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Exploring best practice for diagnosis of ARFID and classification of sub-types

The diagnostic category of ARFID was recently introduced to psychiatric nosology in the Diagnostic and Statistical Manual, Fifth Edition (2013) in an attempt to capture a cohort of patients who restrict the amount of food that they eat or avoid certain foods without the weight or shape concerns associated with anorexia nervosa and bulimia nervosa. Preliminary estimates suggest that ARFID represents a substantial proportion of those seeking help for eating disorders, but there is very limited understanding of its clinical presentation, expected course, and prognosis. This is largely due to the inherent heterogeneity of the disorder, which is an umbrella term encompassing eating problems with complex and diverse causes.

The current study aims to determine whether there are meaningfully distinct subgroups within ARFID defined by their underlying causal processes. It is hoped that this will build an evidence-base for the mechanisms underlying diagnoses of ARFID, helping to lay the foundations for the development of theoretically-informed, targeted interventions.

 

Methodology:

The study will take a two-phase approach. An initial inductive phase will interview individuals with a DSM-5 diagnosis of ARFID, as well as parents, carers and clinicians. It is hoped that this will generate an understanding of how ARFID develops and persists, with an emphasis placed on identifying subgroups defined by distinct causal mechanisms. Following this, a second deductive phase will investigate the validity of the subgroups generated in Phase 1 via their comparison on cognitive and behavioural measurements.

 

This work is the PhD of Laura Bourne who is supervised by Rachel Bryant-Waugh and Will Mandy