A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder (ARFID)

• Published in: The International journal of eating disorders 2024-01, Vol.57 (1), p.27-61
• Main Authors: Willmott, Emma, Dickinson, Rachel, Hall, Celine, Sadikovic, Kevser, Wadhera, Emily, Micali, Nadia, Trompeter, Nora, Jewell, Tom
• Format: Article
• Language: English
• Subjects: Adolescent; ARFID; Avoidant Restrictive Food Intake Disorder; CBT; Child; Cognitive Behavioral Therapy; Eating; eating disorders; family therapy; Feeding and Eating Disorders; Food; Humans; interventions; outcomes; Psychosocial Intervention; Retrospective Studies
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.24073

Objective This scoping review identifies and describes psychological interventions for avoidant restrictive food intake disorder (ARFID) and summarizes how outcomes are measured across such interventions. Method Five databases (Cochrane, Embase, Medline, PsycInfo, Web of Science) were searched up to December 22, 2022. Studies were included if they reported on psychological interventions for ARFID. Studies were excluded if participants did not have an ARFID diagnosis and if psychological interventions were not delivered or detailed. Results Fifty studies met inclusion criteria; almost half were single‐case study designs (23 studies) and most studies reported on psychological interventions for children and adolescents with ARFID (42 studies). Behavioral interventions (16 studies), cognitive‐behavioral therapy (10 studies), and family therapy (5 studies), or combinations of these therapeutic approaches (19 studies) were delivered to support patients with ARFID. Many studies lacked validated measures, with outcomes most commonly assessed via physical health metrics such as weight. Discussion This review provides a comprehensive summary of psychological interventions for ARFID since its introduction to the DSM‐5. Across a range of psychological interventions and modalities for ARFID, there were common treatment components such as food exposure, psychoeducation, anxiety management, and family involvement. Currently, studies reporting on psychological interventions for ARFID are characterized by small samples and high levels of heterogeneity, including in how outcomes are measured. Based on reviewed studies, we outline suggestions for clinical practice and future research. Public Significance Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance or restriction of food due to fear, sensory sensitivities, and/or a lack of interest in food. We reviewed the literature on psychological interventions for ARFID and the outcomes used to measure change. Several psychological interventions have been developed and applied to patients with ARFID. Outcome measurement varies widely and requires further development and greater consensus. o Objetivo Esta revisión de alcance identifica y describe las intervenciones psicológicas para el Trastorno de Evitación y Restricción de la Ingesta de Alimentos (TERIA) y resume cómo se miden los resultados en dichas intervenciones. Método Se hicieron búsquedas en cinco bases de datos (Cochrane, Emb