Harshman, Stephanie G;
Jo, Jenny;
Kuhnle, Megan;
Hauser, Kristine;
Murray, Helen Burton;
Becker, Kendra R;
Misra, Madhusmita;
... Thomas, Jennifer J; + view all
(2021)
A Moving Target: How We Define Avoidant/Restrictive Food Intake Disorder Can Double Its Prevalence.
Journal of Clinical Psychiatry
, 82
(5)
, Article 20m13831. 10.4088/JCP.20m13831.
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Abstract
OBJECTIVE: The DSM-5 criteria for avoidant/restrictive food intake disorder (ARFID) include ambiguities. Diagnostic criteria that allow for clinical judgment are essential for clinical practice. However, ambiguities can have major implications for treatment access and comparability and generalizability of research studies. The purpose of this study was to determine the degree to which distinct operationalizations of the diagnostic criteria for ARFID contribute to differences in the frequency of individuals who are eligible for the ARFID diagnosis. METHODS: Because criteria B, C, and D are rule-outs, we focused on criterion A, identified 19 potential operational definitions, and determined the extent to which these different methods impacted the proportion of individuals who met criteria for ARFID in a sample of children, adolescents, and young adults (n = 80; September 2016–February 2020) enrolled in an avoidant/restrictive eating study. RESULTS: Within each criterion, the proportion of individuals meeting diagnostic criteria differed significantly across the methodologies (all P values < .008). Using the strictest definition of each criterion, 50.0% (n = 40) of participants met criteria for ARFID. In contrast, under the most lenient definition of each criterion, the number nearly doubled, resulting in 97.5% (n = 78) meeting ARFID criteria. CONCLUSIONS: Comparison of diagnostic definitions for ARFID among children, adolescents, and young adults confirmed a broad range of statistically distinct proportions within a single sample. Our findings support the need for additional contextual support and consensus among disciplines on operationalization in both research and clinical settings.
| Type: | Article |
|---|---|
| Title: | A Moving Target: How We Define Avoidant/Restrictive Food Intake Disorder Can Double Its Prevalence |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.4088/JCP.20m13831 |
| Publisher version: | http://doi.org/10.4088/JCP.20m13831 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Adolescence; diagnosis; eating disorder; pediatrics; avoidant/restrictive food intake disorder; feeding and eating disorders; DSM-5 ; diagnostic criteria; Pica; ARFID; Rumination Disorder Interview |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10181923 |
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