Richson Brianne N, Schaefer Lauren M, Becker Kendra R, Murray Matthew F, Romano Kelly A, Anderson Lisa M, Wonderlich Stephen A, Thomas Jennifer J
Sanford Center for Biobehavioral 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. 2025 Feb;58(2):291-307. doi: 10.1002/eat.24341. Epub 2024 Nov 30.
Avoidant/restrictive food intake disorder (ARFID) is a relatively new formal diagnosis for which empirical classification research (defined here as studies using latent class/latent profile analysis-type methods) is still emerging. Such research focused on ARFID is an important gap to fill given questions about (1) the boundaries between ARFID and phenotypically similar presentations (e.g., eating disorders [EDs] such as anorexia nervosa [AN], and pediatric feeding disorder [PFD]), and (2) within-ARFID heterogeneity. These questions have practical implications, including diagnostic reliability and treatment selection.
This forum synthesizes the limited empirical classification literature seeking to quantitatively distinguish ARFID from non-ARFID EDs or from PFD, and/or characterize within-ARFID heterogeneity.
To our knowledge, only five studies in clinical samples have used empirical classification methods to delineate ARFID from non-ARFID EDs and/or characterize within-ARFID heterogeneity; no studies have used such methods to delineate ARFID from PFD. Existing studies are mixed in determining how well ARFID can be distinguished from other EDs (particularly AN), but converge in identifying several potential ARFID subclasses (i.e., sensory sensitivity, low appetite, feared eating-related consequences, and subclass representing a combination of these) with some overlapping features.
The existing ARFID empirical classification literature should guide future ARFID classification research priorities (e.g., incorporating mechanistic variables as classification indicators, incorporating longitudinal variables as classification validators) to inform differences between ARFID and other disorders and between ARFID presentations. Dimensional approaches to conceptualizing, studying, and modeling psychopathology (namely, the Hierarchical Taxonomy of Psychopathology [HiTOP] and the Research Domain Criteria [RDoC]) may offer useful insights.
回避/限制性食物摄入障碍（ARFID）是一种相对较新的正式诊断，针对该疾病的实证分类研究（在此定义为使用潜在类别/潜在剖面分析类型方法的研究）仍在不断涌现。鉴于以下问题，聚焦于ARFID的此类研究是一个需要填补的重要空白：（1）ARFID与表型相似表现（如神经性厌食症[AN]等进食障碍[EDs]以及儿童喂养障碍[PFD]）之间的界限；（2）ARFID内部的异质性。这些问题具有实际意义，包括诊断可靠性和治疗选择。
本论坛综合了有限的实证分类文献，旨在定量区分ARFID与非ARFID的进食障碍或PFD，并/或描述ARFID内部的异质性。
据我们所知，临床样本中仅有五项研究使用实证分类方法来区分ARFID与非ARFID的进食障碍和/或描述ARFID内部的异质性；尚无研究使用此类方法区分ARFID与PFD。现有研究在确定ARFID与其他进食障碍（尤其是AN）的区分程度方面存在分歧，但在识别几个潜在的ARFID亚类（即感官敏感性、低食欲、对进食相关后果的恐惧以及代表这些特征组合的亚类）方面达成了一致，这些亚类具有一些重叠特征。
现有的ARFID实证分类文献应指导未来ARFID分类研究的重点（例如，将机制变量纳入分类指标，将纵向变量纳入分类验证指标），以明确ARFID与其他疾病之间以及ARFID不同表现之间的差异。心理病理学的维度化概念化、研究和建模方法（即心理病理学层次分类法[HiTOP]和研究领域标准[RDoC]）可能会提供有用的见解。
