Child AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER
write a 3-4 page Article critiques on the 6 documents attached, the document title and links are also posted below.
the paper
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articles.
AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER (ARFID)
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
Cognitive-Behavioral Treatment of Avoidant/Restrictive Food Intake Disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235623/pdf/nihms-1511046.pdf
An ARFID case report combining family-based treatment with the unified protocol for Transdiagnostic treatment of emotional disorders in children https://jeatdisord.biomedcentral.com/track/pdf/10.1186/s40337-019-0267-x
Evaluation and Treatment of Avoidant/Restrictive Food Intake Disorder (ARFID) in Adolescents
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534269/pdf/nihms-995861.pdf
Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725687/pdf/ndt-12-213.pdf
Eating Disorder Core Symptoms and Symptom Pathways Across Developmental Stages: A Network Analysis
Use the attachment
CASE REPORT Open Access
An ARFID case report combining family- based treatment with the unified protocol for Transdiagnostic treatment of emotional disorders in children Sarah Eckhardt1* , Carolyn Martell1, Kristina Duncombe Lowe1, Daniel Le Grange2,3 and Jill Ehrenreich-May4
Abstract
Background: This case report discusses the presentation and treatment of a nine-year-old female with a history of significant weight loss and food refusal using a combined approach of Family-Based Treatment (FBT) and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C).
Case presentation: The patient was diagnosed with avoidant/restrictive food intake disorder (ARFID), separation anxiety disorder, and a specific phobia of choking, and subsequently treated with a modified version of FBT, in conjunction with the UP-C. At the end of treatment, improvements were seen in the patient’s weight and willingness to eat a full range of foods. Decreases in anxiety regarding eating/choking, fears of food being contaminated with gluten, and fears of eating while being away from parents were also observed.
Conclusions: These findings highlight promising results from this combined treatment approach, referred to as FBT + UP for ARFID. Further research is needed to evaluate the use of this treatment in patients presenting with a variety of ARFID symptoms.
Keywords: Avoidant/restrictive food intake disorder, Emotional disorders, Family-based treatment, Unified protocol, Transdiagnostic
Background Avoidant/Restrictive Food Intake Disorder (ARFID), a com- plex and heterogeneous diagnosis, has been hypothesized along a dimensional model with presentations including sensory sensitivity, fear of aversive consequences, and lack of interest in eating [1, 2]. Significant literature exists on the treatment of pediatric feeding disorders supporting the use of behavioral feeding interventions among young chil- dren [3]. Recently, individual case reports/series have sug- gested other promising approaches for older children, adolescents, and adults with ARFID, using as a base either family-based treatment (FBT) [4–7];, cognitive behavioral therapy (CBT) [8–10];, or other novel approaches [11]. Despite these new approaches being studied, no published,
randomized controlled trials have yet to evaluate their effi- cacy for the treatment of ARFID [2]. What appears to be lacking in the current treatment models is the ability to concurrently address the high rates of comorbid mood and anxiety disorders in patients with ARFID [12, 13], while also remaining focused on the medical complica- tions associated with those patients who present under- weight or exhibit significant nutritional deficiencies as part of this diagnosis. Consequently, this case presentation proposes a novel treatment approach that attempts to ad- dress both the psychological and emotional comorbidities associated in children and adolescents with ARFID, as well as the hallmark food avoidance features that appear across a heterogeneous array of presentations. This case study describes the treatment of a patient
with ARFID, using a combined approach of FBT [14] and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) [15]. FBT +
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
* Correspondence: sarah.eckhardt@childrensmn.org 1Center for the Treatment of Eating Disorders, Children’s Minnesota, Minneapolis, MN, USA Full list of author information is available at the end of the article
Eckhardt et al. Journal of Eating Disorders (2019) 7:34 https://doi.org/10.1186/s40337-019-0267-x
http://crossmark.crossref.org/dialog/?doi=10.1186/s40337-019-0267-x&domain=pdf
http://orcid.org/0000-0003-0824-4328
http://creativecommons.org/licenses/by/4.0/
http://creativecommons.org/publicdomain/zero/1.0/
mailto:sarah.eckhardt@childrensmn.org
UP for ARFID was developed through a 3 year case consultation process with treatment developers of both FBT and the UP-C. Treatment focuses on a combination of techniques aimed at addressing both weight gain/ normalization of eating and additional symptoms includ- ing fear, disgust, and worry or obsessive thoughts, as well as varying forms of functionally-related avoidance behavior and potential concomitant reinforcement of avoidance by parents/caregivers. A major advantage of this combined approach is that it allows the clinician to personalize treatment based on the patient’s specific presentation using a core set of evidence-based strategies and assessment tools (e.g., Top Problems [16];). The UP-C is transdiagnostic by definition, and contains evidence-based strategies that are flexible enough to address many of the maintaining symptoms that are unique to ARFID. There is also an adolescent version of the UP-C, which when combined with FBT makes this treatment model acceptable for a wide range of patients (named the Unified Protocol for Transdiagnostic Treat- ment of Emotional Disorders in Adolescents; UP-A). The UP for adults has previously been adapted for use with other eating disorder populations (anorexia nervosa, bulimia nervosa, and binge-eating disorder), with early results indicating improvments in anxiety sensitivity, ex- periential avoidance, and mindfulness [17]. While flexible, FBT +UP for ARFID always begins with
sessions focused on FBT principles, including collabora- tive weighing, psychoeducation (specific to ARFID pa- tients and their eating problems), family engagement, separating the eating problem from the child, charging parents with taking control of their child’s eating (includ- ing increasing volume and variety of foods), promoting weight gain as needed, and a family meal. The UP-C or UP-A is then added to build skills that empower the patient to cope with difficult emotions, address avoidance, and increase tolerance of emotions or disgust responses. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) [18] is an emotion-focused, evidence-based treatment that targets the core dysfunction of neuroticism in adults [19]. It has subsequently been adapted to address…
