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Avoidant/Restrictive Food Intake Disorder: A Longitudinal Study of Malnutrition and Psychopathological Risk Factors
Loredana Lucarelli1, Cristina Sechi1, Silvia Cimino2
1Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy.
Insights
Children diagnosed with Infantile Anorexia (IA) face ongoing malnutrition and worsening behavioral issues. Maternal psychopathology also increases, impacting child development long-term.
Area of Science:
- Child Psychology
- Developmental Psychology
- Clinical Psychology
Background:
- Infantile Anorexia (IA), now classified under Avoidant/Restrictive Food Intake Disorder (ARFID) in DSM-5, presents complex challenges.
- Longitudinal data on the developmental trajectory of IA/ARFID and its impact on children and mothers is crucial.
Purpose of the Study:
- To track malnutrition severity and emotional/behavioral development in children with IA over time.
- To examine the relationship between child malnutrition, behavioral issues, and maternal psychopathology.
- To understand the long-term outcomes for children with IA and their mothers.
Main Methods:
- A longitudinal study followed 113 children diagnosed with IA and their mothers across four assessment points (ages 2, 5, 7, 11).
- Evaluated children's growth, malnutrition severity, and emotional/behavioral functioning.
- Assessed mothers' psychopathological symptoms and eating attitudes.
Main Results:
- Malnutrition severity improved over time, but 73% of children remained malnourished at age 11.
- Children exhibited increasing internalizing and externalizing problems.
- Maternal psychopathology and eating problems worsened, with girls and their mothers showing more severe issues at age 11.
- Significant associations were found between maternal psychopathology, child malnutrition, and child behavioral problems.
Conclusions:
- Children with IA experience persistent malnutrition risk and escalating psychopathological symptoms into pre-puberty.
- Maternal psychopathology is linked to child malnutrition and behavioral difficulties.
- Limited psychosocial treatment may contribute to enduring negative outcomes for these families.
Abstract:
Aim: To evaluate different types and degrees of malnutrition over time in a sample of children diagnosed with Infantile Anorexia (IA), based on the DC:0-3R criteria, and recently defined by DSM-5 as the first subtype of Avoidant/Restrictive Food Intake Disorder (ARFID), and to investigate the relationship between children's severity of malnutrition and emotional/behavioral development, and mothers' long-term psychopathological symptoms. Methods: A total of 113 children (58 boys, 55 girls), originally diagnosed with IA, and their mothers, were evaluated at four assessment points at the children's mean age of 2, 5, 7, and 11 years. Several measures were used to assess the children's growth and level of malnutrition, mothers' psychopathological symptoms and eating attitudes, as well as their children's emotional/behavioral functioning. Results: A steady improvement in the severity of malnutrition over time emerged, but 73% of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. Moreover, the children showed increasing internalizing and externalizing emotional/behavioral problems, and their mothers' psychopathological symptoms and eating problems worsened as well over time. At 11 years of age, the girls' emotional/behavioral problems and their mothers' psychopathology and disturbed eating attitudes were more severe than that of the boys and their mothers. Finally, during the last assessment, significant associations between the mothers' psychopathology and disturbed eating attitudes, the severity of the children's malnutrition, and their emotional/behavioral problems emerged. Discussion: Our longitudinal study points out that the developmental course of children, originally diagnosed with IA and who received limited psychosocial treatment, is characterized by an enduring risk of malnutrition and increasing psychopathological symptoms in both, the children and their mothers, up to the sensitive period of pre-puberty.
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