ABSTRACT
Avoidant/restrictive food intake disorder (ARFID) was introduced in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. Three different subtypes of ARFID are described: individuals who seem disinterested in eating, those who avoid certain foods because of a sensitivity to specific characteristics of the food, and those who are concerned about an aversive experience associated with eating. There is currently no first-line treatment for ARFID. Three case studies are presented of patients with ARFID who participated in a family-based partial hospitalization program/intensive outpatient program for eating disorders. A description of the course of treatment is included, as well as ways in which the eating disorder program adapted treatment to more closely meet the unique needs of these patients. An approach with emphasis on parental involvement seems promising, although research is needed to investigate this more fully.
Subject(s)
Avoidant Restrictive Food Intake Disorder , Family Therapy/methods , Feeding and Eating Disorders/therapy , Adult , Ambulatory Care/methods , Child , Child, Preschool , Day Care, Medical/methods , Feeding and Eating Disorders/classification , Female , Humans , Male , Program DevelopmentABSTRACT
Family-based treatment principles have been incorporated into higher levels of care. However, outcome data for these programs, and, in particular, follow-up data, are limited. The current study assessed 3-month follow-up data for patients in a family-based partial hospitalization/intensive outpatient program. Patients completed measures of eating disorder psychopathology and depression, while parents completed measures of self-efficacy and expressed emotion. With the exception of paternal self-efficacy, all measures stayed the same or improved between end of treatment and follow-up, suggesting that improvements in a family-based higher level of care can be sustained once families step down to less intensive treatment.
Subject(s)
Day Care, Medical/methods , Family/psychology , Feeding and Eating Disorders/therapy , Adolescent , Depression/psychology , Expressed Emotion , Female , Follow-Up Studies , Humans , Male , Self Efficacy , Surveys and Questionnaires , Treatment OutcomeABSTRACT
OBJECTIVES: The potential role of an addictive process in problematic eating is a growing area of interest and debate. Children are more vulnerable to the negative effects of addictive substances than adults and may be at increased risk for addictive-like eating behavior. No prior study has evaluated the association of addictive-like eating with objectively measured eating behavior in adults or children. We examined the association between "food addiction" and observed food consumption among children and whether age moderated this association. METHOD: Seventy children participated in an observed dinner meal, completed a dietary recall interview, and answered the Yale Food Addiction Scale for Children (YFAS-C), a questionnaire assessing symptoms of "food addiction". Children's total calories ordered, calories consumed at dinner, calories consumed post-dinner, and a total of calories consumed at dinner and post-dinner were calculated along with their BMI percentile. We used generalized estimated equation models to investigate the relationship between the YFAS-C and food consumption. RESULTS: Elevated "food addiction" symptoms, but not BMI percentile, were positively associated with an increased amount of calories consumed at dinner and post-dinner. Age significantly moderated the relationship between YFAS-C and caloric intake, with only younger children exhibiting this association. CONCLUSIONS: As the first study of objectively measured eating behavior, we found addictive-like eating scores in children were positively associated with the total amount of calories consumed. Among younger children, "food addiction" was more strongly associated with the total calories consumed than BMI percentile, highlighting the importance of assessing behavioral phenotypes when evaluating caloric intake. This association between addictive-like eating and caloric intake among younger, but not older children may be due to differences in inhibitory control and dietary restraint.
Subject(s)
Body Mass Index , Child Behavior , Eating , Energy Intake , Feeding Behavior , Food Addiction , Meals , Adolescent , Age Factors , Behavior, Addictive , Child , Child Behavior/psychology , Child Development , Child, Preschool , Diet Surveys , Eating/psychology , Feeding Behavior/psychology , Female , Food Addiction/complications , Humans , Male , Mental Recall , Obesity/complications , Surveys and QuestionnairesABSTRACT
The purpose of the current study was to examine the relation between parental psychopathology, parental expressed emotion, and patient symptom severity. One hundred twenty-six parents of 79 patients receiving treatment for an eating disorder completed measures of expressed emotion and general psychopathology, and patients completed a measure of eating disorder psychopathology. Mothers reported higher expressed emotion scores than fathers. Both mothers and fathers scored higher on general psychopathology compared to nonpatient population means. Maternal psychopathology was found to be associated with symptom severity. Parental psychopathology and expressed emotion were found to be related, and MANCOVAs revealed that maternal criticism and maternal psychopathology were associated with patient symptom severity, but fathers' scores on the same measures were not. It is recommended that parental expressed emotion and parental psychopathology are assessed at the beginning of treatment so that appropriate clinical interventions can be utilized.
