Objective: To review the literature related to the current DSM-IV-TR diagnostic criteria for feeding disorder of infancy or early childhood; pica; rumination disorder; and other childhood presentations that are characterized by avoidance of food or restricted food intake, with the purpose of informing options for DSM-V.Method: Articles were identified by computerized and manual searches and reviewed to evaluate the evidence supporting possible options for revision of criteria.Results: The study of childhood feeding and eating disturbances has been hampered by inconsistencies in classification and use of terminology. Greater clarity around subtypes of feeding and eating problems in children would benefit clinicians and patients alike.Discussion: A number of suggestions supported by existing evidence are made that provide clearer descriptions of subtypes to improve clinical utility and to promote research. V

Given the central role of weight and shape concern and the importance of weight and shape in diagnosis and predicting onset of disordered eating, it would appear that the EDE is likely to perform well as both a diagnostic and predictive tool. Caution should be exercised with respect to the use and interpretation of the individual subscales in nonclinical populations of young adolescent girls.

Individual-level longitudinal data on biological, behavioural, and social dimensions are becoming increasingly available. Typically, these data are analysed using mixed effects models, with the result summarised in terms of an average trajectory plus measures of the individual variations around this average. However, public health investigations would benefit from finer modelling of these individual variations which identify not just one average trajectory, but several typical trajectories. If evidence of heterogeneity in the development of these variables is found, the role played by temporally preceding (explanatory) variables as well as the potential impact of differential trajectories may have on later outcomes is often of interest. A wide choice of methods for uncovering typical trajectories and relating them to precursors and later outcomes exists. However, despite their increasing use, no practical overview of these methods targeted at epidemiological applications exists. Hence we provide: (a) a review of the three most commonly used methods for the identification of latent trajectories (growth mixture models, latent class growth analysis, and longitudinal latent class analysis); and (b) recommendations for the identification and interpretation of these trajectories and of their relationship with other variables. For illustration, we use longitudinal data on childhood body mass index and parental reports of fussy eating, collected in the Avon Longitudinal Study of Parents and Children.

In a pediatric treatment-seeking sample where ARFID features were common, cases meeting full criteria were rare, suggesting that the diagnosis is not over-inclusive even in a population where eating/feeding difficulties are expected.

Objective Avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder (RD) were added to the revised DSM‐5 Feeding and Eating Disorders chapter in 2013. We developed a structured interview—the Pica, ARFID, and Rumination Disorder Interview (PARDI)—to assess the presence and severity of these diagnoses for evaluation and treatment planning in clinical and research settings. Here, we describe the development of the PARDI and provide a preliminary report on feasibility, acceptability, reliability, and validity in relation to ARFID. Method We created an initial item pool from existing measures of similar constructs and clinical experience. The PARDI includes items assessing the level of endorsement and overall severity of common ARFID features organized into profiles (i.e., sensory sensitivity, lack of interest in eating, and fear of aversive consequences) and algorithms for diagnosing ARFID, pica, and RD. We collected initial psychometric data from participants (10–22 years) with ARFID (n = 39), clinically significant avoidant/restrictive eating (n = 8), and healthy controls (n = 10). Results On average, the PARDI took 39 min to complete and was acceptable to participants. All subscales achieved internal consistency greater ≥0.77, and inter‐rater reliability for the ARFID diagnosis was moderate (κ = 0.75). Individuals with ARFID scored significantly higher than healthy controls on ARFID severity and ARFID profiles. Discussion The PARDI appears acceptable to respondents and preliminary evidence of reliability and validity has been demonstrated in an initial sample. Larger‐scale validation studies are currently underway. The PARDI is freely available to clinicians and researchers.

Objective: A substantial proportion of eating disorder presentations receive a DSM-IV diagnosis of eating disorder not otherwise specified (EDNOS), yet research comparing EDNOS with anorexia nervosa (AN) and bulimia nervosa (BN) is limited. The aim of this study was to further investigate EDNOS in clients at a UK Community Eating Disorder Service. Method: The Eating Disorder Examination (EDE) was used to generate DSM-IV diagnoses. Clinical profiles of EDNOS clients are compared with those of patients with AN and BN and cluster analysis used to identify subgroups based on presenting features rather than diagnosis. Results: 190 of 200 participants had a clinical eating disorder: 11 had AN, 45 had BN, 134 had EDNOS. Cluster analysis suggested four subgroups within the clinical sample: three with similar cognitive psychopathology but varied behavioural presentation, and one with less severe cognitive and behavioural features, but low mean BMI. Discussion: These results highlight the need for further investigation into EDNOS and its usefulness as a diagnosis.

Objective This article describes the use of a slightly modified version of the Eating Disorders Examination (EDE) in children. Methods: Sixteen children aged between 7 and 14 years attending an eating disorders clinic over a 5‐month period were recruited to the study. The two main modifications to the EDE were (A) the inclusion of a sort task to assess overvalued ideas about weight and shape and (B) the reformulation of certain items to assess intent rather than actual behavior. The existing EDE scoring system was used, resulting in item, subscale, and global scores. Results: Of the 16 children (10 F 6 M), 11 had a diagnosis of anorexia nervosa, and 5 of eating disorder not otherwise specified (EDNOS). There were interesting differences in responses on items assessing core overvalued ideas, with weight and/or shape concerns emerging as of great importance in terms of self‐evaluation in the majority of children with anorexia nervosa. Discussion: Results suggest that this may be a useful assessment tool in children, with some children obtaining global and subscale scores consistent with adult norms for females with eating disorders. Problems of the administration of the EDE to this patient group are discussed and details of the modifications used are outlined. © 1996 by John Wiley & Sons, Inc.

This qualitative study examined the experience of parents who had a child with early onset anorexia nervosa. Semi-structured interviews were conducted with 11 parents (seven mothers and four fathers). Qualitative data analysis yielded eight core themes structured around three broad domains: understanding the eating disorder, the impact of the eating disorder, and managing the eating disorder and its impact. The themes revealed that the experience of having a child with anorexia nervosa is extremely demanding and personally challenging for parents. Despite this, parents remained determined to help their child in the face of this debilitating condition. The implications for the delivery of services for children and adolescents with eating disorders and their families are discussed.