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: 7717148
• 负责人: IRENE CHATOOR
• 金额: $ 0.21万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-12-01 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7717148
• 关键词: Address; Adolescent; Adult; Anorexia; Anxiety; Behavior; Child; Classification; Computer Retrieval of Information on Scientific Projects Database; Condition; Conflict (Psychology); Data; Diagnostic; Diet; Disease; Eating; Eating Disorders; Effectiveness; Food; Funding; Grant; Hour; Infant; Institution; Intervention; Malnutrition; Modeling; Mothers; Numbers; Parents; Prevention; Randomized; Regulation; Reporting; Research; Research Personnel; Resources; Source; Suggestion; Testing; Time; Training; United States National Institutes of Health; Weight; Weight Gain; base; design; distraction; early /brief intervention /therapy; elementary school; feeding; infancy; infant temperament

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.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 患有饮食失调症的青少年和成年人的数量一直在增加，据报告，多达三分之一的小学生专注于节食和体重。虽然纵向研究表明，喂养问题和饮食失调往往开始早，并随着时间的推移是稳定的，很少有人知道具体的喂养失调，以及如何在婴儿和幼儿的饮食调节发展。 有人建议，在婴儿期的饮食调节的背景下，父母-婴儿的互动。当特定的婴儿和父母的脆弱性相互作用，喂养过程中出现困难时，就会出现喂养障碍。该项目的具体目标有两个方面：1）验证婴儿厌食症和Chatoor定义的其他七种喂养障碍的诊断标准; 2）基于婴儿厌食症的交易模型测试短期干预的有效性。婴儿厌食症的特征在于在过渡到自我喂养期间持续拒食、营养不良、父母对婴儿食物摄入不足的焦虑以及喂养期间的母婴冲突或谈话和分心（Chatoor等人，1988年，1997年）。 选择了部分拆除设计来测试交易模型和基于该模型的简短干预治疗婴儿厌食症的有效性。将有两个治疗组，每组55名婴儿。婴儿将被随机分配到两种干预措施之一。干预组I将接受完整的治疗模式：心理教育治疗，这将解决婴儿的气质和父母的脆弱性方面的限制设置。这种干预将使父母为干预的第二部分做好准备，即父母培训，该培训为父母提供有关婴儿喂养程序和行为管理的具体建议，以促进对饮食的内部调节。干预组II将接受家长培训，外加4小时的治疗师接触，作为对照条件。这种控制条件被选择为非特异性的，并尽可能与心理教育治疗不同。 如果，如假设的那样，心理教育治疗加父母培训带来了最大的改善，在父母与婴儿的互动，从而促进婴儿的饮食和体重增加，这些数据将进一步验证婴儿厌食症的交易模型。此外，这些数据将阐明如何促进一般婴幼儿饮食的内部调节。饮食的内在调节原则也可以应用于儿童和青少年其他饮食障碍的预防和治疗。