Schmidt Ricarda, Hiemisch Andreas, Kiess Wieland, von Klitzing Kai, Schlensog-Schuster Franziska, Hilbert Anja
Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.
LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany.
Int J Eat Disord. 2022 Dec;55(12):1708-1720. doi: 10.1002/eat.23805. Epub 2022 Aug 24.
This study presents a psychometric evaluation of the avoidant/restrictive food intake disorder (ARFID) module 2.0 for the Eating Disorder Examination (EDE), its child (ChEDE), and parent version. Within a pediatric sample seeking treatment for restrictive feeding or eating disorders and non-treatment-seeking controls, the module's interrater reliability, parent-child agreement, and its convergent, divergent, and discriminant validity were examined.
The child, adult, and/or parent version of the German ARFID module was administered to N = 176 children and adolescents (0-17 years) and their parents, as were the (Ch)EDE, well-established measures on food-avoidance behaviors, food variety, and body esteem, and objective anthropometric measures.
Across all versions of the ARFID module, substantial to almost perfect interrater reliability was shown. Parent-child agreement for ARFID diagnosis was substantial. Based on medium-to-large associations between interview-assessed avoidant/restrictive food intake and questionnaire-assessed food-avoidance behaviors, food variety, and objective weight status, the module showed high convergent validity, especially for the child and parent version. Low associations of avoidant/restrictive food intake with weight and shape concern demonstrated divergent validity. Individuals with ARFID differed significantly from those with anorexia nervosa and individually matched controls in a range of clinical characteristics, indicating discriminant validity.
This comprehensive validation supports the EDE ARFID module to be a valuable measure for the assessment and diagnosis of ARFID in 0-17-year-olds based on self- and parent-report. Validation of the ARFID module against other interview-based measures on ARFID and its evaluation in an adult sample are pending.
Based on good reliability and validity of the avoidant/restrictive food intake disorder (ARFID) module for the Eating Disorder Examination (EDE) in its child, adult, and parent version, the present study paves the way for the clinical and research use of the interview-based EDE ARFID module for assessing ARFID across childhood and adolescence.
本研究对饮食失调检查（EDE）的回避/限制性食物摄入障碍（ARFID）模块2.0及其儿童版（ChEDE）和家长版进行了心理测量评估。在寻求治疗限制性喂养或饮食障碍的儿科样本以及未寻求治疗的对照组中，检验了该模块的评分者间信度、亲子一致性及其聚合效度、区分效度和判别效度。
对N = 176名儿童和青少年（0 - 17岁）及其家长施测德国ARFID模块的儿童版、成人版和/或家长版，同时施测（Ch）EDE、成熟的食物回避行为、食物种类和身体自尊测量方法以及客观人体测量指标。
在ARFID模块的所有版本中，均显示出较高至几乎完美的评分者间信度。ARFID诊断的亲子一致性较高。基于访谈评估的回避/限制性食物摄入与问卷评估的食物回避行为、食物种类和客观体重状况之间的中等到较大关联，该模块显示出较高的聚合效度，尤其是儿童版和家长版。回避/限制性食物摄入与体重和体型关注之间的低关联显示出区分效度。患有ARFID的个体在一系列临床特征上与神经性厌食症患者及个体匹配的对照组有显著差异，表明具有判别效度。
这一全面验证支持EDE ARFID模块是基于自我报告和家长报告对0 - 17岁儿童进行ARFID评估和诊断的有价值工具。针对其他基于访谈的ARFID测量方法对ARFID模块的验证及其在成人样本中的评估尚待进行。
基于饮食失调检查（EDE）的回避/限制性食物摄入障碍（ARFID）模块的儿童版、成人版和家长版具有良好的信度和效度，本研究为基于访谈的EDE ARFID模块在儿童期和青少年期评估ARFID的临床和研究应用铺平了道路。
