Feeling and Body Investigators (FBI)-ARFID Division: Sensory and Somatic Exposure for Children with Avoidant Restrictive Food Intake Disorder

感觉和身体调查员 (FBI)-ARFID 部门：患有回避型限制性食物摄入障碍的儿童的感觉和躯体暴露

• 批准号: 10286200
• 负责人: GUILLERMO R SAPIRO
• 金额: $ 75.37万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-20 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10286200
• 关键词: 9 year old; Address; Affect; Aftercare; Age; Age of Onset; Ambulatory Care; Attention; Body mass index; Caregivers; Cartoons; Cells; Cellular Phone; Child; Clinical; Code; Computers; Consumption; Control Groups; Curiosities; DSM-V; Decision Trees; Depressed mood; Development; Diagnosis; Diagnostic; Diet; Diet Fads; Disease; Distress; Dose; Early Diagnosis; Early Intervention; Eating; Eating Disorders; Emotional; Emotions; Engineering; Esthesia; Etiology; Evaluation; Face; Family; Feeling; Food; Fright; Goals; Growth; Growth and Development function; Guidelines; Heterogeneity; Home; Impairment; Individual; Intervention; Interview; Investigation; Lead; Learning; Link; Maps; Measurement; Measures; Mediating; Mediator of activation protein; Medical; Mental Depression; Morbidity - disease rate; Motivation; Outcome; Parents; Pathway interactions; Pattern; Primary Health Care; Randomized; Randomized Controlled Trials; Reaction; Research; Research Personnel; Retreatment; Risk; Role; Self Perception; Sensory; Smell Perception; Symptoms; Syndrome; Testing; Texture; Time; Vomiting; Work; approach avoidance behavior; approach behavior; arm; autism spectrum disorder; avoidant restrictive food intake disorder; base; clinical diagnostics; comorbidity; design; dietary; dosage; early childhood; effective intervention; emotional reaction; experience; family support; feeding; follow-up; food avoidance; food consumption; gastrointestinal; improved; improved functioning; interest; machine learning algorithm; negative affect; novel; nutrition; personalized intervention; psychologic; psychosocial; reduce symptoms; response; social; theories; tool; treatment response

Avoidant Restrictive Food Intake Disorder (ARFID) is a newly articulated eating disorder in the DSM-5 in which individuals are not able to consume an adequate quantity or variety of food to sustain healthy growth and de- velopment. ARFID typically onsets in early childhood, yet identification of the disorder is poor. The end result is that children often have sustained inadequate nutrition with resulting severe physical consequences and threats to optimal social and emotional development. Early intervention is essential. However, there are no em- pirically validated treatments for young children with ARFID. Children with ARFID are known to be sensitive individuals: with a low threshold for noticing internal body sensations (e.g., gastrointestinal distress) and exter- nal sensory sensations (e.g., smells) and experiencing these sensations as uncomfortable/aversive. This sen- sitivity, and the associated negative emotional reactions (e.g., of disgust, fear, sadness), may encourage avoidance of activities that cause these sensory experiences, such as eating. An intervention that could change reactions to sensory and somatic sensations to one of playful curiosity may increase approach behav- ior and food consumption. We designed an acceptance-based interoceptive exposure treatment for children to achieve this goal. We teach children and caregivers to be “FBI Agents,” individuals who view somatic and sen- sory sensations as clues to a mystery via the use of engaging illustrative cartoon characters (e.g., Gassy Gus), body investigations that provoke intense sensations and worksheets that map sensations to meanings and ac- tions. The goal is to make somatic and sensory experiences playful – and to promote adaptive self-awareness and food approach. The overall objective of this study is to determine whether treatment results in reduced negative emotions to somatic and sensory sensations, including those associated with food and eating, and whether this, in turn, increases food approach. This will be accomplished by a randomized controlled trial (N = 140, 70 per cell) comparing The Feeling and Body Investigators (FBI) - ARFID Division treatment, a 20-session outpatient treatment, to a control group in children (5 to 9 years of age) with ARFID. The control treatment (FAD: Family-Assisted Diet) will provide family-supported exposure. Our proposed mediator of treatment re- sponse is negative affect: a child’s facial affect in response to food presentation as measured via smartphone videos. Outcomes include changes in anthropometric measurements, nutrition variety and adequacy, and psy- chosocial functioning. Medical and psychological measurements will be assessed pre- and post-treatment, at every session, and 3-month follow-up. Deliverables include an empirically validated treatment(s); medical guidelines for the early detection of insufficient nutrition; practical tools for assessing food acceptance in the home via smartphones; and guidance about the number of food presentations necessary to facilitate acceptance. Ultimately, we will evaluate this treatment and disseminate materials via primary care to provide tools to intervene early on food avoidance.

回避型限制性食物摄入障碍 (ARFID) 是 DSM-5 中新阐述的一种饮食失调症，其中 个人无法消耗足够数量或种类的食物来维持健康生长和发育 ARFID 通常在儿童早期发病，但最终结果却很差。 儿童经常营养不足，导致严重的身体后果， 对最佳社交和情感发展的威胁是必不可少的。 针对患有 ARFID 的幼儿的经过验证的治疗方法 众所周知，患有 ARFID 的儿童是敏感的。 个体：注意到身体内部感觉（例如胃肠道不适）和外部感觉的阈值较低 最终的感官感觉（例如气味），并将这些感觉体验为不舒服/厌恶。 积极性以及相关的负面情绪反应（例如厌恶、恐惧、悲伤）可能会鼓励 避免引起这些感官体验的活动，例如可能的干预。 将对感官和躯体感觉的反应转变为一种顽皮的好奇心可能会增加接近行为 我们为儿童设计了一种基于接受的内感受暴露治疗。 我们教导儿童和照顾者成为“联邦调查局特工”，即看待身体和情感的人。 通过使用引人入胜的卡通人物（例如加西·格斯），将感觉作为解开谜团的线索， 激发强烈感觉的身体调查和将感觉映射到含义和行为的工作表 目标是让躯体和感官体验变得有趣，并促进适应性自我意识。 本研究的总体目标是确定治疗是否会导致减少。 对躯体和感官的负面情绪，包括与食物和饮食有关的情绪，以及 这是否反过来会增加饮食方法这将通过随机对照试验来完成（N = 140 个，每个单元 70 个）比较感觉和身体调查员 (FBI) - ARFID 部门治疗，20 个疗程 门诊治疗，对照组为患有 ARFID 的儿童（5 至 9 岁）。 （FAD：家庭辅助饮食）将提供我们建议的治疗重新中介。 反应是负面影响：通过智能手机测量孩子对食物呈现的面部反应 结果包括人体测量、营养多样性和充足性以及心理方面的变化。 将在治疗前和治疗后评估医学和心理功能。 每次疗程和 3 个月的随访成果包括经经验验证的医疗治疗； 早期发现营养不足的指南；评估人们对食物接受程度的实用工具； 通过智能手机回家；以及有关必要的食物展示数量的指导 最终，我们将评估这种治疗方法并通过初级保健传播材料以提供治疗。 早期干预避免食物的工具。