Radcliffe ARFID Workgroup: Toward operationalization of research diagnostic criteria and directions for the field

• Type of Material: Article
• Authors: Kamryn T. Eddy, Massachusetts General Hospital; Stephanie G. Harshman, Massachusetts General Hospital; Kendra R. Becker, Massachusetts General Hospital; Elana Bern, Boston Childrens Hospital; Rachel Bryant-Waugh, University College London; Anja Hilbert, Leipzig University; Debra K. Katzman, University of Toronto; Elizabeth A. Lawson, Massachusetts General Hospital; Laurie D. Manzo, MassGen Hospital for Children; Jessie Menzel, University of California San Diego; Nadia Micali, University College London; Rollyn Ornstein, Penn State College of Medicine; Sarah Sally, MassGen Hospital for Children; Sharon P. Serinsky, MassGen Hospital for Children; William Sharp, Emory University; Kathryn Stubbs, Emory University; B. Timothy Walsh, Columbia University; Hana Zickgraf, University of Pennsylvania; Nancy Zucker, Duke University; Jennifer J. Thomas, Massachusetts General Hospital
• Language: English
• Date: 2019-04-01
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 John Wiley & Sons, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1002/eat.23042
• Title of Journal or Parent Work: International Journal of Eating Disorders
• Volume: 52
• Issue: 4
• Start Page: 361
• End Page: 366
• Grant/Funding Information: Funding: Radcliffe Institute for Advanced Study/Academic Ventures (PIs: Thomas, Eddy); 1R01MH108595 (PIs: Thomas, Lawson, Micali); 1F32MH118824 (PI: Harshman); F32MH111127 (PI: Becker); German Federal Ministry of Education and Research, grant 01EO1501 (Hilbert).
• Keywords: Social Sciences; Life Sciences & Biomedicine; Science & Technology; Food-intake disorder; Partial hospitalization program; DSM-5; ARFID; Psychiatry; ARFID workgroup; research diagnostic criteria; Nutrition & Dietetics; diagnosis; Psychology; Validation; Psychology, Clinical
• Research Categories: Health Sciences, Nutrition; Psychology, Psychobiology; Health Sciences, Public Health; Psychology, Clinical; Health Sciences, Pathology

Abstract

Objective: Since its introduction to the psychiatric nomenclature in 2013, research on avoidant/restrictive food intake disorder (ARFID) has proliferated highlighting lack of clarity in how ARFID is defined. Method: In September 2018, a small multi-disciplinary pool of international experts in feeding disorder and eating disorder clinical practice and research convened as the Radcliffe ARFID workgroup to consider operationalization of DSM-5 ARFID diagnostic criteria to guide research in this disorder. Results: By consensus of the Radcliffe ARFID workgroup, ARFID eating is characterized by food avoidance and/or restriction, involving limited volume and/or variety associated with one or more of the following: weight loss or faltering growth (e.g., defined as in anorexia nervosa, or by crossing weight/growth percentiles); nutritional deficiencies (defined by laboratory assay or dietary recall); dependence on tube feeding or nutritional supplements (≥50% of daily caloric intake or any tube feeding not required by a concurrent medical condition); and/or psychosocial impairment. Conclusions: This article offers definitions on how best to operationalize ARFID criteria and assessment thereof to be tested in existing clinical populations and to guide future study to advance understanding and treatment of this heterogeneous disorder.