PEDIATRIC, NUTRITIONAL, AND LIMITED PSYCHOSOCIAL INTERVENTION FOR AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID) IN AN ITALIAN LONGITUDINAL STUDY FROM INFANCY TO 11 YEARS OF AGE.

Loredana Lucarelli
First
Conceptualization
2019-01-01

Abstract

Objectives: The objective of this presentation is to evaluate the evolution of malnutrition and long-term psychopathological risk factors in an Italian cohort of children diagnosed with the first subtype of ARFID. Following a transactional model, which recognizes the complex interplay between the individual characteristics of the mother and the child in the origin of developmental psychopathology, this clinical study explored longitudinally the children’s malnutrition, maternal psychopathology, and dysfunctional eating attitudes and the emotional/behavioral development of children from infancy to prepuberty. Methods: Loredana Lucarelli, PhD, will report data from toddlers and their mothers, who were evaluated at the children’s mean ages of 2, 5, 7, and 11 years and received some psychoeducation about the children’s lack of interest in eating or food but did not pursue any specific psychotherapeutic treatment for various reasons, such as lived in or moved to another city, premature termination of treatment, and so on. However, these children were followed closely by their pediatricians and were treated with nutritional supplements at the hospitals in Rome and in their community. They were periodically called back for follow-up appointments at the hospital. Results: This clinical study shows continuation of symptoms when untreated and highlights the importance of early diagnosis and specific treatment. A steady improvement in the severity of malnutrition over time emerged, yet 73 percent of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. These children showed increasing emotional/behavioral problems, and their mothers’ psychopathological and dysfunctional eating symptoms also worsened over time. At 11 years of age, the girls’ emotional/ behavioral problems and their mothers’ psychopathology were more severe than that of the boys and their mothers. Conclusions: The developmental course of children who received limited psychosocial interventions for their apparent lack of interest in eating or food up to the sensitive period of prepuberty is characterized by an enduring risk of malnutrition and increasing psychopathological risk factors in both the children and their mothers. EA, LONG, PSP https://doi.org/10.1016/j.jaac.2019.07.487
2019
Inglese
58
10S October 2019
85
86
2
WOS:000518857301046
https://www.jaacap.org/
Esperti anonimi
internazionale
scientifica
Feeding and Eating Disorders Longitudinal Study Psychopathological Risk Factors Clinical Assessment
Il contributo di cui è Autore Lucarelli Loredana è stato presentato nel seguente Workshop organizzato e coordinato da Irene Chatoor nel 66th Annual Meeting dell'American Academy of Child and Adolescent Psychiatry: : CLINICAL PERSPECTIVES 60 LACK OF INTEREST IN EATING OR FOOD, A SUBTYPE OF AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID): DIAGNOSIS, TREATMENT, AND FOLLOW-UP FROM INFANCY TO LATE CHILDHOOD Irene Chatoor, MD, Children’s National Health System, ichatoor@cnmc.org Objectives: Recognizing that feeding disorders often start in infancy but can continue into childhood, adolescence, or even adulthood, DSM-5 has introduced the new diagnostic category of avoidant/restrictive food intake disorder (ARFID), which covers all age groups. Lack of interest in eating or food is one of the 3 major subtypes of ARFID. Two studies addressed the challenges of treating children with ARFID at different ages, and 2 different treatment methods are presented: one for toddlers and one for young children ranging in age from 5 to 10 years. Two longitudinal studies point to the ongoing eating difficulties and additional psychopathology in older children with ARFID. Methods: Irene Chatoor, MD, describes a treatment study for toddlers ranging in age from 12 to 42 months. The focus of the study was to help parents understand their child’s special temperament, which causes hyperarousal and difficulty downregulating when it is time to relax for eating and sleeping or when upset. The parents were given specific feeding guidelines and a special time-out procedure to help their child to learn self-calming. Nancy Zucker, PhD, describes a new method, “the Feeling and Body Investigators” (FBI), for helping children ranging in age from 5 to 10 years to change avoided, aversive sensations into tolerable ones by focusing on playful curiosity about feelings, increasing approach behaviors, and reducing food avoidance. Results: Loredana Lucarelli, PhD, describes a Rome longitudinal study of children who were diagnosed with ARFID at age 2 years and followed periodically up to 11 years of age. These children received pediatric and nutritional interventions but very limited psychosocial help for their feeding problems. This study highlights that these children and their mothers developed increasing eating and psychopathological symptoms. A longitudinal study presented by Rebecca Begtrup, DO, MPH, highlights that in spite of being underweight, these children with ARFID do well cognitively and that one-third of the children performed in the superior range of intelligence. However, one-third of the children treated as toddlers continued to struggle as older children and developed additional sleep and anxiety disorders. Conclusions: New methods of treating toddlers and young children with ARFID have been developed. However, without specific and adequate treatment, children with ARFID continue to have ongoing eating problems and develop additional psychopathology. EA, TREAT, LONG https://doi.org/10.1016/j.jaac.2019.07.484 60.1
no
266
1 Contributo su Rivista::1.5 Abstract in rivista
info:eu-repo/semantics/article
1.5 Abstract in rivista
none
Lucarelli, Loredana
1
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