Feeling and Body Investigators (FBI)-ARFID Division: Sensory and Somatic Exposure for Children with Avoidant Restrictive Food Intake Disorder

回避性限制性食物摄取障碍(ARFID)是DSM-5中新提出的一种进食障碍，其中 个人不能消费足够数量或种类的食物来维持健康的生长和退化。 发展。ARFID通常在儿童早期发病，但对这种疾病的识别能力很差。最终结果是 儿童经常持续营养不足，造成严重的身体后果， 对最佳社会和情感发展的威胁。早期干预至关重要。然而，并没有- 对患有急性呼吸窘迫综合征的幼儿进行经海盗验证的治疗。众所周知，患有ARFID的儿童很敏感 个人：注意到身体内部感觉(例如，胃肠道不适)的门槛较低，并且- Nal感官感觉(例如，气味)，并将这些感觉体验为不舒服/厌恶。这个感官- 敏感度和相关的负面情绪反应(例如，厌恶、恐惧、悲伤)可能会鼓励 避免引起这些感官体验的活动，如吃东西。一种干预可能会 将对感觉和躯体感觉的反应改变为一种好玩的好奇心，可能会增加接近行为- IOR和食物消费。我们为儿童设计了一种基于接受的内感受性暴露治疗 实现这一目标。我们教育儿童和照顾者成为“联邦调查局特工”，即观察躯体和感官的个体。 通过使用引人入胜的说明性卡通人物(例如，充气的格斯)将Sory感觉作为谜团的线索， 身体调查，激发强烈的感觉和工作表，将感觉映射到意义和交流- 特兹。目标是让躯体和感官体验变得有趣--并促进适应性自我意识 以及接近食物的方式。这项研究的总体目标是确定治疗是否导致减少 对躯体和感官感觉的负面情绪，包括与食物和进食有关的情绪，以及 这是否反过来增加了食物供应。这将通过随机对照试验(N= 140，每个细胞70)比较感觉和身体调查(FBI)-ARFID分区治疗，20个疗程 门诊治疗，对照组为ARFID患儿(5~9岁)。对照处理 (FAD：家庭辅助饮食)将提供家庭支持的接触。我们建议的治疗调停人- 海绵是负面情绪：通过智能手机测量儿童对食物呈现的面部情绪 录像。结果包括人体测量、营养多样性和充分性的变化，以及心理健康- 选择社会功能。将在治疗前和治疗后评估医学和心理测量， 每次疗程，并进行3个月的随访。可交付成果包括经验性治疗(S)；医疗 早期发现营养不足的指南；评估食品接受度的实用工具 通过智能手机回家；并指导必要的食物展示数量，以促进 接受。最终，我们将对这种治疗进行评估，并通过初级保健传播材料，以提供 及早干预避免进食的工具。

Avoidant Restrictive Food Intake Disorder (ARFID) is a newly articulated eating disorder in the DSM-5 in which individuals are not able to consume an adequate quantity or variety of food to sustain healthy growth and de- velopment. ARFID typically onsets in early childhood, yet identification of the disorder is poor. The end result is that children often have sustained inadequate nutrition with resulting severe physical consequences and threats to optimal social and emotional development. Early intervention is essential. However, there are no em- pirically validated treatments for young children with ARFID. Children with ARFID are known to be sensitive individuals: with a low threshold for noticing internal body sensations (e.g., gastrointestinal distress) and exter- nal sensory sensations (e.g., smells) and experiencing these sensations as uncomfortable/aversive. This sen- sitivity, and the associated negative emotional reactions (e.g., of disgust, fear, sadness), may encourage avoidance of activities that cause these sensory experiences, such as eating. An intervention that could change reactions to sensory and somatic sensations to one of playful curiosity may increase approach behav- ior and food consumption. We designed an acceptance-based interoceptive exposure treatment for children to achieve this goal. We teach children and caregivers to be “FBI Agents,” individuals who view somatic and sen- sory sensations as clues to a mystery via the use of engaging illustrative cartoon characters (e.g., Gassy Gus), body investigations that provoke intense sensations and worksheets that map sensations to meanings and ac- tions. The goal is to make somatic and sensory experiences playful – and to promote adaptive self-awareness and food approach. The overall objective of this study is to determine whether treatment results in reduced negative emotions to somatic and sensory sensations, including those associated with food and eating, and whether this, in turn, increases food approach. This will be accomplished by a randomized controlled trial (N = 140, 70 per cell) comparing The Feeling and Body Investigators (FBI) - ARFID Division treatment, a 20-session outpatient treatment, to a control group in children (5 to 9 years of age) with ARFID. The control treatment (FAD: Family-Assisted Diet) will provide family-supported exposure. Our proposed mediator of treatment re- sponse is negative affect: a child’s facial affect in response to food presentation as measured via smartphone videos. Outcomes include changes in anthropometric measurements, nutrition variety and adequacy, and psy- chosocial functioning. Medical and psychological measurements will be assessed pre- and post-treatment, at every session, and 3-month follow-up. Deliverables include an empirically validated treatment(s); medical guidelines for the early detection of insufficient nutrition; practical tools for assessing food acceptance in the home via smartphones; and guidance about the number of food presentations necessary to facilitate acceptance. Ultimately, we will evaluate this treatment and disseminate materials via primary care to provide tools to intervene early on food avoidance.