进食障碍父母培训方案（“ARFID-PTP”）：一项简短的父母培训方案治疗回避/限制型摄食障碍的随机试点试验结果。
ARFID Parent Training Protocol ("ARFID-PTP"): Results of a Randomized Pilot Trial Evaluating a Brief, Parent-Training Program for Avoidant/Restrictive Food Intake Disorder.
机构信息
Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.
Department of Psychology, University at Albany, State University of New York, Albany, New York, USA.
出版信息
Int J Eat Disord. 2024 Nov;57(11):2306-2317. doi: 10.1002/eat.24269. Epub 2024 Jul 19.
OBJECTIVE
Accessible treatment options for avoidant/restrictive food intake disorder (ARFID) in children are limited. The current study sought to assess acceptability, feasibility, and preliminary efficacy of a brief, virtual intervention for ARFID in children ("ARFID-PTP").
METHOD
Families of children ages 5-12 with ARFID (n = 30) were randomized to immediate or waitlist treatment groups, with both groups ultimately receiving ARFID-PTP. ARFID-PTP consists of two, 2-h individual treatment sessions with an optional booster session at 4-week follow-up. Families completed acceptability and feasibility measures at end-of-treatment, as well as preliminary efficacy measures at 4-week, 3-month, and 6-month follow-up.
RESULTS
Of 30 families who completed an intake session, 27 (90%) completed treatment. Families rated acceptability as high (M = 7.75). Treatment was feasible by participant retention. Exposure adherence was lower than expected, and booster session requests were higher than expected, indicating that achieving feasibility across measures may require treatment modifications. Regarding preliminary efficacy, children in the immediate treatment group had a decrease in ARFID symptoms compared to those on the waitlist. Overall, at 6-month follow-up linear mixed models showed participants had significantly reduced ARFID symptoms by presentation (p < 0.05) and in follow-up completers, children incorporated eight new foods on average.
DISCUSSION
ARFID-PTP is acceptable and preliminarily efficacious. The protocol may benefit from modifications to increase feasibility; however, booster session content and treatment outcomes suggest a priori feasibility markers may not accurately capture the utility of ARFID-PTP. Further work should continue to examine the efficacy ARFID-PTP, particularly in diverse samples where treatment accessibility is urgently needed.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT04913194.
目的
儿童回避/限制型食物摄入障碍（ARFID）的可及治疗选择有限。本研究旨在评估一种针对儿童 ARFID 的简短虚拟干预措施（ARFID-PTP）的可接受性、可行性和初步疗效。
方法
将 30 名年龄在 5-12 岁的 ARFID 儿童的家庭随机分为即刻治疗组或候补治疗组，两组最终均接受 ARFID-PTP 治疗。ARFID-PTP 由两次 2 小时的个体治疗会议组成，在 4 周随访时可选择进行一次强化会议。家庭在治疗结束时完成可接受性和可行性测量，以及在 4 周、3 个月和 6 个月随访时完成初步疗效测量。
结果
在完成入组访谈的 30 个家庭中，有 27 个（90%）完成了治疗。家庭对可接受性的评价很高（M=7.75）。通过参与者保留，治疗是可行的。暴露依从性低于预期，强化会议的请求高于预期，这表明要在所有措施上达到可行性，可能需要对治疗进行修改。关于初步疗效，与候补治疗组相比，即刻治疗组的儿童 ARFID 症状有所减少。总体而言，在 6 个月随访时线性混合模型显示，参与者的 ARFID 症状在呈现时（p<0.05）和在随访完成者中显著减少，儿童平均增加了 8 种新食物。
讨论
ARFID-PTP 是可接受和初步有效的。该方案可能需要修改以提高可行性；然而，强化会议内容和治疗结果表明，先验可行性指标可能无法准确捕捉 ARFID-PTP 的效用。需要进一步研究来检验 ARFID-PTP 的疗效，特别是在急需治疗可及性的多样化样本中。
试验注册
ClinicalTrials.gov 标识符：NCT04913194。
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