THE INVESTIATION OF THE DIAG CLASSIFICATION AND TREATMENT OF INFANTILE ANOREXIA

小儿厌食症的诊断分类及治疗探讨

• 批准号: 7376169
• 负责人: IRENE CHATOOR
• 金额: $ 1.65万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376169
• 关键词: INVESTIATION; DIAG; CLASSIFICATION; TREATMENT; INFANTILE

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The number of adolescents and adults with eating disorders has been increasing, and it has been reported that up to one third of elementary school children are preoccupied with dieting and weight. Although longitudinal research suggests that feeding problems and eating disorders often start early and are stable over time, little is known about specific feeding disorders and how the regulation of eating develops in infants and young children. It is proposed that the regulation of eating in infancy develops in the context of parent-infant interactions. Feeding disorders develop when specific infant and parent vulnerabilities interact and difficulties arise during feeding. The specific aims of this project are twofold: 1) To validate the diagnostic criteria for Infantile Anorexia and for seven other feeding disorders as defined by Chatoor; 2) To test the effectiveness of a short-term intervention based on a transactional model for Infantile Anorexia. Infantile Anorexia is characterized by the onset of persistent food refusal during the transition to self-feeding, malnutrition, parental anxiety about the infant's poor food intake, and mother-infant conflict or talk and distraction during feeding (Chatoor, et al., 1988, 1997). A partial dismantling design has been chosen to test the transactional model and the efficacy of a brief intervention, based on this model, to treat Infantile Anorexia. There will be two treatment groups with 55 infants in each group. The infants will be randomly assigned to one of two interventions. Intervention Group I will receive the full treatment model: a Psycho-Educational Treatment which will address the infant's temperament and the parent's vulnerability in regard to limit setting. This intervention will prepare the parents for the second part of the intervention, the Parent Training, which gives the parents specific suggestions on feeding routines and behavior management of the infant in order to facilitate internal regulation of eating. Intervention Group II will receive Parent Training plus four hours of therapist contact which serves as a Control Condition. This Control Condition was chosen to be as non-specific and as different as possible from the Psycho-Educational Treatment. If, as hypothesized, the Psycho-Educational Treatment plus Parent Training brings the greatest improvement in parent-infant interactions and thus facilitates the infant's eating and gaining weight, these data will further validate the transactional model for Infantile Anorexia. In addition, these data will clarify how to facilitate internal regulation of eating in infants and young children in general. The principles of internal regulation of eating can be applied to the prevention and treatment of other eating disorders of children and adolescents as well.

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。患有饮食失调症的青少年和成年人的数量一直在增加，据报道，多达三分之一的小学生都被节食和体重所困扰。尽管纵向研究表明，喂养问题和饮食失调通常很早就开始了，并且随着时间的推移保持稳定，但人们对具体的喂养失调以及婴幼儿的饮食调节如何发展知之甚少。研究人员提出，婴儿饮食的调节是在亲子互动的背景下发展起来的。当特定的婴儿和父母的脆弱性相互作用并在喂养过程中出现困难时，就会出现喂养障碍。该项目的具体目的有两个：1)验证Chatoor定义的婴儿厌食症和其他七种喂养障碍的诊断标准；2)检验基于交易模型的短期干预对婴幼儿厌食症的有效性。婴儿厌食症的特点是在向自我喂养过渡期间出现持续拒食、营养不良、父母对婴儿食物摄入不足的焦虑、喂养过程中母婴冲突或说话分心（Chatoor, et al., 1988,1997）。选择部分拆解设计来测试交易模型和基于该模型的短暂干预治疗婴儿厌食症的效果。将有两个治疗组，每组55名婴儿。这些婴儿将被随机分配到两种干预措施中的一种。干预组I将接受完整的治疗模式：一种心理教育治疗，将解决婴儿的气质和父母在限制设置方面的脆弱性。这一干预将使家长为干预的第二部分——父母培训做好准备。父母培训将为家长提供关于婴儿喂养习惯和行为管理的具体建议，以促进内部饮食调节。干预组II将接受家长培训和4小时的治疗师接触，作为控制条件。这个控制条件被选择为非特异性的，并尽可能不同于心理教育治疗。如果如假设的那样，心理教育治疗加父母训练能最大程度地改善亲子互动，从而促进婴儿的进食和体重增加，这些数据将进一步验证婴幼儿厌食症的交易模型。此外，这些数据将阐明如何促进婴幼儿饮食的内部监管。饮食内部调节的原则也可以应用于儿童和青少年其他饮食失调的预防和治疗。