rated on a Likert scale ranging from 0 (not at all) to 5 (absolutely). It has excellent internal consistency reliability with Cronbach’s α=0.96 and strong 2-week test–retest reliability at r=0.93, p<0.001 35. It also shows good criterion and known-groups validity.…”

Section: Methodsmentioning

confidence: 98%

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Acceptability and efficacy of the Zemedy app versus a relaxation training and meditation app for IBS: protocol for a randomised controlled trial

et al. 2022

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IntroductionIrritable bowel syndrome (IBS) has high rates of psychiatric comorbidity, and impairs health-related quality of life (HRQL). Cognitive–behavioural therapy (CBT) is an effective treatment for IBS, but access to treatment remains low. Our proposed solution is a CBT-based smartphone app, Zemedy.Methods and analysisThis randomised controlled trial of Zemedy (V.2.0) uses an education and relaxation training active control app meant to simulate treatment as usual. A target N of 300 participants complete baseline questionnaires and consent at screening, and are then allocated to either the immediate treatment (Zemedy) or the active control. Treatment lasts 8 weeks, after which both groups complete the same battery used at baseline, and the control group is crossed over to Zemedy. After another 8 weeks, the crossed-over participants will be surveyed once more. Follow-up questionnaires are administered at 3, 6 and 12 months post-treatment. Primary outcomes include gastrointestinal symptom severity and HRQL. Clinically significant change will be defined as post-treatment scores falling within 2 SD of the healthy mean. Analysis will include intent-to-treat between-groups comparisons, controlling for baseline symptom severity, as well as moderation and mediation analyses. We hypothesise that the Zemedy app will outperform the active control app in reducing IBS symptom severity and improving HRQL.Ethics and disseminationThis study was approved by the Institutional Review Board at the University of Pennsylvania. Results will provide essential information on the efficacy and acceptability of an app-based CBT treatment for IBS. The data gathered may help establish the Zemedy app as an empirically supported intervention for IBS and will assist funding bodies in deciding whether to invest in its further development and dissemination. The results will be disseminated to patients with IBS via the media and the company website, to healthcare professionals via professional training (e.g. webinars and grand rounds talks) and to researchers via conferences and publications.Trial registration numberNCT04665271 (https://clinicaltrials.gov/ct2/show/NCT04665271).

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Assessing Fears of Negative Consequences in Children With Symptoms of Avoidant Restrictive Food Intake Disorder

Gianneschi,

Washington,

Nicholas

et al. 2024

Intl J Eating Disorders

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ObjectiveFear of Aversive Consequences (FOAC), such as choking or vomiting, is an important associated feature of Avoidant/Restrictive Food Intake Disorder (ARFID). However, the manifestation of FOAC in young children is poorly understood. This study aimed to describe the fears of children with ARFID symptoms and examine the concordance between parent and child ratings of fear.MethodChild‐reported FOAC was assessed using an interview designed for children between 6 and 10 years old, the Gustatory Avoidance and Gastrointestinal Stress Symptoms (GAGSS). Parents were administered a semi‐structured diagnostic interview regarding their child's symptoms, the Pica, ARFID, and Rumination Interview.ResultsAmong 68 children with ARFID diagnoses or symptoms (41.2% female, 85.3% White, mean age = 8.2 years, SD = 1.1 years; range 5.2–9.9 years), 91.2% of children endorsed at least one fear relative to 26.5% of parents. Among parent–child dyads, 36.8% disagreed about the child's fear of stomach pain (κ = 0.12) and 48.5% disagreed about the child's fear of vomiting, (κ = 0.08), both indicating low inter‐rater reliability. On average, children endorsed 4.3 (SD = 2.3) fears out of 9 options. The most frequently endorsed fears were that food will “taste bad,” (n = 43, 63.2%), “make you gag” (n = 37, 54.4%), and “look disgusting” (n = 36, 52.9%).DiscussionFindings highlight ways in which fear may manifest in children with ARFID that are not easily discernable by adults. Greater precision in depicting childhood fears may facilitate the earlier detection of problematic eating behaviors.

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“If I could survive without eating, it would be a huge relief”: Development and initial validation of the Fear of Food Questionnaire

Cited by 14 publications

References 51 publications

Development of a brief cognitive‐behavioral treatment for avoidant/restrictive food intake disorder in the context of disorders of gut–brain interaction: Initial feasibility, acceptability, and clinical outcomes

Development of a brief cognitive‐behavioral treatment for avoidant/restrictive food intake disorder in the context of disorders of gut–brain interaction: Initial feasibility, acceptability, and clinical outcomes

Acceptability and efficacy of the Zemedy app versus a relaxation training and meditation app for IBS: protocol for a randomised controlled trial

Assessing Fears of Negative Consequences in Children With Symptoms of Avoidant Restrictive Food Intake Disorder

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