A Seven-Year-Old Girl With Dysphagia Due to Fear of Swallowing: A Favorable Outcome With Cognitive Behavioral Therapy Using an Anxiety Hierarchy Chart

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance and aversion to food and eating. Food restriction is not due to a body image disturbance but rather to an anxiety or phobia of food and eating or abnormal hypersensitivity to food, such as its texture,...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-12, Vol.14 (12), p.e33196
Main Authors: Etoh, Mika, Itonaga, Tomoyo, Oguri, Saori, Kiyota, Akio, Ihara, Kenji
Format: Article
Language:English
Subjects:
Anorexia
Anxiety disorders
Autism
Behavior modification
Blood
Case reports
Children & youth
Cognitive behavioral therapy
Dysphagia
Eating disorders
Fear & phobias
Food
Hospitalization
Insulin-like growth factors
Mental disorders
Neurology
Nutrition
Patients
Pediatrics
Post traumatic stress disorder
Psychiatry
Rice
Swallowing
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Summary:Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance and aversion to food and eating. Food restriction is not due to a body image disturbance but rather to an anxiety or phobia of food and eating or abnormal hypersensitivity to food, such as its texture, taste, or smell, or a lack of interest in food/eating. We herein report a seven-year-old girl with dysphagia due to a fear of swallowing with a favorable outcome thanks to cognitive behavioral therapy using an anxiety hierarchy chart. After a scary experience of seeing her bother choking on a sausage, the patient struggled with a strong fear of eating, especially swallowing, and was diagnosed with ARFID. We constructed a hierarchical chart of food insecurity, listing her favorite sweets in order, from soft to hard. She picked out daily sweets and snacks from the list. She gradually learned to eat hard-shaped food, achieved an adequate oral calorie intake, and was discharged on the twenty-second hospital day. This case indicates that cognitive behavioral therapy using the anxiety hierarchy chart can be applied to the treatment of school-age children with ARFID.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.33196