Editorial: Limitations on the Predictive Validity of the Avoidant/Restrictive Food Intake Disorder Diagnosis - 29/01/25

Résumé |
Avoidant/restrictive food intake disorder (ARFID) first entered the psychiatric nosology with the 2013 publication of DSM-5. Unlike binge eating disorder (BED), which was also new to DSM-5 but which had first been described by Stunkard in 1959,1,2 ARFID had never been described in the psychiatric literature as a single diagnostic entity. The new diagnosis encompassed clinical constructs that were previously proposed and studied but not described in DSM (ie, causes of “non-organic failure to thrive” including infantile anorexia and post-traumatic feeding disorder,3 and extreme food selectivity in children with autism spectrum disorder4) and the DSM-IV Feeding Disorder of Infancy and Early Childhood (FDIEC).5 The ARFID diagnosis supplanted FDIEC and incorporated earlier descriptions of pediatric feeding problems into a lifespan diagnosis for patients with restrictive eating characterized by food selectivity, poor appetite/lack of interest in eating, or fear of aversive consequences of eating that led to significant weight loss or failure to grow, nutritional deficiency, supplement dependence, and/or psychosocial impairment. Because the diagnosis was so new when DSM-5 was published, the ARFID criteria were not yet supported by descriptive psychopathology research in population-based or clinical samples. Kambanis et al.6 have made an important contribution to the descriptive psychopathology of ARFID by describing the naturalistic illness course over 2 years in a well-characterized adolescent and adult sample.6 In addition to providing novel information about the course of ARFID, findings from Kambanis et al.6 highlight and illustrate 3 limitations of the predictive validity of the current DSM-5-TR ARFID criteria.
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| The author has reported no funding for this work. |
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| Disclosure: Dr. Zickgraf has reported partial support by a gift from the Franklin Street Giving Tree Foundation to Rogers Philadelphia. |
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| All statements expressed in this column are those of the authors and do not reflect the opinions of the Journal of the American Academy of Child and Adolescent Psychiatry. See the Guide for Authors for information about the preparation and submission of Editorials. |
Vol 64 - N° 2
P. 117-119 - février 2025 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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