Co-Director, Eating Disorders Clinical & Research Program, Massachusetts General Hospital; Associate Professor of Psychology, Department of Psychiatry, Harvard Medical School Neurobiology and treatment of avoidant/restrictive food intake disorder across the lifespan Avoidant/restrictive food intake disorder (ARFID) was recently added to the Feeding and Eating Disorders section of DSM-5 to describe children, adolescents, and adults who cannot meet their nutritional needs, typically because of sensory sensitivity, fear of aversive consequences, and/or apparent lack of interest in eating or food. Our team at Massachusetts General Hospital has been actively involved in investigating the neurobiology of ARFID and creating novel treatments. In this presentation I will cover three main topics. First, I will discuss the hypotheses and preliminary results from our ongoing NIMH-funded study “Neurobiological and Behavioral Risk Mechanisms of Youth Avoidant/Restrictive Eating Trajectories” (R01MH108595) in which we are recruiting 100 boys and girls with ARFID ages 10-22 years, and comparing them to 50 healthy controls across multiple units of analysis including neuroimaging, hormones, and behavior. These hypotheses include a three-dimensional model of ARFID that highlights unique potential etiologies and maintenance factors for the three clinical presentations of sensory sensitivity, fear of aversive consequences, and apparent lack of interest in eating or food. Second, I will briefly share findings from a recent clinical trial of adolescents and young adults (n = 20) treated with the protocol described in our new book Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults (Cambridge University Press, 2019). Third, I will discuss special considerations and case examples for the use of CBT-AR with adults, many of whom present with decades of intractable illness and whose motivations for help-seeking may differ from those of youth patients.
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