Pediatric Avoidant and Restrictive Eating: A biopsychosocial investigation

ended

Avoidant Restrictive Food Intake Disorder (ARFID) is a newly defined psychological disorder that is estimated to affect ~5% of children. Children with ARFID eat a limited quantity or range of foods due to sensory sensitivity to the food (i.e., taste, smell, texture, temperature, appearance), low interest/appetite, fear of adverse consequences of eating (e.g., choking, vomiting, pain), or a combination of these reasons. ARFID causes children to have significant nutritional deficiencies, growth impairment and/or significant psychosocial problems. However, little is known about what causes ARFID, particularly in early childhood when symptoms typically begin. A recent attempt to inform the pathophysiology of ARFID has been made through the introduction of the Three-Dimensional Neurobiological Model of ARFID, but this model has yet to be evaluated in early childhood. Given the powerful effect of parent feeding behavior on early childhood eating, it is essential to understand how parent feeding behavior interacts with a child’s biological vulnerabilities for ARFID to develop effective behavioral interventions for ARFID in early childhood. I will extend my research on child anxiety, parenting behavior and psychophysiological assessment, while obtaining essential training in the etiology and biology of feeding and eating disorders and emotional processing of food stimuli to conduct the first evaluation of the interaction of biological risks and parenting behavior on ARFID symptoms in young children. In a sample of 60 children ages 4-7 years (30 with avoidant/restrictive eating and 30 typically developing controls), I will 1) identify biological vulnerabilities for the sensory sensitivity and fear dimensions of avoidant/restrictive eating and 2) test the interaction of parent factors and biological vulnerabilities on the severity of symptoms in the sensory sensitivity and fear of aversive consequences dimensions of avoidant/restrictive eating.