Sanford Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA.
Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA.
Int J Eat Disord. 2024 Oct;57(10):1991-1998. doi: 10.1002/eat.24233. Epub 2024 May 28.
Avoidant/restrictive food intake disorder (ARFID) is a heterogeneous disorder wherein restrictive eating is primarily attributed to non-shape/weight-based reasons (e.g., sensory sensitivity) that empirical research continues to explore. Mounting evidence suggests that ARFID often presents alongside neurodevelopmental diagnoses (NDs) or divergent neurodevelopment broadly. Executive functioning (EF) differences often characterize divergent neurodevelopmental trajectories. Additionally, restrictive eating in anorexia nervosa has been conceptualized as related to EF factors (e.g., set shifting). Given the neurodevelopmental phenotype that may be associated with ARFID and the role of EF in anorexia nervosa, this paper proposes EF as a potentially important, yet understudied factor in ARFID pathology. We posit that various observed ARFID behavioral/cognitive tendencies can be conceptualized in relation to EF differences. We contextualize commonly observed ARFID presentations within "core" EF components (i.e., cognitive flexibility, working memory, inhibitory control), leading to hypotheses about EF in ARFID. Finally, we offer additional considerations/directions for future research on EF in ARFID. Increased research on EF in ARFID is needed to consider this potential common factor in the etiology and maintenance of this heterogeneous disorder. We aim to promote further consideration of EF in ARFID etiology, maintenance, and treatment-outcome research. PUBLIC SIGNIFICANCE: This article proposes that aspects of executive functioning (EF) may play a role in the onset and maintenance of avoidant/restrictive food intake disorder (ARFID), although this notion is largely untested by existing research. Further research on the role of EF in ARFID may assist with refining models and treatments for this heterogeneous disorder.
回避/限制型食物摄入障碍（ARFID）是一种异质障碍，其中限制进食主要归因于非体型/体重相关的原因（例如，感官敏感性），实证研究仍在继续探索。越来越多的证据表明，ARFID 通常与神经发育诊断（NDs）或广泛的神经发育差异一起出现。执行功能（EF）差异通常是神经发育轨迹差异的特征。此外，神经性厌食症中的限制进食被认为与 EF 因素有关（例如，转换思维）。鉴于可能与 ARFID 相关的神经发育表型和 EF 在神经性厌食症中的作用，本文提出 EF 是 ARFID 病理中一个潜在重要但研究不足的因素。我们假设，各种观察到的 ARFID 行为/认知倾向可以与 EF 差异相关联。我们将常见的 ARFID 表现置于“核心”EF 成分（即认知灵活性、工作记忆、抑制控制）中，从而提出了关于 ARFID 中 EF 的假设。最后，我们为 ARFID 中 EF 的未来研究提供了其他考虑和方向。需要更多关于 ARFID 中 EF 的研究，以考虑这种潜在的共同因素在这种异质障碍的病因学和维持中的作用。我们旨在促进进一步考虑 EF 在 ARFID 病因学、维持和治疗结果研究中的作用。
