Lucarelli Loredana, Sechi Cristina, Cimino Silvia, Chatoor Irene
Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy.
Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy.
Front Psychol. 2018 Aug 31;9:1608. doi: 10.3389/fpsyg.2018.01608. eCollection 2018.
To evaluate different types and degrees of malnutrition over time in a sample of children diagnosed with Infantile Anorexia (IA), based on the DC:0-3R criteria, and recently defined by DSM-5 as the first subtype of Avoidant/Restrictive Food Intake Disorder (ARFID), and to investigate the relationship between children's severity of malnutrition and emotional/behavioral development, and mothers' long-term psychopathological symptoms. A total of 113 children (58 boys, 55 girls), originally diagnosed with IA, and their mothers, were evaluated at four assessment points at the children's mean age of 2, 5, 7, and 11 years. Several measures were used to assess the children's growth and level of malnutrition, mothers' psychopathological symptoms and eating attitudes, as well as their children's emotional/behavioral functioning. A steady improvement in the severity of malnutrition over time emerged, but 73% of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. Moreover, the children showed increasing internalizing and externalizing emotional/behavioral problems, and their mothers' psychopathological symptoms and eating problems worsened as well over time. At 11 years of age, the girls' emotional/behavioral problems and their mothers' psychopathology and disturbed eating attitudes were more severe than that of the boys and their mothers. Finally, during the last assessment, significant associations between the mothers' psychopathology and disturbed eating attitudes, the severity of the children's malnutrition, and their emotional/behavioral problems emerged. Our longitudinal study points out that the developmental course of children, originally diagnosed with IA and who received limited psychosocial treatment, is characterized by an enduring risk of malnutrition and increasing psychopathological symptoms in both, the children and their mothers, up to the sensitive period of pre-puberty.
根据DC:0 - 3R标准，对被诊断为婴儿厌食症（IA）且最近被《精神疾病诊断与统计手册》第5版定义为回避/限制性食物摄入障碍（ARFID）第一亚型的儿童样本，评估不同类型和程度的营养不良随时间的变化情况，并调查儿童营养不良的严重程度与情绪/行为发展以及母亲长期精神病理症状之间的关系。共有113名最初被诊断为IA的儿童（58名男孩，55名女孩）及其母亲在儿童平均年龄为2岁、5岁、7岁和11岁时的四个评估点接受了评估。采用了多种测量方法来评估儿童的生长和营养不良水平、母亲的精神病理症状和饮食态度以及他们孩子的情绪/行为功能。随着时间的推移，营养不良的严重程度出现了稳步改善，但73%的儿童在11岁时仍存在持续的轻度至中度至重度营养不良。此外，儿童表现出越来越多的内化和外化情绪/行为问题，随着时间的推移，他们母亲的精神病理症状和饮食问题也恶化了。在11岁时，女孩的情绪/行为问题以及她们母亲的精神病理学和紊乱的饮食态度比男孩及其母亲更为严重。最后，在最后一次评估中，母亲的精神病理学和紊乱的饮食态度、儿童营养不良的严重程度以及他们的情绪/行为问题之间出现了显著关联。我们的纵向研究指出，最初被诊断为IA且接受有限心理社会治疗的儿童的发育过程具有以下特点：在青春期前的敏感期之前，儿童及其母亲都存在持续的营养不良风险和不断增加的精神病理症状。
