Screening for Avoidant/Restrictive Food Intake Disorder Symptoms Among Autistic Adults: Measurement Invariance With a...

Area of Science:

• Psychiatry and Psychology
• Neurodevelopmental Disorders
• Eating Disorders

Background:

• Avoidant/restrictive food intake disorder (ARFID) is increasingly recognized in autistic individuals.
• ARFID symptoms in autistic people may be misattributed to autistic traits or co-occurring gastrointestinal issues, leading to underdiagnosis.
• Validating ARFID screening tools is crucial for accurate assessment and treatment monitoring in autistic populations.

Purpose of the Study:

• To evaluate the measurement invariance of the Nine-Item ARFID Screen (NIAS) in autistic adults compared to a general sample.
• To determine if the NIAS is a valid instrument for assessing ARFID symptomatology in autistic adults.

Main Methods:

• Multigroup confirmatory factor analysis was employed to assess the NIAS factor structure, loadings, and intercepts.
• Two samples were compared: autistic adults (n=248) and a general population sample (n=398).

Main Results:

• The NIAS demonstrated strong measurement invariance (configural, metric, scalar) across both samples.
• Autistic adults reported significantly higher scores on all three NIAS subscales: selective eating, appetite impairment, and fear-driven avoidance.
• Effect sizes for higher ARFID symptomatology in autistic adults ranged from d=0.27 to d=0.54.

Conclusions:

• The NIAS is a valid and reliable measure for assessing ARFID symptoms in autistic adults.
• Autistic adults exhibit elevated ARFID symptomatology across selective eating, appetite impairment, and fear-based avoidance.
• Further research is needed to confirm the efficacy of existing ARFID treatments for autistic adults or to adapt them.