Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment

Thomas, Jennifer J.; Lawson, Elizabeth A.; Micali, Nadia; Misra, Madhusmita; Deckersbach, Thilo; Eddy, Kamryn T.

doi:10.1007/s11920-017-0795-5

Cited by 223 publications

(253 citation statements)

References 48 publications

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“…Potential ARFID subdomains are described in seven original research publications (14%) and two reviews (11%). The most common subgrouping, reported in five original research publications (10%) (Eddy et al, ; Kurz et al, ; Kurz et al, ; Norris et al, ; Zickgraf & Ellis, ) and one review (5%) (Thomas et al, ), consists of the three presentations that are used as examples in the DSM‐5. One original research publication (Bryson et al, ) also reports the identification of three subdomains, albeit slightly different ones.…”

Section: Resultsmentioning

confidence: 99%

“…In some of the narrative reviews, it is emphasized that full remission (e.g., full weight restoration/normalization, achievement of nonselective eating habits, etc.) may not be realistic (Thomas et al, ; Zimmerman & Fisher, ). However, this assumption is not uniformly supported by published original research (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…There is emerging evidence to support such a model. Thomas et al (, p. 5) introduce a hypothetical three‐dimensional model whereby “a given individuals's ARFID presentation can be plotted as a single point along a three‐dimensional space, meaning that the three prototypic presentations vary in severity and are not mutually exclusive.” The authors propose neurobiological underpinnings for each of the three presentations: that the ARFID subdomain presenting as lack of interest in food might be associated with differences in activiation of appetite‐regulating centers in the brain, that the selective eating subdomain might be associated with oversensitivity in taste perception (as seen in Table , this has been found by Kauer et al, ), and that the fear of aversive consequences subdomain might be associated with hyperactivation of fear processing brain circuitry. A recent study by Norris et al (), specifically exploring whether the three prototypic presentations could retrospectively be identified as subdomains in a clinical sample of children and adolescents, lends support to the three‐dimensional model.…”

Section: Discussionmentioning

confidence: 99%

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A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder

Strand

Hausswolff-Juhlin

Welch

2018

Intl J Eating Disorders

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Objective Avoidant/restrictive food intake disorder (ARFID) was introduced as a new diagnosis in the DSM‐5. This systematic scoping review explores how ARFID as a diagnostic entity is conceptualized in the research literature and evaluates the diagnostic validity according to the Feighner criteria. Method A systematic scoping review of papers on ARFID in PubMed/MEDLINE and Web of Science was undertaken, following PRISMA and Joanna Briggs Institute guidelines. Results Fifty‐one original research publications, 23 reviews and commentaries, and 20 case reports were identified. The use of ARFID as a conceptual category varies significantly within this literature. At this time, the ARFID diagnosis does not fulfil the Feighner criteria for evaluating the validity of diagnostic constructs, the most urgent problem being the demarcation toward other disorders. A three‐dimensional model—lack of interest in food, selectivity based on sensory sensitivity, and fear of aversive consequences—is gaining support in the research literature. Discussion The introduction of the ARFID diagnosis has undoubtedly increased the recognition of a previously largely neglected group of patients. However, this article points to an inability of the current DSM‐5 diagnostic criteria to ensure optimal diagnostic validity, which risks making them less useful in clinical practice and in epidemiological research. To increase the conceptual validity of the ARFID construct, several possible alterations to the current diagnostic criteria are suggested, including a stronger emphasis of the three identified subdomains and further clarifying the boundaries of ARFID.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder

Strand

Hausswolff-Juhlin

Welch

2018

Intl J Eating Disorders

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“…Rather than existing as diagnostic subtypes, our clinical impression is that these rationales for restriction represent dimensions on which any given patient can be high or low (3). …”

Section: What Is Known About Arfid?mentioning

confidence: 99%

“…Similar to other eating and feeding disorders, it is probable that both biological and environmental factors—and their interplay—contribute to pathogenesis. We hypothesize that there may be biological bases that underlie sensory sensitivity, trait anxiety, and both homeostatic and hedonic appetites, which may increase vulnerability to ARFID (3). Environmental factors such as family meal milieu, availability of fruits and vegetables in the local environment, and exposure to models of healthy eating and/or diverse foods may also play a role.…”

Section: What Is Known About Arfid?mentioning

confidence: 99%

Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

et al. 2018

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Purpose of review: Avoidant/restrictive food intake disorder (ARFID) was added to the psychiatric nomenclature in 2013. However, youth with ARFID often present first to medical— rather than psychiatric—settings, making its evaluation and treatment relevant to pediatricians. Recent findings: ARFID is defined by limited volume or variety of food intake motivated by sensory sensitivity, fear of aversive consequences, or lack of interest in food or eating, and associated with medical, nutritional, and/or psychosocial impairment. It appears to be as common as anorexia nervosa and bulimia nervosa and can occur in individuals of all ages. ARFID is heterogeneous in presentation and may require both medical and psychological management. Summary: Pediatricians should be aware of the diagnostic criteria for ARFID and the possibility that these patients may require medical intervention and referral for psychological treatment. The neurobiology underlying ARFID is unknown, and novel treatments are currently being tested.

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Incidence and Age- and Sex-Specific Differences in the Clinical Presentation of Children and Adolescents With Avoidant Restrictive Food Intake Disorder

et al. 2021

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Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment

Cited by 223 publications

References 48 publications

A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder

A systematic scoping review of diagnostic validity in avoidant/restrictive food intake disorder

Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents

Incidence and Age- and Sex-Specific Differences in the Clinical Presentation of Children and Adolescents With Avoidant Restrictive Food Intake Disorder

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