Emotional-Behavioral Functioning, Maternal Psychopathologic Risk and Quality of Mother–Child Feeding Interactions in Children with Avoidant/Restrictive Food Intake Disorder

Abstract

The literature on food intake disorder (ARFID) in early childhood has evidenced psychopathologic difficulties in both children and their mothers and a poor quality of feeding interactions. Only a few studies have focused on three different ARFID subtypes: irritable/impulsive (I/I), sensory food aversions (SFA) and post traumatic feeding disorder (PTFD). The aim of this study was to explore possible differences between the three groups in children’s emotional-behavioral functioning, maternal psychopathologic risk and the quality of mother–child feeding interactions, comparing these clinical groups with a control group. The sample consisted of 100 child–mother dyads, of which 23 children with I/I, 25 children with SFA, 27 children with PTFD and 27 children with no diagnosis. The mothers primarily filled out questionnaires assessing their psychopathologic symptoms and children’s emotional-behavioral functioning. Then, all dyads were videotaped during a main meal. Results revealed significant differences between the study groups in relation to children’s emotional–adaptive functioning, mothers’ psychological profile and mother–child interactions during feeding. These findings are relevant for the development of target intervention programs to treat specific ARFID disorders.

DAT1 and Its Psychological Correlates in Children with Avoidant/Restrictive Food Intake Disorder: A Cross-Sectional Pilot Study

“…This study suggests that even a child exposed to an early food-related trauma may be at higher risk to develop dysregulation problems. Moreover, our findings are in accordance with previous studies that have shown the highest psychopathological risk in children with PTFD and among their mothers compared to other ARFID diagnosis [ 28 , 31 ].…”

“…In addition, these children reported the lowest dysregulation problems compared to other clinical groups and, in turn, their mothers’ showed the lowest psychopathological risk than mothers of other ARFID groups. These results are in line with the study by Lucarelli and colleagues [ 28 ] and Cerniglia and colleagues [ 31 ] that have evidenced lower psychopathological problems in children with SFA and among their mothers, compared to other ARFID subtypes.…”

“…Children with ARFID fail to eat adequate intake of food and required nutrients manifesting impaired social and psychological functioning [ 26 , 27 ]. Very importantly, ARFID encompasses different clinical manifestations, and some studies have used the term subtypes [ 28 , 29 , 30 , 31 ], according to the nature of their eating restrictions. One possibility is that children may be highly selective and avoid specific foods due to their smell, texture, or appearance, a subtype named sensory food aversion (SFA) [ 27 , 32 ].…”

“…It has also been reported significant association between impulsive/hyperactive difficulties and food refusal behaviors among preschooler children [ 15 , 34 ], as well a history of selective eating during the early childhood of children with ADHD [ 35 ]. Although difficulties in emotional/behavioral regulation have been posited as correlated with EDs in adolescents and adults, very few studies have focused on children with ARFID [ 36 , 37 , 38 ], considering its subtypes [ 31 , 39 ]. Maternal psychopathology is also frequently associated with internalizing and externalizing, emotional/behavioral dysregulation, and eating/feeding disorders in children [ 28 , 39 , 40 ].…”

“…Based on the above premises, this pilot study aimed at increasing knowledge of these processes among children with three specific ARFID sub-groups (impulsive/irritable (I/I), SFA, PTFD), compared with a control group. In accordance with previous literature [ 28 , 29 , 30 , 31 ], we have chosen to focus on three specific clinical manifestations of ARFID, defining them in terms of subtypes. In particular, we wanted to explore: (a) the possible association between children’s DAT1 genotype and ARFID diagnosis; (b) the possible significant differences on children’s DAT1 total methylation, their dysregulation problems, and maternal psychopathological risk; and (c) the possible mediation role played by children’s DAT1 methylation on the relationship between mothers’ psychopathological risk on children’s dysregulation problems, moderated by children’s DAT1 genotype.…”