Feeling and body investigators (FBI): ARFID division—An acceptance‐based interoceptive exposure treatment for children with ARFID. Issue 4 (31st December 2018)

• Record Type: Journal Article
• Authors: Zucker, Nancy L.; LaVia, Maria C.; Craske, Michelle G.; Foukal, Martha; Harris, Adrianne A.; Datta, Nandini; Savereide, Erik; Maslow, Gary R.
• Other Names: Eddy Kamryn T. guestEditor.; Thomas Jennifer J. guestEditor.
• Is Part Of: International journal of eating disorders. Volume 52:Issue 4(2019)
• Page Start: 466
• Page End: 472
• Publication Date: 2018-12-31
• Subjects: ARFID -- exposure -- interoception -- treatment; Appetite disorders -- Periodicals; Ingestion disorders -- Periodicals; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/eat.22996
• Languages: English
• ISSNs: 0276-3478

Abstract

Abstract: Objective: Individuals with Avoidant Restrictive Food Intake Disorder (ARFID) experience impairing health consequences from insufficient nutritional variety and/or quantity. Early medical conditions and/or somatic symptoms such as abdominal pain may lead some with ARFID to experience somatic sensations as aversive. As such, food avoidance may be part of a broader behavioral repertoire aimed at suppressing bodily sensations. Avoiding these necessary and informative signals (e.g., growls of hunger) may subvert the emergence of healthy self‐awareness and self‐regulation. Teaching children with ARFID to engage adaptively with bodily sensations may help decrease aversiveness, increase self‐awareness, and increase approach behaviors. Method: Drawing from interventions for panic disorder and irritable bowel syndrome, we developed an acceptance‐based interoceptive exposure treatment for young children with ARFID, Feeling and Body Investigators (FBI)‐ARFID Division. Using playful cartoons and developmentally sensitive exposures, we teach young children how to map interoceptive sensations onto meanings (e.g., emotions) and actions (e.g., if I feel nervous, I'll hold someone's hand). Results: We present a case study of a 4‐year old child with lifelong poor appetite/food indifference. Discussion: Some individuals with ARFID may avoid food to avoid internal sensations. Developmentally appropriate interoceptive exposures may decrease ARFID symptoms while increasing more general self‐regulation skills.