Sensory sensitivity mediates the relationship between anxiety and picky eating in children/ adolescents ages 8–17, and in college undergraduates: A replication and age-upward extension

Abstract

This study explores the relationships among anxiety, sensitivity to sensory stimuli, and picky eating (PE). An earlier study in 95 children ages 5-10 found that sensory sensitivity fully mediated the relationship between anxiety and picky eating. We replicated this finding in a sample of 158 children, ages 8-17, and in 813 young adult college students. As in the previous child sample, the relationship between anxiety and picky eating appears to be mediated by sensory sensitivity. This relationship extends into adolescence and young adulthood and holds even in a sample of children with obsessive-compulsive-spectrum and anxiety disorders. However, there may be developmental differences in the relationship between sensory sensitivity and PE; the magnitude of this relationship was significantly greater for children than young adults. Although there was a trend towards a stronger relationship in a subsample of young adults with high anxiety, the effect was still smaller than that observed in children, suggesting that this difference is developmental and not completely driven by higher anxiety in the child sample. Sensory sensitivity is a candidate mechanism of picky eating, although the cross-sectional nature of this study means that we cannot address whether it is an etiological or maintaining mechanism, or both. Implications for behavioral treatment of picky eating in clinically anxious and non-clinical samples are discussed.

Characteristics of outpatients diagnosed with the selective/neophobic presentation of avoidant/restrictive food intake disorder

“…Patients diagnosed with the selective/neophobic presentation of ARFID were predominantly white and male, predominantly schoolaged, and the majority reported normal weight and growth, with more patients reporting overweight/obesity than underweight. The male predominance among ARFID patients was greater than that of the clinic as a whole during 3 of the 4 years covered by this chart review, where 58% of patients with anxiety and OC-spectrum diagnoses were male (Zickgraf & Elkins, 2018 Having more than one avoidant/restrictive eating pattern might increase impairment generally, but it might also be the case that the selective/neophobic presentation of ARFID is less likely to be associated with weight loss, growth problems, or gross nutritional deficiencies because selective eating results in inadequate dietary variety, but not necessarily inadequate caloric intake. In a food environment where many common foods such as dairy and grain products are nutritionally enriched, selective eaters may be able to meet many of their nutritional needs within their narrow diets.…”

“…Patients diagnosed with the selective/neophobic presentation of ARFID were predominantly white and male, predominantly school‐aged, and the majority reported normal weight and growth, with more patients reporting overweight/obesity than underweight. The male predominance among ARFID patients was greater than that of the clinic as a whole during 3 of the 4 years covered by this chart review, where 58% of patients with anxiety and OC‐spectrum diagnoses were male (Zickgraf & Elkins, ). In every case, the onset of selective eating was before age five; the modal age of onset was during the toddler years.…”

Variations in the Strength of Association between Food Neophobia and Food and Beverage Acceptability: A Data-Driven Exploratory Study of an Arousal Hypothesis

“…Indeed, both anxiety and a broad sensory sensitivity have been shown to be associated with selective/picky eating in children [ 39 ], and such sensitivity also appears to link anxiety and FN in young adults [ 40 ]. One consequence of such sensitivity may be attentional biases towards novelty in foods, which in children is evident, generally when presented with unfamiliar fruits and vegetables, but which is much stronger in those with high FN [ 41 ].…”

Child and Maternal Correlates of Picky Eating in Young Children

“…Cano et al (2016) found that about a third of their community sample of children were described as picky eaters at one time or another. Children who choose to eat certain foods and not others may be asserting themselves and developing individual tastes, opposing their parents and/or seeking attention (Rubio & Rigal, 2017) or responding emotionally to sensory aspects of foods such as taste, smell, temperature or texture (Zickgraf & Elkins, 2018). In the majority of children picky eating is transient and will have little or no detrimental effect on development (Cano et al, 2016).…”