ABSTRACT
Aim: To evaluate different types and degrees of malnutrition over time in a sample of children diagnosed with Infantile Anorexia (IA), based on the DC:0-3R criteria, and recently defined by DSM-5 as the first subtype of Avoidant/Restrictive Food Intake Disorder (ARFID), and to investigate the relationship between children's severity of malnutrition and emotional/behavioral development, and mothers' long-term psychopathological symptoms. Methods: A total of 113 children (58 boys, 55 girls), originally diagnosed with IA, and their mothers, were evaluated at four assessment points at the children's mean age of 2, 5, 7, and 11 years. Several measures were used to assess the children's growth and level of malnutrition, mothers' psychopathological symptoms and eating attitudes, as well as their children's emotional/behavioral functioning. Results: A steady improvement in the severity of malnutrition over time emerged, but 73% of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. Moreover, the children showed increasing internalizing and externalizing emotional/behavioral problems, and their mothers' psychopathological symptoms and eating problems worsened as well over time. At 11 years of age, the girls' emotional/behavioral problems and their mothers' psychopathology and disturbed eating attitudes were more severe than that of the boys and their mothers. Finally, during the last assessment, significant associations between the mothers' psychopathology and disturbed eating attitudes, the severity of the children's malnutrition, and their emotional/behavioral problems emerged. Discussion: Our longitudinal study points out that the developmental course of children, originally diagnosed with IA and who received limited psychosocial treatment, is characterized by an enduring risk of malnutrition and increasing psychopathological symptoms in both, the children and their mothers, up to the sensitive period of pre-puberty.
ABSTRACT
Özyurt G, Çagan-Appak Y, Karakoyun M, Eliaçik K, Baran M. Father`s role in infantile anorexia. Turk J Pediatr 2018; 60: 608-611. Organic diseases account for only 16-30% of early feeding disorders. During the infancy period, mother-child relationship is in the center of feeding and disturbances in this relationship can also cause feeding disorders. Infantile anorexia (IA) usually begins within the first three years of age, but it has most commonly been observed to emerge between 9 and 18 months of age, a time during which babies transition to spoon and self-feeding. It is also worth noting that babies start to gain autonomy during this time frame. The present study discusses the case of an 8-month-old girl diagnosed with IA after ruling out food allergies, gastro-esophageal reflux disease, malrotation, and neurological problems. The patient was diagnosed with IA was treated with the relational regulation of parents and active participation of her father during the treatment process. It is found that mother-child relational disturbances and conflicts decreased dyadic reciprocity and non-appropriate affects in feeding times are associated with IA. Effective treatment strategies for non-organic feeding disorders might be developed by giving importance to maternal mental health and providing paternal involvement in baby caregiving.
Subject(s)
Anorexia/diagnosis , Family Conflict/psychology , Fathers/psychology , Feeding and Eating Disorders/diagnosis , Parent-Child Relations , Anorexia/etiology , Anorexia/therapy , Feeding and Eating Disorders/therapy , Female , Humans , Infant , Male , Psychotherapy/methodsABSTRACT
Infantile Anorexia (IA), defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Revised (DC: 0-3R, Zero To Three, 2005), occurs when the child (a) refuses to eat adequate amounts of food for at least 1 month, and shows growth deficiency, (b) does not communicate hunger and lacks interest in food, and (c) the child's food refusal does not follow a traumatic event and is not due to an underlying medical illness. IA usually emerges during the transition to self-feeding, when the child issues of autonomy are played out daily in the feeding situation. Studies evidence that the feeding interactions between children with IA and their mothers are characterized by low reciprocity, greater interactional conflict and negative affects (Chatoor et al., 2000; Ammaniti et al., 2010, 2012). Moreover, these studies pointed out that maternal depression and eating disorders are frequently associated with IA (Cooper et al., 2004; Ammaniti et al., 2010; Lucarelli et al., 2013). To date, research has focused almost exclusively on the mother-child dyad, while fathers' involvement, co-parental and family interactions are poorly studied. The current study is a pilot research that investigated mother-father-child triadic interactions, during feeding and play, in families with children diagnosed with IA, in comparison to families with normally developing children. Until now, at the study participated N = 10 families (five with a child with IA diagnosis and five with lack of child's IA diagnosis, matched for child's age and gender). The parents-child triadic interactions were assessed in feeding and play contexts using the Lausanne Trilogue Play (Fivaz-Depeursinge and Corboz-Warnery, 1999), adapted to observe father-mother-infant primary triangle in the feeding context, compared to the play context (Lucarelli et al., 2012). Families of the IA-group showed difficulties in expressing and sharing pleasure and positive affects, and in structuring a predictable and flexible context. Children showed little autonomy and difficulty in being actively engaged and tune with parents. Dysfunctional family interactions are a critical issue for IA that affects co-parental and family subsystems, stressing the importance of an articulated diagnostic assessment in order to target effective treatment approaches.
ABSTRACT
Objective To evaluate the efficacy of pivot-regulating manipulations applied in traditional Chinese medicine (TCM) clinical nursing for infantile anorexia based on the meridian and acupoint theory. Methods One hundred and twenty children with anorexia were randomly divided into trial group and control group , 60 cases in each group. The control group was given spine-pinching therapy based on the conventional nursing care. The trial group was given pivot-regulating manipulations based on the conventional nursing care , and the pivot-regulating manipulations covered manipulating spleen -stomach meridian , regulating Neibagua, kneading Banmen, kneading abdomen, manipulating acupoints of Zhongwan, Tianshu and Zusanli, and pinching spine according to the deficiency-excess differentiation, once every other day and 3 times constituting one course of treatment. After treatment for 2 courses, the clinical efficacy of the two groups was evaluated. The changes in TCM symptom scores and physical examination indexes of body height, body mass, head circumference, chest circumference, height-for-age (HT/A), weight-for-age (WT/A) in the two groups were observed before and after treatment. Results(1) Five cases(3 differentiated into excess syndrome and 2 into deficiency syndrome) of the trial group dropped out and quitted from the trial, and 6 cases of the control group dropped out and quitted from the trial. (2) After two courses of treatment, the total effective rate of the trial group was 94.55％, and that of the control group was 87.04％, the difference being significant (P < 0.05). (3) After treatment, the scores of appetite and food-intake amount, complexion and lip color, water intake, restlessness, and urination as well as TCM symptom scores in both groups were improved; the WT/A of the trial group was also improved (P < 0.05 compared with those before treatment). The trial group had better effect on improving the scores of appetite and food-intake amount, complexion and lip color, and restlessness as well as TCM symptom scores than the control group (P < 0.05 or P < 0.001). The trial group also showed better effect on improving body mass, body height, head circumference, and HT/A than the control group(P<0.05). Conclusion As a nursing method based on the meridian and acupoint theory as well as syndrome differentiation and treatment, pivot-regulating manipulations are effective for the treatment of infantile anorexia by quickly starting an effect and obviously relieving the symptoms.
ABSTRACT
Eve é uma menininha de seis meses nascida em um squat¹ sujo de uma mãe perdida e isolada. Recolhida pelos serviços sociais em um estado de desnutrição avançado, será encaminhada a uma instituição médica que fará de tudo para curá-la. A precariedade social tem relação com a precariedade simbólica de sua mãe psicótica e anoréxica. A perspectiva psicanalítica é capaz de dar à criança todas as chances de renascer para o desejo e separá-la de um gozo mortífero que não permite a inscrição simbólica do Sujeito no desejo do Outro. Do isolamento à solidão subjetiva, Eve renascerá para a vida. Testemunho clínico e engajamento político.(AU)
Eve is a little girl of six months born in a dirty squat from a lost and isolated mother. Collected by social services in an advanced state of malnutrition, she will be handled in a medical institution that will make everything that is possible to save her. Social insecurity is not unrelated to the symbolic precariousness of her psychotic and anorexic mother. Been orientated by psychoanalysis can give every opportunity for this child to be born again in her desire and to separate herself from a mortiferal jouissance that does not allow the symbolic inscription of the Subject into the desire of the Other. From isolation to subjective loneliness, Eve reborn to life. Clinical Evidence and political engagement.(AU)
Eve est une petite fille de six mois née dans un squat sale d'une mère perdue et isolée. Recueillie par les services sociaux dans un état de dénutrition avancée, elle sera prise en charge dans une institution médicalisée qui mettra tout en uvre pour la guérir. La précarité sociale n'est pas sans rapport avec la précarité symbolique de sa mère psychotique et anorexique. S'orienter de la psychanalyse permet de donner toutes les chances à un enfant de renaître au désir et de se séparer d'une jouissance mortifère qui ne permet pas l'inscription symbolique du Sujet dans le désir de l'Autre. De l'isolement à la solitude subjective, Eve renaîtra à la vie. Témoignage clinique et engagement politique.(AU)
Subject(s)
Humans , Female , Infant , Social Behavior , Interpersonal Relations , Anorexia/psychology , Maternal Behavior/psychology , Mother-Child Relations/psychology , Loneliness/psychology , InfantABSTRACT
Eve é uma menininha de seis meses nascida em um squat¹ sujo de uma mãe perdida e isolada. Recolhida pelos serviços sociais em um estado de desnutrição avançado, será encaminhada a uma instituição médica que fará de tudo para curá-la. A precariedade social tem relação com a precariedade simbólica de sua mãe psicótica e anoréxica. A perspectiva psicanalítica é capaz de dar à criança todas as chances de renascer para o desejo e separá-la de um gozo mortífero que não permite a inscrição simbólica do Sujeito no desejo do Outro. Do isolamento à solidão subjetiva, Eve renascerá para a vida. Testemunho clínico e engajamento político.
Eve is a little girl of six months born in a dirty squat from a lost and isolated mother. Collected by social services in an advanced state of malnutrition, she will be handled in a medical institution that will make everything that is possible to save her. Social insecurity is not unrelated to the symbolic precariousness of her psychotic and anorexic mother. Been orientated by psychoanalysis can give every opportunity for this child to be born again in her desire and to separate herself from a mortiferal jouissance that does not allow the symbolic inscription of the Subject into the desire of the Other. From isolation to subjective loneliness, Eve reborn to life. Clinical Evidence and political engagement.
Eve est une petite fille de six mois née dans un squat sale d'une mère perdue et isolée. Recueillie par les services sociaux dans un état de dénutrition avancée, elle sera prise en charge dans une institution médicalisée qui mettra tout en uvre pour la guérir. La précarité sociale n'est pas sans rapport avec la précarité symbolique de sa mère psychotique et anorexique. S'orienter de la psychanalyse permet de donner toutes les chances à un enfant de renaître au désir et de se séparer d'une jouissance mortifère qui ne permet pas l'inscription symbolique du Sujet dans le désir de l'Autre. De l'isolement à la solitude subjective, Eve renaîtra à la vie. Témoignage clinique et engagement politique.
