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

Abstract

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.

Characteristics of avoidant/restrictive food intake disorder in a general paediatric inpatient sample

“…Longitudinal studies with larger sample sizes covering a broader age range may help identifying cause‐and‐effect connections between ARFID and its physical correlates, as it is currently unclear whether physical diseases are followed by ARFID or vice versa. Although self‐report is a well‐established way to assess children and adolescents at risk for eating disturbances, interview‐based assessments (Bryant‐Waugh et al, 2019; Schmidt et al, 2019), parent report, and detailed nutritional information would greatly enhance self‐report. With these new insights, researchers may improve existing assessment and treatment options in general paediatric hospitals as well as specialized eating disorder programs.…”

Youth with Avoidant/Restrictive Food Intake Disorder: Examining Differences by Age, Weight Status, and Symptom Duration

“…This may have led to missing presentations if characteristics were not disclosed in patient charts at their initial visit. Research is currently working to rectify this gap in the literature, with new assessments including the Pica, ARFID, and Rumination Disorder Interview (PARDI) and the ARFID module for the EDE in current development [43,44]. Additionally, the modest sample sizes within each different ARFID presentation group prohibited us from further examining clinical and psychological differences between presentations.…”

Radcliffe ARFID Workgroup: Toward operationalization of research diagnostic criteria and directions for the field

“…A mental health clinician (e.g., psychologist, psychiatrist, social worker) should complete the diagnostic interviews and assessment of psychosocial impairment and functioning. Diagnostic tools that are available for use in research include the Eating Disorder Assessment for DSM‐5 (EDA‐5; Sysko et al, ), the new ARFID module of the Eating Disorder Examination (Schmidt, Kirsten, Hiemisch, Kiess, & Hilbert, in press), and the Pica, ARFID, Rumination Disorder Interview (PARDI) (Bryant‐Waugh et al, in press). Preliminary reports on the EDE‐ARFID module and the PARDI are included in the current IJED special issue, and larger‐scale studies of the psychometric features of these measures for individuals across the lifespan are underway.…”