Psychological and Mental Health Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.
Int J Eat Disord. 2024 Jan;57(1):27-61. doi: 10.1002/eat.24073. Epub 2023 Oct 24.
This scoping review identifies and describes psychological interventions for avoidant restrictive food intake disorder (ARFID) and summarizes how outcomes are measured across such interventions.
Five databases (Cochrane, Embase, Medline, PsycInfo, Web of Science) were searched up to December 22, 2022. Studies were included if they reported on psychological interventions for ARFID. Studies were excluded if participants did not have an ARFID diagnosis and if psychological interventions were not delivered or detailed.
Fifty studies met inclusion criteria; almost half were single-case study designs (23 studies) and most studies reported on psychological interventions for children and adolescents with ARFID (42 studies). Behavioral interventions (16 studies), cognitive-behavioral therapy (10 studies), and family therapy (5 studies), or combinations of these therapeutic approaches (19 studies) were delivered to support patients with ARFID. Many studies lacked validated measures, with outcomes most commonly assessed via physical health metrics such as weight.
This review provides a comprehensive summary of psychological interventions for ARFID since its introduction to the DSM-5. Across a range of psychological interventions and modalities for ARFID, there were common treatment components such as food exposure, psychoeducation, anxiety management, and family involvement. Currently, studies reporting on psychological interventions for ARFID are characterized by small samples and high levels of heterogeneity, including in how outcomes are measured. Based on reviewed studies, we outline suggestions for clinical practice and future research.
Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance or restriction of food due to fear, sensory sensitivities, and/or a lack of interest in food. We reviewed the literature on psychological interventions for ARFID and the outcomes used to measure change. Several psychological interventions have been developed and applied to patients with ARFID. Outcome measurement varies widely and requires further development and greater consensus.
本范围综述旨在确定并描述针对回避性限制型摄食障碍（ARFID）的心理干预措施，并总结此类干预措施的结果评估方法。
截至 2022 年 12 月 22 日，我们对五个数据库（Cochrane、Embase、Medline、PsycInfo、Web of Science）进行了检索。如果研究报告了针对 ARFID 的心理干预措施，则将其纳入研究。如果参与者没有 ARFID 诊断或心理干预措施未实施或未详细报告，则将排除这些研究。
共有 50 项研究符合纳入标准；其中近一半为单病例研究设计（23 项研究），且大多数研究报告了针对 ARFID 儿童和青少年的心理干预措施（42 项研究）。为了支持 ARFID 患者，实施了行为干预（16 项研究）、认知行为疗法（10 项研究）和家庭治疗（5 项研究）或这些治疗方法的组合（19 项研究）。许多研究缺乏经过验证的测量方法，最常通过体重等身体健康指标评估结果。
本综述提供了自 DSM-5 引入 ARFID 以来针对 ARFID 的心理干预措施的全面总结。在针对 ARFID 的一系列心理干预措施和模式中，存在常见的治疗成分，例如食物暴露、心理教育、焦虑管理和家庭参与。目前，报告 ARFID 心理干预措施的研究存在样本量小且异质性高的特点，包括结果评估方法。根据综述研究，我们概述了临床实践和未来研究的建议。
回避性限制型摄食障碍（ARFID）是一种饮食障碍，其特征是由于恐惧、感官敏感和/或对食物缺乏兴趣而避免或限制食物摄入。我们对 ARFID 的心理干预措施及用于衡量变化的结果进行了文献回顾。已经开发并应用了几种心理干预措施来治疗 ARFID 患者。结果评估方法差异很大，需要进一步发展和更大的共识。
