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Updated: Oct 3, 2026
A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
When Food Avoidance Meets Compatible Diagnostic Criteria: Avoidant/Restrictive Food Intake Disorder Features in
Hiba Mikhael-Moussa1, Alexandra Aupetit2,3, Olivia Guérin4
1Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis, Rouen, France.
Background:
Alone, the Nine Item Avoidant/Restrictive Food Intake Disorder (ARFID) Screen (NIAS) only allows for ARFID-like symptom detection, potentially overestimating its prevalence. We aimed to investigate the prevalence of ARFID-like symptoms and DSM-5-compatible ARFID (based on medical chart review) in irritable bowel syndrome (IBS), and to compare characteristics associated with these definitions.
Methods:
Adult patients with IBS according to Rome IV criteria, consulting in our tertiary care center between January 2024 and February 2025, were included. Patient data were collected using validated questionnaires, including NIAS-Fr. ARFID-like symptoms were defined as meeting the cut-off for at least one NIAS-Fr subscale (≥ 10 on "picky" or "fear," or ≥ 9 on "appetite"). A medical chart review using our center's clinical data warehouse was conducted for detecting medical impairment and eating disorder (ED) diagnosis. Patients with a positive NIAS-Fr, without ED, and with at least one medical/psychosocial impairment were considered to be in the "DSM-5 compatible ARFID" group. Univariate and multiple logistic regression analyses were conducted.
Key Results:
Among the 326 included patients, 47.5% had ARFID-like symptoms, and 33.4% met DSM-5-compatible criteria for ARFID. Functional dyspepsia (FD) was prevalent in 60.4% of patients. Depressive symptoms, somatic symptom severity, and FD were independently associated with having ARFID-like symptoms (Nagelkerke R2 = 0.138). Depressive symptoms and IBS symptom severity were independently associated with DSM-5 compatible ARFID (Nagelkerke R2 = 0.203).
Conclusions And Inferences:
ARFID-like symptoms were more prevalent than DSM-5-compatible ARFID in our population. Applying DSM-5-compatible criteria was associated with more severe gastrointestinal and depressive symptoms. Standardized DSM-5 ARFID assessment methods remain to be established.
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