ABSTRACT
OBJECTIVE: To examine whether infantile anorexia is associated with physiological dysregulation. METHOD: This study included eight toddlers with infantile anorexia and eight healthy eaters matched for age, race, socioeconomic status, and gender. Physiological measures of heart period and respiratory sinus arrhythmia were assessed across three different situations: mother-toddler interaction, toddler-stranger interaction, and toddler left alone with a toy while mother and stranger talked to each other at the other side of the room. RESULTS: Across all three situations, toddlers with infantile anorexia showed significantly shorter heart periods (i.e., faster heart rates) than controls (p <.05). In addition, as social demand decreased from episode 2 to episode 3, control toddlers exhibited an increase in respiratory sinus arrhythmia, whereas toddlers with infantile anorexia showed a decrease in respiratory sinus arrhythmia (p <.001). CONCLUSIONS: Toddlers with infantile anorexia showed consistently shorter heart periods and were less adaptive in their physiological regulation than controls. Such physiological dysregulation may constitute a tendency for less optimal internal homeostatic regulation of feeding in toddlers with infantile anorexia.
Subject(s)
Anorexia/physiopathology , Arousal/physiology , Arrhythmia, Sinus/physiopathology , Heart Rate/physiology , Mother-Child Relations , Social Environment , Adaptation, Psychological/physiology , Anorexia/psychology , Arrhythmia, Sinus/diagnosis , Arrhythmia, Sinus/psychology , Autonomic Nervous System/physiopathology , Child, Preschool , Electrocardiography , Female , Humans , Individuality , Infant , Male , TemperamentABSTRACT
OBJECTIVE: The goal of this study was to examine the relative contributions of growth deficiency and psychosocial factors to cognitive development in toddlers with infantile anorexia. METHODS: Eighty-eight toddlers, ranging in age from 12 to 33 months, were enrolled in this study. Toddlers were evaluated by 2 child psychiatrists and placed into 1 of 3 groups: infantile anorexia, picky eater, and healthy eater. All 3 groups were matched for age, race, gender, and socioeconomic status (SES). Toddlers underwent nutritional evaluations and cognitive assessments with the Bayley Scales of Infant Development. Toddlers and their mothers were also videotaped during feeding and play interactions, which later were rated independently by 2 observers. RESULTS: On average, toddlers with infantile anorexia performed within the normal range of cognitive development. However, the Mental Developmental Index (MDI) scores of the healthy eater group (MDI = 110) were significantly higher than those of the infantile anorexia (MDI = 99) and picky eater (MDI = 96) groups. Within the infantile anorexia group, correlations between MDI scores and the toddlers' percentage of ideal body weight approached statistical significance (r =.32). Across all groups, the toddlers' MDI scores were associated with the quality of mother-child interactions, SES level, and maternal education level. Collectively, these variables explained 22% of the variance in MDI scores. CONCLUSIONS: This study demonstrated that psychosocial factors, such as mother-toddler interactions, maternal education level, and SES level, are related to the cognitive development of toddlers with feeding problems and explain more unique variance in MDI scores than nutritional status.