Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial validation and prevalence in 4-7-year-old Japanese children
Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial validation and prevalence in 4-7-year-old Japanese children
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DOI：
10.1016/j.appet.2021.105735
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发表时间：
2021-10-14
期刊：
影响因子：
5.4
通讯作者：
Gillberg, Christopher
中科院分区：
文献类型：
--
作者：
Dinkler, Lisa;Yasumitsu-Lovell, Kahoko;Gillberg, Christopher
一般儿童人群中回避/限制性食物摄入障碍（ARFID）的患病率在很大程度上仍然是未知的，缺乏有效的筛查工具。本研究的目的是（1）使用新开发的父母报告的筛查工具，调查日本出生队列中ARFID筛查阳性儿童的患病率，（2）估计ARFID儿童的患病率，这些儿童的饮食模式会导致身体和心理社会后果，（3）为新筛查工具的有效性提供初步证据。数据收集自2011年至2014年在日本高知县出生的3728名4-7岁儿童（应答率为56.5%）;日本环境与儿童研究（JECS）的子样本。家长完成了一份调查问卷，包括ARFID筛查和其他几项评估收敛有效性的措施。ARFID筛查阳性儿童的点患病率为1.3%;其中一半符合仅基于心理社会障碍的ARFID标准，而另一半符合与身体障碍相关的诊断标准（在许多情况下还有额外的心理社会障碍）。对食物特性的感官敏感（63%）和/或对进食缺乏兴趣（51%）是最普遍的食物回避驱动因素。ARFID筛查阳性的儿童体重较轻，身高较矮，他们表现出更多与进餐时间和营养摄入相关的问题行为，他们更经常选择性进食，对饱腹感更敏感，这些都为新筛查工具的有效性提供了初步支持。这是迄今为止在7岁以下儿童中进行的最大规模的ARFID筛查研究。未来的研究应使用临床确诊病例检查新ARFID筛选器的诊断有效性。需要进一步研究ARFID在一般人群中的流行情况。
The prevalence of avoidant/restrictive food intake disorder (ARFID) in the general child population is still largely unknown and validated screening instruments are lacking. The aims of this study were (1) to investigate the prevalence of children screening positive for ARFID in a Japanese birth cohort using a newly developed parent-reported screening tool, (2) to estimate the prevalence of children with ARFID experiencing physical versus psychosocial consequences of their eating pattern, and (3) to provide preliminary evidence for the validity of the new screening tool. Data were collected from 3728 4-7-year-old children born between 2011 and 2014 in Kochi prefecture, Japan (response rate was 56.5%); a sub-sample of the Japan Environment and Children's Study (JECS). Parents completed a questionnaire including the ARFID screener and several other measures to assess convergent validity. The point prevalence of children screening positive for ARFID was 1.3%; half of them met criteria for ARFID based on psychosocial impairment alone, while the other half met diagnostic criteria relating to physical impairment (and additional psychosocial impairment in many cases). Sensory sensitivity to food characteristics (63%) and/or lack of interest in eating (51%) were the most prevalent drivers of food avoidance. Children screening positive for ARFID were lighter in weight and shorter in height, they showed more problem behaviors related to mealtimes and nutritional intake, and they were more often selective eaters and more responsive to satiety, which together provides preliminary support for the validity of the new screening tool. This is the largest screening study to date of ARFID in children up to 7 years. Future studies should examine the diagnostic validity of the new ARFID screener using clinically ascertained cases. Further research on ARFID prevalence in the general population is needed.