User:PsychologyGrad2023/Avoidant/restrictive food intake disorder

Anorexia

''Additionally, when compared to patients diagnosed with anorexia nervosa or bulimia nervosa, patients with ARFID are more likely to be diagnosed with a co-occurring medical condition. . Lastly, ARFID patients are more likely to have an anxiety disorder, but less likely to present with a mood disorder (e.g., bipolar, depression) .''

Epidemiology

Literature suggests that parental pressure for a child to eat could potentially have a negative impact on the child's food intake. This is associated with picky eating and a decrease in weight during childhood. This can be contributing to the child's hunger cues, as well as, the child eating for reasons other than their hunger (e.g., emotions).

Types of ARFID patients

There are two types of ARFID patients identified : short-term and long-term patients. These are based on the amount of time an individual has had ARFID symptoms. Short-term patients have been recently diagnosed with ARFID. More recent onset can be associated with fear of choking or vomiting after experiencing or witnessing an event, and/or fear of gastrointestinal problems. Long-term patients are those who report with a long history of ARFID symptoms. Long-term ARFID patients include a history of selective or poor eating habits, a history of gastrointestinal problems, or generalized anxiety that impacted eating behaviors throughout childhood or for the past number of years.

Treatment

Assessment

The Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) can be a tool used by professionals to assess the presence of ARFID. This is a 9-item, 6-point Likert scale (e.g., strongly disagree to strongly agree) screener. The assessment has a total score of 0-45 points. An ARFID diagnosis is most likely if an individual scores are greater than 10 on the picky eating scale, greater than 9 on the appetite scale, and/or greater than 10 on the fear scale. This measure should be used in concordance with other measures to increase sensitivity (true positive) of the diagnosis.

Medical Treatment

Individuals with ARFID might need additional help outside of psychotherapy to increase their caloric intake and get to receive nutritional needs. Individuals with ARFID might take nutritional supplements. Patients may require nasogastric or gastrostomy tube feeding. Patients with ARFID are more likely than those diagnosed with another eating disorder to be initially evaluated in an outpatient setting while relying on long-term nasogastric or gastrostomy feedings. Patients with another eating disorder typically receive short-term nasogastric or gastrostomy feedings.

For Both Adults and Children

The main goals of treatment for CBT-AR are to achieve or to maintain a health weight, treat nutritional deficits, consume items from all 5 of the basic dietary groups, and to be more comfortable in social settings and circumstances. CBT-AR workbook can be used as a resource for professionals. This workbooks includes psychoeducation about ARFID, self-monitoring records for food logs, and the different stages in treatment.

Prevention

While there is no way to predict who will develop ARFID, there might be ways to help diminish the probability of developing the disorder. Pediatricians should take special care in recognizing a child's eating patterns and intake, specifically parental concerns. Particularly, many parents worry that their child is not consuming enough food daily. As a result, they frequently coerce or bribe the child into eating even though the child is of normal development. This could negatively impact the child's view on different foods and create backlash from the child to the parent. Also, it is important for the parent and child to establish appropriate feeding practices. The child's doctor can assist to establish the proper feeding tool to allow the child to develop normally and create a positive relationship towards food and eating. The parent is responsible for when, where, and what the food is, and the child is responsible for how much they eat. It is important to keep meals consistent and set an example of proper dining etiquette and to not force the child to eat.