Attributes of children and adolescents with avoidant/restrictive food intake disorder

Helene Keery, Sarah Lemay-Russell, Timothy L. Barnes, Sarah Eckhardt, Carol B Peterson, Julie Lesser, Sasha Gorrell, Daniel Le Grange

Research output: Contribution to journalArticle

Abstract

Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is a comparatively new DSM-5 diagnosis. In an effort to better understand this heterogeneous patient group, this study aimed to describe the physical and psychological attributes of children and adolescents with ARFID, and to compare them to patients with full-threshold or atypical anorexia nervosa (AN). Methods: Children and adolescents aged 7-to-19 years (N = 193) were examined upon presenting at a pediatric eating disorder center between July 2015 and December 2017. Data included diagnosis assessed via the semi-structured Eating Disorder Examination interview along with measures of anthropometrics, depression, anxiety, self-esteem, perfectionism and clinical impairment. Results: Compared to AN and atypical AN (n = 87), patients with ARFID (n = 106) were significantly younger (12.4 vs. 15.1 years, p <.0001), male (41% vs. 15%, p <.0002), and were more likely to be diagnosed with at least one co-morbid DSM-5 diagnosis (75% vs. 61%, p =.04). Patients with ARFID were less likely to be bradycardic (4.7% vs. 24.1%, p <.0001), amenorrheic (11.1 and 34.7%, p =.001), admitted to the hospital (14.2% vs. 27.6%, p =.02), and have a diagnosis of depression (18.9% vs. 48.3%, p <.0001). Patients with ARFID were significantly less likely to experience acute weight loss vs. chronic weight loss as compared with those with AN or atypical AN (p =.0001). On self-report measures, patients with ARFID reported significantly fewer symptoms of depression, anxiety, perfectionism, clinical impairment, concerns about weight and shape, and higher self-esteem than patients with AN or atypical AN (all ps <.0001). No differences were observed by race, anxiety disorder, orthostatic instability, suicidal ideation, and history of eating disorder treatment. Conclusions: Study results highlight the clinical significance of ARFID as a distinct DSM-5 diagnosis and the physical and psychological differences between ARFID and AN/atypical AN. The novel finding that ARFID patients are more likely than those diagnosed with AN to experience chronic, rather than acute, weight loss suggests important related treatment considerations.

Original languageEnglish (US)
Article number31
JournalJournal of Eating Disorders
Volume7
Issue number1
DOIs
StatePublished - Sep 12 2019

Fingerprint

Anorexia Nervosa
Eating
Weight Loss
Depression
Self Concept
Anxiety
Psychology
Suicidal Ideation
Anxiety Disorders
Self Report
Interviews
Pediatrics
Weights and Measures

Keywords

  • Anorexia nervosa
  • Atypical anorexia nervosa
  • Avoidant/restrictive food intake disorder
  • Pediatric eating disorder

Cite this

Attributes of children and adolescents with avoidant/restrictive food intake disorder. / Keery, Helene; Lemay-Russell, Sarah; Barnes, Timothy L.; Eckhardt, Sarah; Peterson, Carol B; Lesser, Julie; Gorrell, Sasha; Le Grange, Daniel.

In: Journal of Eating Disorders, Vol. 7, No. 1, 31, 12.09.2019.

Research output: Contribution to journalArticle

Keery, H, Lemay-Russell, S, Barnes, TL, Eckhardt, S, Peterson, CB, Lesser, J, Gorrell, S & Le Grange, D 2019, 'Attributes of children and adolescents with avoidant/restrictive food intake disorder', Journal of Eating Disorders, vol. 7, no. 1, 31. https://doi.org/10.1186/s40337-019-0261-3
Keery, Helene ; Lemay-Russell, Sarah ; Barnes, Timothy L. ; Eckhardt, Sarah ; Peterson, Carol B ; Lesser, Julie ; Gorrell, Sasha ; Le Grange, Daniel. / Attributes of children and adolescents with avoidant/restrictive food intake disorder. In: Journal of Eating Disorders. 2019 ; Vol. 7, No. 1.
@article{cfe392c4c283408084af14490ed77d7f,
title = "Attributes of children and adolescents with avoidant/restrictive food intake disorder",
abstract = "Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is a comparatively new DSM-5 diagnosis. In an effort to better understand this heterogeneous patient group, this study aimed to describe the physical and psychological attributes of children and adolescents with ARFID, and to compare them to patients with full-threshold or atypical anorexia nervosa (AN). Methods: Children and adolescents aged 7-to-19 years (N = 193) were examined upon presenting at a pediatric eating disorder center between July 2015 and December 2017. Data included diagnosis assessed via the semi-structured Eating Disorder Examination interview along with measures of anthropometrics, depression, anxiety, self-esteem, perfectionism and clinical impairment. Results: Compared to AN and atypical AN (n = 87), patients with ARFID (n = 106) were significantly younger (12.4 vs. 15.1 years, p <.0001), male (41{\%} vs. 15{\%}, p <.0002), and were more likely to be diagnosed with at least one co-morbid DSM-5 diagnosis (75{\%} vs. 61{\%}, p =.04). Patients with ARFID were less likely to be bradycardic (4.7{\%} vs. 24.1{\%}, p <.0001), amenorrheic (11.1 and 34.7{\%}, p =.001), admitted to the hospital (14.2{\%} vs. 27.6{\%}, p =.02), and have a diagnosis of depression (18.9{\%} vs. 48.3{\%}, p <.0001). Patients with ARFID were significantly less likely to experience acute weight loss vs. chronic weight loss as compared with those with AN or atypical AN (p =.0001). On self-report measures, patients with ARFID reported significantly fewer symptoms of depression, anxiety, perfectionism, clinical impairment, concerns about weight and shape, and higher self-esteem than patients with AN or atypical AN (all ps <.0001). No differences were observed by race, anxiety disorder, orthostatic instability, suicidal ideation, and history of eating disorder treatment. Conclusions: Study results highlight the clinical significance of ARFID as a distinct DSM-5 diagnosis and the physical and psychological differences between ARFID and AN/atypical AN. The novel finding that ARFID patients are more likely than those diagnosed with AN to experience chronic, rather than acute, weight loss suggests important related treatment considerations.",
keywords = "Anorexia nervosa, Atypical anorexia nervosa, Avoidant/restrictive food intake disorder, Pediatric eating disorder",
author = "Helene Keery and Sarah Lemay-Russell and Barnes, {Timothy L.} and Sarah Eckhardt and Peterson, {Carol B} and Julie Lesser and Sasha Gorrell and {Le Grange}, Daniel",
year = "2019",
month = "9",
day = "12",
doi = "10.1186/s40337-019-0261-3",
language = "English (US)",
volume = "7",
journal = "Journal of Eating Disorders",
issn = "2050-2974",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Attributes of children and adolescents with avoidant/restrictive food intake disorder

AU - Keery, Helene

AU - Lemay-Russell, Sarah

AU - Barnes, Timothy L.

AU - Eckhardt, Sarah

AU - Peterson, Carol B

AU - Lesser, Julie

AU - Gorrell, Sasha

AU - Le Grange, Daniel

PY - 2019/9/12

Y1 - 2019/9/12

N2 - Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is a comparatively new DSM-5 diagnosis. In an effort to better understand this heterogeneous patient group, this study aimed to describe the physical and psychological attributes of children and adolescents with ARFID, and to compare them to patients with full-threshold or atypical anorexia nervosa (AN). Methods: Children and adolescents aged 7-to-19 years (N = 193) were examined upon presenting at a pediatric eating disorder center between July 2015 and December 2017. Data included diagnosis assessed via the semi-structured Eating Disorder Examination interview along with measures of anthropometrics, depression, anxiety, self-esteem, perfectionism and clinical impairment. Results: Compared to AN and atypical AN (n = 87), patients with ARFID (n = 106) were significantly younger (12.4 vs. 15.1 years, p <.0001), male (41% vs. 15%, p <.0002), and were more likely to be diagnosed with at least one co-morbid DSM-5 diagnosis (75% vs. 61%, p =.04). Patients with ARFID were less likely to be bradycardic (4.7% vs. 24.1%, p <.0001), amenorrheic (11.1 and 34.7%, p =.001), admitted to the hospital (14.2% vs. 27.6%, p =.02), and have a diagnosis of depression (18.9% vs. 48.3%, p <.0001). Patients with ARFID were significantly less likely to experience acute weight loss vs. chronic weight loss as compared with those with AN or atypical AN (p =.0001). On self-report measures, patients with ARFID reported significantly fewer symptoms of depression, anxiety, perfectionism, clinical impairment, concerns about weight and shape, and higher self-esteem than patients with AN or atypical AN (all ps <.0001). No differences were observed by race, anxiety disorder, orthostatic instability, suicidal ideation, and history of eating disorder treatment. Conclusions: Study results highlight the clinical significance of ARFID as a distinct DSM-5 diagnosis and the physical and psychological differences between ARFID and AN/atypical AN. The novel finding that ARFID patients are more likely than those diagnosed with AN to experience chronic, rather than acute, weight loss suggests important related treatment considerations.

AB - Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is a comparatively new DSM-5 diagnosis. In an effort to better understand this heterogeneous patient group, this study aimed to describe the physical and psychological attributes of children and adolescents with ARFID, and to compare them to patients with full-threshold or atypical anorexia nervosa (AN). Methods: Children and adolescents aged 7-to-19 years (N = 193) were examined upon presenting at a pediatric eating disorder center between July 2015 and December 2017. Data included diagnosis assessed via the semi-structured Eating Disorder Examination interview along with measures of anthropometrics, depression, anxiety, self-esteem, perfectionism and clinical impairment. Results: Compared to AN and atypical AN (n = 87), patients with ARFID (n = 106) were significantly younger (12.4 vs. 15.1 years, p <.0001), male (41% vs. 15%, p <.0002), and were more likely to be diagnosed with at least one co-morbid DSM-5 diagnosis (75% vs. 61%, p =.04). Patients with ARFID were less likely to be bradycardic (4.7% vs. 24.1%, p <.0001), amenorrheic (11.1 and 34.7%, p =.001), admitted to the hospital (14.2% vs. 27.6%, p =.02), and have a diagnosis of depression (18.9% vs. 48.3%, p <.0001). Patients with ARFID were significantly less likely to experience acute weight loss vs. chronic weight loss as compared with those with AN or atypical AN (p =.0001). On self-report measures, patients with ARFID reported significantly fewer symptoms of depression, anxiety, perfectionism, clinical impairment, concerns about weight and shape, and higher self-esteem than patients with AN or atypical AN (all ps <.0001). No differences were observed by race, anxiety disorder, orthostatic instability, suicidal ideation, and history of eating disorder treatment. Conclusions: Study results highlight the clinical significance of ARFID as a distinct DSM-5 diagnosis and the physical and psychological differences between ARFID and AN/atypical AN. The novel finding that ARFID patients are more likely than those diagnosed with AN to experience chronic, rather than acute, weight loss suggests important related treatment considerations.

KW - Anorexia nervosa

KW - Atypical anorexia nervosa

KW - Avoidant/restrictive food intake disorder

KW - Pediatric eating disorder

UR - http://www.scopus.com/inward/record.url?scp=85072161083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072161083&partnerID=8YFLogxK

U2 - 10.1186/s40337-019-0261-3

DO - 10.1186/s40337-019-0261-3

M3 - Article

C2 - 31528341

AN - SCOPUS:85072161083

VL - 7

JO - Journal of Eating Disorders

JF - Journal of Eating Disorders

SN - 2050-2974

IS - 1

M1 - 31

ER -