Table 1.
Pre-treatment demographic and clinical characteristics of 20 patients in an initial proof-of-concept study of cognitive-behavioral therapy for avoidant/restrictive food intake disorder (CBT-AR)
| M (SD) or n (%) | |
|---|---|
| Age (years) | 13.2 (2.1) |
| Gender | |
| Male | 11 (55%) |
| Female | 9 (45%) |
| Race | |
| Caucasian | 18 (90%) |
| Non-Caucasian | 2 (10%) |
| Ethnicity | |
| Hispanic | 1 (5%) |
| Non-Hispanic | 19 (95%) |
| ARFID Presentation(s) | |
| Sensory Sensitivity only | 6 (30%) |
| Lack of Interest only | 1 (5%) |
| Fear of Aversive Consequences only | 3 (15%) |
| Sensory Sensitivity + Lack of Interest | 10 (50%) |
| Sensory Sensitivity + Fear of Aversive Consequences | 0 (0%) |
| Lack of Interest + Fear of Aversive Consequences | 0 (0%) |
| All 3 presentations | 0 (0) |
| DSM-5 criteria met for ARFID (A1-A4) based on patient-rated PARDI | |
| A1 Low weight (BMI < 10th percentile), significant weight loss, and/or failure to grow | 14 (70%) |
| A2 Nutritional deficiency (diagnosed by healthcare professional via blood test) | 2 (10%) |
| A3 Dependence on nutritional supplements (i.e., prescribed vitamins or high-energy drinks) | 8 (40%) |
| A4 Psychosocial impairment (one or more PARDI impairment items ≥ 4) | 12 (60%) |
| Current comorbid psychiatric diagnoses by KSADS-PL* | |
| Panic disorder | 1 (5%) |
| Subthreshold panic disorder | 1 (5%) |
| Social anxiety disorder | 1 (5%) |
| Phobic disorder | 3 (15%) |
| Generalized anxiety disorder | 4 (20%) |
| Obsessive-compulsive disorder | 1 (5%) |
| Attention deficit hyperactivity disorder | 1 (5%) |
| Other specified attention deficit hyperactivity disorder | 1 (5%) |
| No comorbid diagnoses | 13 (65%) |
| Weight status** | |
| Underweight | 14 (70%) |
| BMI percentile | 9.80 (9.1) |
| Normal weight | 6 (30%) |
| BMI percentile | 45.7 (31.8) |
| Eating Disorder Examination-Questionnaire Global | 0.17 (0.29) |
| Treatment format | |
| Family-supported | 18 (90%) |
| Individual | 2 (10%) |
Diagnoses do not add up to 100% because some patients had multiple comorbid diagnoses.
None of the patients in this study were overweight (BMI > 85th percentile) or obese (BMI > 95th percentile). One patient was reclassified during treatment from not underweight to underweight because he grew taller without commensurate weight gain. Accordingly, the therapist prioritized weight gain as a focus for the remainder of the treatment. However, the patient continued in the individual version of the treatment and did not switch to the family-supported version.
Note. ARFID = avoidant/restrictive food intake disorder; PARDI = Pica, ARFID, and Rumination Disorder Interview; KSADS-PL = Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version; BMI = body mass index