Eilender, Cara;
(2022)
Avoidant Restrictive Food Intake Disorder (ARFID) and the Service Provision Wish-list: A contribution to the evidence base to inform the improvement of ARFID Service Provision in the NHS.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Aims: Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnostic category added to the DSM-5 in 2013 (APA, 2013). At present, there is limited evidence regarding best clinical practice for people with ARFID. The aim of this study was to contribute to an evidence base that can inform the improvement of ARFID service provisions in the NHS. Method: A mixed method approach was used to explore the optimisation of service delivery for those with ARFID. The heterogeneous presentation of ARFID was investigated using pre-existing quantitative clinical data to examine whether three predetermined subgroups (reflecting autism diagnostic status, age and weight) had an influence on the commonly observed drivers of ARFID: (i) avoidance based on the sensory characteristics of food, (ii) apparent lack of interest in eating or food and (iii) fear of aversive consequences of eating (e.g. Choking, vomiting). Based on these findings, the study made inferences regarding the heterogeneity amongst children with ARFID and how it can be parsed, to make recommendations to improve service delivery. The qualitative part of the study consulted carers whose children had accessed ARFID services and sought recommendations on improving ARFID service provisions though semi-structured interviews. Results: Quantitative analysis indicated that autism diagnosis and age had a statistically significant association with the sensory sensitivity driver of ARFID. There were no statistically significant associations between, the independent variables (autism diagnosis, age or weight) and the other ARFID drivers (lack of interest and fear of aversive consequences). The qualitative data analysis yielded two themes on current service limitations and how these could be addressed: lack of knowledge (subthemes: service limitations, implications for client journeys and underestimation of impact of reported difficulties) and the service provision wish list (subthemes: better knowledge among professionals, adaptations to improve fit with individual need, reducing burden on families and joined up working). Conclusions: Understanding the ARFID population better and taking stakeholder views into consideration may give insight into actionable suggestions of improving ARFID service provisions.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Avoidant Restrictive Food Intake Disorder (ARFID) and the Service Provision Wish-list: A contribution to the evidence base to inform the improvement of ARFID Service Provision in the NHS |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10156507 |
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