Feeling and body investigators (FBI): ARFID division—An acceptance-based interoceptive exposure treatment for children with ARFID
Open accessAbstract
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. © 2018 Wiley Periodicals, Inc.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
11 of 20 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Exposures that deliberately provoke interoceptive sensations should aim to disconfirm negative outcome expectancies.
“According to this model, exposures that intentionally provoke interoceptive sensations should be designed to disconfirm underlying expectancies of negative outcomes (e.g., I can’t handle pain; Craske et al., 2014).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Craske et al., 2014 source
- Premisecitation
Pain-avoidance learning models may guide ARFID treatment.
“Learning models of pain avoidance may inform ARFID treatment approaches (Vlaeyen & Linton, 2000).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Vlaeyen & Linton, 2000 source
Sections 3 and 4 describe learning models of pain avoidance, and Section 13 discusses using the fear-avoidance model to guide treatment for musculoskeletal pain. Our copy does not address ARFID or propose applying the model to its treatment, so that extension is not supported by this source. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Premisecitation
Interoceptive exposure is more effective when it closely mimics the avoided experience and creates an expectancy violation.
“The degree to which these exposures more closely replicate the avoided experience (e.g., provoking a strong sensation) and create an expectancy violation (i.e., helping the individual to learn that outcomes differ from expectations), the more effective the interoceptive exposure.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Craske et al., 2014 source
- Premisereasoning
Pain may enhance learning and memory mechanisms.
“Given the importance of pain and the recognition and avoidance of pain for survival, it is logical that pain may facilitate mechanisms to increase learning and memory (Vlaeyen & Linton, 2000).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Vlaeyen & Linton, 2000 source
Section 3 (‘Model 1: the “activity” avoidance model’; page unavailable) describes learning to predict pain and avoid situations associated with it. That supports pain-related avoidance learning, but the paper does not say that pain enhances memory or learning mechanisms generally; a search for memory found no supporting passage. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Premisecitation
Unpleasant or painful bodily sensations are frequent among children with ARFID.
“painful or unpleasant somatic sensations are common in children with ARFID (Cooney, Lieberman, Guimond, & Katzman, 2018; Sharp et al., 2013).”
Quote in the paperSubstantial claim1 of 2 sources checked
- Findingown data
By the end of treatment, Sophie no longer met ARFID criteria.
“At the conclusion, Sophie no longer met criteria for ARFID and was given the option to discharge from treatment.”
Quote in the paperSubstantial claim - Findingown data
Sophie's food consumption increased after 2 sessions.
“After 2 sessions, quantity of food consumed improved.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Interoceptive exposure treatments for anxiety and gastrointestinal disorders may offer a useful framework for addressing sensation avoidance in ARFID.
“Interoceptive exposure treatments developed for anxiety and gastrointestinal disorders may provide a relevant framework to address the sensation avoidance in ARFID.”
Quote in the paperSubstantial claim - Interpretationnone given
Some people with ARFID may avoid food in order to avoid internal sensations.
“Some individuals with ARFID may avoid food to avoid internal sensations.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Sophie's treatment can be seen as inhibitory learning, where high arousal and unknown sensations previously led to food-related immobilization and anticipated discomfort.
“This can be conceptualized as a form of inhibitory learning: formerly the presence of high arousal and/or the experience of sensations that were unknown or uncertain resulted in immobilization around food and potentially, the threat of discomfort.”
Quote in the paperSubstantial claim - Interpretationreasoning
Avoiding informative signals like hunger may hinder healthy self-awareness and self-regulation.
“Avoiding these necessary and informative signals (e.g. growls of hunger) may subvert the emergence of healthy self-awareness and self-regulation.”
Quote in the paperSubstantial claim- Rests on an assumption: Mapping interoceptive states onto meaning and action is the foundation of healthy self-awareness.
- Premisecitation
A core developmental task in childhood is learning to interpret and respond to motivational and emotional needs by mapping interoceptive states to meaning and action.
“One of the fundamental tasks of healthy childhood development is learning to decipher and respond to one’s motivational and emotional needs; to map interoceptive states onto meaning and action: gut butterflies = anxiety = hold someone’s hand (Hietanen, Glerean, Hari, & Nummenmaa, 2016).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hietanen, Glerean, Hari, & Nummenmaa, 2016 source
- Premisecitation
In a pilot treatment study of children with ARFID, 60% had gastroesophageal reflux, where eating is followed by pain.
“in a pilot treatment study for children with ARFID, 60% had gastroesophogeal reflux, a condition whereby pain follows eating (Sharp et al., 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sharp et al., 2016 source
- Interpretationreasoning
Similar learning principles may apply to exteroceptive sensations like taste and texture, leading individuals to restrict food variety to avoid unpleasant oral feelings.
“Comparable learning frameworks can be applied to exteroceptive sensations such as taste and texture, whereby the individual avoids unpleasant oral sensations by restricting food variety.”
Quote in the paperSubstantial claim - Interpretationreasoning
The FBI-ARFID approach may also support the development of self-awareness.
“Thus, an additional advantage of our approach is that it may aid in the emergence of self-awareness.”
Quote in the paperSubstantial claim- Rests on an assumption: Mapping interoceptive states onto meaning and action is the foundation of healthy self-awareness.
- Interpretationreasoning
In treatment, Sophie is learning to view uncertain or intense sensations as clues rather than signals of impending threat.
“In treatment, Sophie is having a new learning experience in which uncertain or intense sensations are no longer viewed as signals of impending threat but are viewed as clues to a mystery.”
Quote in the paperSubstantial claim - Interpretationreasoning
Sophie experienced repeated events that may have conditioned her to find food, eating, or somatic sensations aversive.
“Thus, it is notable that Sophie experienced repeated events that may have resulted in aversive conditioning to food, to the process of eating, or to the experience of somatic sensations more generally.”
Quote in the paperSubstantial claim - Premisecitation
Classical and operant conditioning can make the fear-pain link maladaptive.
“This process can become maladaptive, however, through classical and operant conditioning (Pavlov, 1957; Skinner, 1969).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Pavlov, 1957
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Skinner, 1969
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Rests on an assumption: Pain is a danger signal, so linking fear with pain is adaptive.
- Premisecitation
Bodily discomfort and pain serve as salient, informative signals.
“Theorists have long proposed that pain specifically, and unpleasant bodily sensations more generally, are salient and informative events (Cannon, 1915).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Cannon, 1915 source
- Study design and conductown data
The study did not objectively assess psychological outcomes.
“Additional limitations of the study include our lack of objective assessment of psychological outcomes.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Food avoidance may be part of a broader behavioral pattern aimed at suppressing bodily sensations.
“As such, food avoidance may be part of a broader behavioral repertoire aimed at suppressing bodily sensations.”
Quote in the paperSubstantial claim
- May combine two claims. 17
- Classified as probably not a substantial claim. 6
May combine two claims.
PremisecitationMany people with ARFID experience somatic, interoceptive, or sensory sensations as aversive and act to suppress them.
“Early medical conditions and/or somatic symptoms such as abdominal pain may lead some with ARFID to experience somatic sensations as aversive.”
- Also stated in: § Introduction · hedged
“one process that may be relevant for many individuals with ARFID is the experience of somatic/interoceptive or sensory sensations as aversive and the engagement in behaviors created to suppress these sensations.”
Quote in the paperSubstantial claim1 of 3 sources checked- cites Cooney, Lieberman, Guimond, & Katzman, 2018 source
The Results (page unavailable) report abdominal pain as a trigger for eating disturbance in five children and document fear of vomiting, supporting a possible link between bodily symptoms and food avoidance. The paper does not establish that early medical conditions cause people with ARFID to experience somatic sensations as aversive, or that they act to suppress those sensations. (LLM, conf=0.81)
Experimental — accuracy not yet measured - cites Sharp et al., 2013 source
- cites Sharp et al., 2016 source
- Also stated in: § Introduction · hedged
May combine two claims.
PremisecitationInitial FBI treatment showed medium-to-large statistical and clinical effects on negative affect, distress about somatic sensations, and pain in 24 children with functional abdominal pain; 12% met ARFID criteria retrospectively.
“Data on the initial FBI treatment established changes in negative affect, distress about somatic sensations, and pain with results of medium to large statistical and clinical effect in 24 children with functional abdominal pain (Zucker et al., 2017), with 12% meeting criteria for ARFID in a retrospective analysis.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Zucker et al., 2017 source
The Results sections on pain reduction, distress about pain, and positive and negative affect report significant pre-to-post changes in the 24-child cohort, with medium-to-large effect sizes for several outcomes. The paper measures distress specifically about pain, and our copy does not report that 12% met ARFID criteria or describe a retrospective ARFID analysis. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Classified as probably not a substantial claim.
PremisecitationInhibitory learning is one proposed mechanism for interoceptive exposure treatments.
“One hypothesis whereby interoceptive exposure treatments exert their influence is via inhibitory learning (Craske, Treanor, Conway, Zbozinek, & Vervliet, 2014).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Craske, Treanor, Conway, Zbozinek, & Vervliet, 2014 source
May combine two claims.
PremisecitationFBI was first created for children aged 5 to 10 with functional abdominal pain as a 10-session outpatient intervention.
“FBI was originally developed for children from age 5 to up to age 10 years old with functional abdominal pain in a 10-session outpatient intervention (Zucker et al., 2017).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Zucker et al., 2017 source
May combine two claims.
PremisecitationARFID encompasses varied presentations, such as sensory aversions, that reflect distinct pathophysiology and call for different treatments.
“Emerging research suggests that within ARFID there are diverse manifestations (e.g., sensory aversions) indexing a different pathophysiology and requiring distinct treatments (Thomas et al., 2017).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Thomas et al., 2017 source
May combine two claims.
InterpretationcitationEarly aversive experiences of sensations may disrupt this mapping, hindering self-awareness and leading to conditions and symptoms that mute bodily sensations.
“The experience of sensations as aversive early in development may disrupt this mapping - preventing the emergence of self-awareness and leading to conditions and symptoms intended to mute bodily sensations (Zucker et al., 2017).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Zucker et al., 2017 source
The Discussion (page unavailable) says that fear of bodily sensations can lead to suppression or avoidance, muting informative sensations and potentially hindering the development of capacities such as emotional self-regulation. It does not specifically say that this disrupts a developmental mapping or prevents self-awareness from emerging, or that the resulting conditions and symptoms are intended to mute sensations. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Rests on an assumption: Mapping interoceptive states onto meaning and action is the foundation of healthy self-awareness.
May combine two claims.
Findingown dataSophie improved in managing change, enjoying preschool, and responding to soothing from herself and others.
“In addition, there was a noted improvement in Sophie’s capacity to manage change, to enjoy and participate in preschool, and to respond to soothing by both self and others.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAt age four, Sophie did not express fears of vomiting or other food-related fears.
“At four years old, she did not articulate any beliefs about fears of vomiting or other fears related to food.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAfter 6 sessions, Sophie requested snacks spontaneously more often and managed distress better.
“After 6 sessions, spontaneous requesting of snacks increased as did the capacity to manage distress more generally.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataSophie's parents stopped supplemental feeds about two months after treatment began.
“The parents began gradually reducing the amount of supplemental feedings and stopped supplemental feeds approximately two months after treatment initiation.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningAversive reactions and sensitivity to digestive-tract sensations may contribute to food avoidance in ARFID.
“Sensitivity and aversive reactions to sensations from various parts of the digestive tract could contribute to food avoidance (e.g., oral sensitivity to taste/texture; esophageal sensitivity to feelings of gagging and choking; bloating from constipation contributing to aversive feelings of fullness).”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningTeaching children with ARFID to engage adaptively with bodily sensations may reduce aversiveness, boost self-awareness, and increase approach behaviors.
“Teaching children with ARFID to engage adaptively with bodily sensations may help decrease aversiveness, increase self-awareness, and increase approach behaviors.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
InterpretationreasoningFBI-ARFID may give children a playful way to organize arousal so that internal sensations stop feeling threatening.
“Conceivably, FBI-ARFID division may provide children with a playful framework to organize arousal so that internal sensations are no longer threatening.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe model of visceral and oral sensitivity and its management strategies may not generalize to all ARFID cases.
“However, our conceptual model of visceral and oral sensitivity and the development of strategies to manage this sensitivity may not apply to all cases of ARFID.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningSophie is best understood as having food indifference, limited hunger awareness, and fearful reactions to arousal.
“In considering diverse food motivations that contribute to ARFID, Sophie is best conceptualized as having indifference to food, lack of awareness of hunger, and fearful reactions to arousal.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningPsychological factors-chronic high emotional arousal, poor appetite sensing, and poor arousal regulation-were judged to contribute to Sophie's food indifference and ARFID diagnosis.
“This led to the conclusion that psychological barriers including chronic high emotional arousal, poor appetite sensing, and poor arousal regulation were contributing to food indifference and an ARFID diagnosis.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningEven if aversive interoceptive or exteroceptive sensations do not cause ARFID, their presence may complicate its course and require treatment.
“Importantly, whether or not the aversive experience of interoceptive and/or exteroceptive sensations contribute to disorder etiology, the presence of these sensations may complicate the course of the disorder, necessitating treatment.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningSophie appeared to have a nervous system highly sensitive to change, with intense arousal impairing eating, preschool attendance, and coping with routine changes.
“Rather, she has a nervous system seemingly very sensitive to change and one in which intense arousal impeded several areas of functioning: eating, attending preschool, and managing changes in routine.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationEvidence for psychopharmacologic treatment of ARFID is limited, but one case report supported Mirtazapine for weight gain, gastric emptying, and reducing nausea and vomiting.
“There is little evidence for the use of psychopharmacologic agents in the treatment of ARFID, however, a case report supported the use of Mirtazapine to promote weight gain and improve gastric emptying while decreasing nausea and vomiting (Gray, Chen, Menzel, Schwartz, & Kaye, 2018).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gray, Chen, Menzel, Schwartz, & Kaye, 2018 source
Checked before — its earlier verdict is held back until a new check runs.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningMirtazapine may have facilitated or caused Sophie's treatment gains.
“It is possible that the medication helped to facilitate (or was responsible for) treatment gains.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataDevelopmentally appropriate interoceptive exposures may reduce ARFID symptoms and improve general self-regulation.
“Developmentally appropriate interoceptive exposures may decrease ARFID symptoms while increasing more general self-regulation skills.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductreasoningParent observations and PEG tube removal reduce but do not remove concerns about the lack of objective assessment.
“The behavioral observations of the parents and successful removal of the PEG tube help to minimize but not eliminate these concerns.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Interoceptive sensations carry information and communicate needs such as hunger or fatigue, or signal emotional experience.
“since interoceptive sensations are informative and communicate needs such as hunger or fatigue or signal emotional experience, it was important to give children tools to help decipher their meaning and link these sensations to adaptive actions that meet particular needs.”
The paper relies on this without support.
ARFID often begins in early childhood.
“This is particularly crucial given the age of onset of ARFID, often in early childhood.”
The paper relies on this without support.
Mapping interoceptive states onto meaning and action is the foundation of healthy self-awareness.
“The mapping process is the foundation of healthy self-awareness.”
The paper relies on this without support.
Pain is a danger signal, so linking fear with pain is adaptive.
“That is, since pain is a danger signal, it would be adaptive for fear and pain to be linked.”
The paper relies on this without support.
Children with ARFID may have a trait-like sensitivity to interoceptive and exteroceptive sensations.
“Given that children with ARFID may exhibit sensitivity to interoceptive and exteroceptive sensations as a trait feature, we provided children with a framework whereby they can perceive these sensations with curiosity rather than fear, in order to learn to tolerate the sensations.”
Cites
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
Vlaeyen, J. W. S., & Linton, S. J. (2000) · Pain · doi:10.1016/s0304-3959(99)00242-0 · Cited by 4,931 · cited 2× · see citing works
“Given the importance of pain and the recognition and avoidance of pain for survival, it is logical that pain may facilitate mechanisms to increase learning and memory (Vlaeyen & Linton, 2000).”
Maximizing exposure therapy: An inhibitory learning approach
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.04.006 · Cited by 2,339 · cited 1× · see citing works
“According to this model, exposures that intentionally provoke interoceptive sensations should be designed to disconfirm underlying expectancies of negative outcomes (e.g., I can’t handle pain; Craske et al., 2014).”
Self-citationContingencies of reinforcement: A theoretical analysis
Eysenck, H. J. (1970) · Behavior Therapy · doi:10.1016/s0005-7894(70)80039-9 · Cited by 1,368 · see citing works
A modern learning theory perspective on the etiology of panic disorder.
Bouton, M. E., Mineka, S., & Barlow, D. H. (2001) · Psychological Review · doi:10.1037/0033-295x.108.1.4 · Cited by 1,017 · see citing works
Sharp, W. G., Berry, R. C., McCracken, C., Nuhu, N. N., Marvel, E., Saulnier, C. A., Klin, A., Jones, W., & Jaquess, D. L. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1771-5 · Cited by 643 · cited 1× · see citing works
“In support of this hypothesis, painful or unpleasant somatic sensations are common in children with ARFID (Cooney, Lieberman, Guimond, & Katzman, 2018; Sharp et al., 2013).”
Cannon, W. B. (1915) · doi:10.1037/10013-000 · Cited by 621 · see citing works
Thomas, J. J., Lawson, E. A., Micali, N., Misra, M., Deckersbach, T., & Eddy, K. T. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0795-5 · Cited by 380 · cited 2× · see citing works
“Emerging research suggests that within ARFID there are diverse manifestations (e.g., sensory aversions) indexing a different pathophysiology and requiring distinct treatments (Thomas et al., 2017).”
Craske, M. G., Wolitzky-Taylor, K. B., Labus, J., Wu, S., Frese, M., Mayer, E. A., & Naliboff, B. D. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.04.001 · Cited by 243 · cited 1× · see citing works
“If sensations of hunger predict aversive sensations of fullness, then the neutral sensation of hunger can be classically conditioned to be experienced as aversive, increasing the chances of avoidance (see also Craske et al., 2011).”
Self-citationMaximizing exposure therapy An inhibitory learning approach
Pittig, A., Stevens, S., Vervliet, B., Treanor, M., Conway, C., Zbozinek, T. D., & Craske, M. G. (2015) · Kölner Universitäts PublikationsServer (Universität zu Köln) · Cited by 182 · see citing works
Self-citationCooney, M., Lieberman, M., Guimond, T., & Katzman, D. K. (2018) · Journal of Eating Disorders · doi:10.1186/s40337-018-0193-3 · Cited by 133 · see citing works
What do we really know about newborn infant pain?
Fitzgerald, M. (2015) · Experimental Physiology · doi:10.1113/ep085134 · Cited by 120 · cited 1× · see citing works
“This case raises intriguing questions about the experience and impact of early nociceptive pain on the strength of visceral memories and subsequent aversive conditioning (Fitzgerald, 2015; Kassab, Hamadneh, Nuseir, B, & Hamadneh, 2018).”
Sharp, W. G., Stubbs, K. H., Adams, H., Wells, B. M., Lesack, R. S., Criado, K. K., Simon, E. L., McCracken, C. E., West, L. L., & Scahill, L. D. (2016) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001043 · Cited by 102 · cited 1× · see citing works
“For example, in a pilot treatment study for children with ARFID, 60% had gastroesophogeal reflux, a condition whereby pain follows eating (Sharp et al., 2016).”
Bodily maps of emotions across child development
Hietanen, J. K., Glerean, E., Hari, R., & Nummenmaa, L. (2016) · Developmental Science · doi:10.1111/desc.12389 · Cited by 81 · see citing works
MANLEY, G., & KENT, P. W. (1964) · BMJ · doi:10.1136/bmj.1.5381.451 · Cited by 70 · see citing works
Mirtazapine and Weight Gain in Avoidant and Restrictive Food Intake Disorder
Gray, E., Chen, T., Menzel, J., Schwartz, T., & Kaye, W. H. (2018) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.01.011 · Cited by 67 · see citing works
Acceptance-based interoceptive exposure for young children with functional abdominal pain
Zucker, N., Mauro, C., Craske, M., Wagner, H. R., Datta, N., Hopkins, H., Caldwell, K., Kiridly, A., Marsan, S., Maslow, G., et al. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.07.009 · Cited by 47 · cited 3× · see citing works
“…FBI treatment established changes in negative affect, distress about somatic sensations, and pain with results of medium to large statistical and clinical effect in 24 children with functional abdominal pain (Zucker et al., 2017), with 12% meeting criteria for ARFID in a retrospective analysis.”
Self-citationFactors Associated With Infant Pain Severity Undergoing Immunization Injections
Kassab, M. I., Hamadneh, S., Nuseir, K. Q., et al. (2018) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2018.04.002 · Cited by 16 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Avoidant/restrictive food intake disorder: A systematic scoping review of the current literature
Bourne, L., Bryant‐Waugh, R., Cook, J. M., & Mandy, W. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112961 · Cited by 171 · see citing works
Thomas, J. J., Becker, K. R., Kuhnle, M. C., Jo, J. H., Harshman, S. G., Wons, O. B., Keshishian, A. C., Hauser, K., Breithaupt, L., Liebman, R. E., et al. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23355 · Cited by 146 · see citing works
“A growing number of reports have highlighted the potential application of cognitive-behavioral (Gormez et al., 2018; Steen et al., 2018; Zucker et al., 2019), family-based (Eckhardt et al.”
BackgroundMurray, H. B., Dreier, M. J., Zickgraf, H. F., Becker, K. R., Breithaupt, L. E., Eddy, K. T., & Thomas, J. J. (2021) · International Journal of Eating Disorders · doi:10.1002/eat.23520 · Cited by 146 · see citing works
“For example, interoceptive exposure can be an effective tool that may facilitate increased volume intake for ARFID lack of interest (Thomas & Eddy, 2019; Zucker et al., 2019) and behavioral exposures (mostly with food stimuli) is the core treatment technique for ARFID fear of aversive consequences (Thomas & Eddy, 2019…”
BackgroundMethodInfluentialSchaumberg, K., Reilly, E. E., Gorrell, S., Levinson, C. A., Farrell, N. R., Brown, T. A., Smith, K. M., Schaefer, L. M., Essayli, J. H., Haynos, A. F., et al. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101952 · Cited by 121 · see citing works
“In addition to considerations related to timing, it may be the case that shifting to an acceptance- and tolerability-based exposure framework will be a useful approach for feared outcomes that are highly likely (or expected) to occur (Linde et al., 2015; Merwin et al., 2013; Zucker et al., 2019).”
BackgroundEddy, K. T., Harshman, S. G., Becker, K. R., Bern, E., Bryant‐Waugh, R., Hilbert, A., Katzman, D. K., Lawson, E. A., Manzo, L. D., Menzel, J., et al. (2019) · International Journal of Eating Disorders · doi:10.1002/eat.23042 · Cited by 100 · see citing works
Self-citationGastrointestinal Interoception in Eating Disorders: Charting a New Path
Khalsa, S. S., Berner, L. A., & Anderson, L. M. (2022) · Current Psychiatry Reports · doi:10.1007/s11920-022-01318-3 · Cited by 100 · see citing works
“For example, emerging evidence suggests that interoceptive exposure techniques targeting the gastrointestinal interoceptive cues (e.g., fullness, bloating) triggering anxiety and aversive states may attenuate symptom severity in adults and adolescents with eating disorders [148, 149, 150•].”
Smith, R. S., Feinstein, J. S., Kuplicki, R., Forthman, K. L., Stewart, J. L., Paulus, M. P., Tulsa 1000 Investigators, Aupperle, R. L., Bodurka, J., Savitz, J. B., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-81307-3 · Cited by 82 · see citing works
Evidence Based Update on Psychosocial Treatments for Eating Disorders in Children and Adolescents
Datta, N., Matheson, B. E., Citron, K. E., Wye, E. M. V., & Lock, J. (2022) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2022.2109650 · Cited by 77 · see citing works
Self-citationShimshoni, Y., Silverman, W. K., & Lebowitz, E. R. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23341 · Cited by 79 · see citing works
“These include elevated levels of anxiety and avoidance (Fisher et al., 2014; Norris et al., 2014; Pallister & Waller, 2008; Zucker et al., 2019) and family accommodation (Brigham, Manzo, Eddy, & Thomas, 2018; Eddy et al.”
BackgroundMethodNeophobia—A Natural Developmental Stage or Feeding Difficulties for Children?
Białek-Dratwa, A., Szczepańska, E., Szymańska, D., Grajek, M. K., Krupa-Kotara, K. H., & Kowalski, O. (2022) · Nutrients · doi:10.3390/nu14071521 · Cited by 68 · see citing works
Assessment and Treatment of Avoidant/Restrictive Food Intake Disorder
Kambanis, P. E., & Thomas, J. J. (2023) · Current Psychiatry Reports · doi:10.1007/s11920-022-01404-6 · Cited by 65 · see citing works
Heim, N., Bobou, M., Tanzer, M., Jenkinson, P. M., Steinert, C., & Fotopoulou, A. (2023) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13576 · Cited by 61 · see citing works
ARFID—Strategies for Dietary Management in Children
Białek-Dratwa, A., Szymańska, D., Grajek, M. K., Krupa-Kotara, K. H., Szczepańska, E., & Kowalski, O. (2022) · Nutrients · doi:10.3390/nu14091739 · Cited by 59 · see citing works
Weeks, I., Abber, S. R., Thomas, J. J., Calabrese, S., Kuo, B., Staller, K. D., & Murray, H. B. (2023) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000001853 · Cited by 48 · see citing works
Zucker, N. L., & Bulik, C. M. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23255 · Cited by 48 · see citing works
“Finally, developing interventions that aid individuals in interoceptive re-mapping may hold promise in helping patients develop more accurate cartography of their internal sensations, their meaning, and their threat (Craske et al., 2011; Plasencia, Sysko, Fink, & Hildebrandt, 2019; Zucker et al., 2017; Zucker et al.,…”
BackgroundSelf-citationNicholas, J. K., van Tilburg, M. A. L., Pilato, I. B., Erwin, S., Rivera‐Cancel, A. M., Ives, L. T., Marcus, M. D., & Zucker, N. L. (2021) · International Journal of Eating Disorders · doi:10.1002/eat.23536 · Cited by 44 · see citing works
“Visceral hypersensitivity, sensitivity to changes in the state of visceral organs (Tait & Sayuk, 2021), has been hypothesized to be elevated in ARFID (Zucker et al., 2019).”
BackgroundSelf-citationClassification of Children and Adolescents With Avoidant/Restrictive Food Intake Disorder
Katzman, D. K., Guimond, T. H., Spettigue, W. J., Agostino, H., Couturier, J. L., & Norris, M. L. (2022) · PEDIATRICS · doi:10.1542/peds.2022-057494 · Cited by 45 · see citing works
Eckhardt, S., Martell, C., Lowe, K. D., Grange, D. L., & Ehrenreich, J. T. (2019) · Journal of Eating Disorders · doi:10.1186/s40337-019-0267-x · Cited by 38 · see citing works
Lapidus, R. C., Puhl, M., Kuplicki, R., Stewart, J. L., Paulus, M. P., Rhudy, J. L., Feinstein, J. S., Khalsa, S. S., & on behalf of the Tulsa 1000 Investigators (2020) · PLoS ONE · doi:10.1371/journal.pone.0235346 · Cited by 28 · see citing works
“…we suspect that targeting heightened affective reactivity to the perturbation of interoceptive signals through interventions such as interoceptive exposure (as is being increasingly suggested [78, 79]) might help individuals with EDs to increase the perceived tolerance of discomforting body states.”
Bryant‐Waugh, R., Loomes, R., Munuve, A., & Rhind, C. (2021) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2020.11.001 · Cited by 29 · see citing works
Nitsch, A., Knopf, E., Manwaring, J. L., & Mehler, P. S. (2021) · Current Pediatrics Reports · doi:10.1007/s40124-021-00239-8 · Cited by 25 · see citing works
Validating the visceral sensitivity index in an eating disorder sample
Brown, T. A., Reilly, E. E., Murray, H. B., Perry, T. R., Kaye, W. H., & Wierenga, C. E. (2021) · International Journal of Eating Disorders · doi:10.1002/eat.23471 · Cited by 24 · see citing works
“…such as interoceptive exposure for EDs (Boswell et al., 2019; Boswell, Anderson, & Anderson, 2015; Hildebrandt, Bacow, Greif, & Flores, 2014; Zucker et al., 2019), which involve GI-specific exposures such as gulping water and pushing the stomach out (Boswell et al., 2015), the VSI may be a…”
de la Cruz, F., Teed, A. R., Lapidus, R. C., Upshaw, V., Schumann, A., Paulus, M. P., Bär, K., & Khalsa, S. S. (2022) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2022.12.009 · Cited by 17 · see citing works
Noel, R. J. (2023) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000001267 · Cited by 17 · see citing works
“’’ This program utilizes cartoons to expand access of CBT concepts to younger children and has been successful in the treatment of ARFID [39].”
MethodThe peril and promise of sensitivity in eating disorders
Sim, L. A., & Peterson, C. B. (2021) · International Journal of Eating Disorders · doi:10.1002/eat.23606 · Cited by 17 · see citing works
New directions in research on somatic concerns in individuals with eating disorders
Cusack, C. E., Ralph‐Nearman, C., Nicholas, J. K., & Levinson, C. A. (2022) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2022.100937 · Cited by 17 · see citing works
Datta, N., & Lock, J. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00914-9 · Cited by 17 · see citing works
“Thus, it is possible that disruptions in interoception may be a transdiagnostic feature of restrictive eating [21, 25].”
BackgroundSelf-citationShimshoni, Y., & Lebowitz, E. R. (2020) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-20-00009 · Cited by 16 · see citing works
“…elevated levels and anxiety and avoidance behaviors (Fisher et al., 2014; Norris et al., 2014; Pallister & Waller, 2008; Swinbourne & Touyz, 2007; Zucker et al., 2019) and the presence of family accommodation (Brigham, Manzo, Eddy, & Thomas, 2018; Eddy et al., 2019; Zickgraf, Murray, et al.,…”
BackgroundInfluentialDolman, L. I., Thornley, S., Doxtdator, K., Leclerc, A., Findlay, S. M., Grant, C., Breakey, V. R., & Couturier, J. L. (2020) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104520981401 · Cited by 16 · see citing works
“…age of onset, with a limited number of prior studies describing ARFID onset in infancy (Lock et al., 2019; Pitt & Middleman, 2018; Reilly et al., 2019; Rienecke et al., 2020; Zucker et al., 2019), as well as the lack of an identifiable triggering event or association with Autism Spectrum Disorder.”
BackgroundEddy, K. T., & Thomas, J. J. (2019) · International Journal of Eating Disorders · doi:10.1002/eat.23052 · Cited by 15 · see citing works
Cara, M. D., Rizzo, C., Corallo, F., Cardile, D., Calabrò, R. S., Quartarone, A., Buda, M., & Cucinotta, F. (2023) · Children · doi:10.3390/children10081297 · Cited by 13 · see citing works
“Treatment moves both on a cognitive level (with cognitive analysis and restructuring) and on a behavioral level (with behavioral prescriptions [25,26,28,52,53].”
BackgroundMethodInfluentialHoward, M., Hembry, P., Rhind, C., Siddall, A., Uddin, M. F., & Bryant‐Waugh, R. (2023) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x22000629 · Cited by 13 · see citing works
Exploring the role of disgust sensitivity and propensity in selective eating
Brown, T. A., Menzel, J. E., Reilly, E. E., Luo, T. J., & Zickgraf, H. F. (2022) · Appetite · doi:10.1016/j.appet.2022.106018 · Cited by 12 · see citing works
Zickgraf, H. F., & Schwartz, R. A. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104677 · Cited by 10 · see citing works
Stein, K., Warne, N., Heron, J., Zucker, N. L., & Bould, H. (2021) · International Journal of Eating Disorders · doi:10.1002/eat.23513 · Cited by 13 · see citing works
Self-citationSharpe, S. L. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01073-1 · Cited by 12 · see citing works
“Given existing evidence that traumatic experiences involving food, pain, and/or medical procedures can precipitate ARFID development [9, 46, 51, 53, 56], it is possible that such experiences may produce long-lasting avoidance, aversion [53], or lack of interest in food for certain individuals.”
BackgroundSchneider, E., Schmidt, R., Cryan, J. F., & Hilbert, A. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24326 · Cited by 11 · see citing works
Bohrer, B. K., Chen, Y., Christensen, K. A., Forbush, K. T., Thomeczek, M. L., Richson, B. N., Chapa, D. A. N., Jarmolowicz, D. P., Gould, S. R., Negi, S., et al. (2023) · International Journal of Eating Disorders · doi:10.1002/eat.23987 · Cited by 11 · see citing works
Breiner, C. E., Miller, M. L., & Hormes, J. M. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24269 · Cited by 9 · see citing works
Advancing the Science of Avoidant/Restrictive Food Intake Disorder ( ARFID ): Six Key Questions
Kambanis, P. E., & Thomas, J. J. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24418 · Cited by 9 · see citing works
Pediatric hospital utilization for patients with avoidant restrictive food intake disorder
Milliren, C. E., Crowley, M., Carmody, J. K., Bern, E. M., Eldredge, O., & Richmond, T. K. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-00996-z · Cited by 10 · see citing works
Avoidant/Restrictive Food Intake Disorder: Review and Recent Advances
Menzel, J. E., & Perry, T. R. (2024) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20240008 · Cited by 10 · see citing works
Avoidant/restrictive food intake disorder (ARFID) in New Zealand and Australia: a scoping review
Kennedy, H., Hitchman, L. M., Pettie, M. A., Bulik, C. M., & Jordan, J. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00922-9 · Cited by 8 · see citing works
Smith, R. S., Feinstein, J. S., Kuplicki, R., et al. (2020) · doi:10.31234/osf.io/9h327 · Cited by 8 · see citing works
Avoidant/Restrictive Food Intake Disorder (ARFID): Review of Case Studies
Medina‐Tepal, K. A., Arévalo, R. V., Trujillo, E., & Díaz, J. M. M. (2023) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.22201/fesi.20071523e.2023.1.748 · Cited by 7 · see citing works
Gianneschi, J. R., Washington, K. A., Nicholas, J. K., Pilato, I. B., LeMay‐Russell, S., Rivera‐Cancel, A. M., Mines, E., Jackson, J. E., Marsan, S., Lachman, S. E., et al. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24303 · Cited by 8 · see citing works
Self-citationThe Persistence of Picky Eating: Opportunities to Improve Our Strategies and Messaging
Zucker, N. L., & Hughes, S. O. (2020) · PEDIATRICS · doi:10.1542/peds.2020-0893 · Cited by 7 · see citing works
Self-citationMatheson, B. E., Datta, N., Wye, E. M. V., Yang, H., & Lock, J. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24273 · Cited by 6 · see citing works
Self-citationDatta, N., Matheson, B. E., Walker, A. C., Wye, E. M. V., & Lock, J. (2023) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045231169141 · Cited by 7 · see citing works
“, 2020), and interoceptive-based exposure treatments (Zucker et al., 2019).”
Self-citationMultidisciplinary Treatment of Avoidant/Restrictive Food Intake Disorder
Winten, C. G., Strodl, E. S., & ROSS, L. J. (2024) · Psychiatric Annals · doi:10.3928/00485713-20240119-01 · Cited by 6 · see citing works
Mind–body treatments for children with functional gastrointestinal disorders
Stein, K., Howarth, L. J., & Zucker, N. L. (2025) · BJPsych Advances · doi:10.1192/bja.2024.76 · Cited by 5 · see citing works
Self-citationYoung, M. A., Boerner, K. E., Marshall, S. K., Dhariwal, A. K., & Coelho, J. S. (2024) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2024.01.002 · Cited by 5 · see citing works
Breiner, C. E., Miller, M. L., & Hormes, J. M. (2024) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2024.04.004 · Cited by 5 · see citing works
Nederkoorn, C., van den Heuvel, E., van den Brand, A. J. P., Swart, N., Schreuder, C., & Hendriks-Hartensveld, A. E. M. (2024) · Appetite · doi:10.1016/j.appet.2024.107767 · Cited by 5 · see citing works
Sikora, D. (2022) · Psychoterapia · doi:10.12740/pt/141443 · Cited by 5 · see citing works
Richson, B. N., DeVille, D. C., Wierenga, C. E., Kaye, W. H., & Ramirez, A. L. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-00972-7 · Cited by 5 · see citing works
“This approach is similar to the Feeling and Body Investigators (FBI) [35, 36] approach, for example, in which interoceptive sensitivity is harnessed to promote more adaptive engagement with bodily sensations (including acceptance and interoceptive exposures).”
Optimizing treatment environments for trait sensitivity in eating disorders
Peterson, C. B., Weber, E., & Sim, L. A. (2024) · Eating Disorders · doi:10.1080/10640266.2024.2306429 · Cited by 4 · see citing works
“According to Zucker et al. (2019, targeted treatment options include in vivo exposure to avoided body parts and sensory experiences including tight fitting clothing and interoceptive stimuli (e.g., increased heart rate).”
BackgroundMethodAvoidant/Restrictive Food Intake Disorder (ARFID) in Adults
Todisco, P. (2021) · Springer eBooks · doi:10.1007/978-3-030-81174-7_10 · Cited by 4 · see citing works
Perceptual Dysfunction in Eating Disorders
Reilly, E. E., Brown, T. A., & Frank, G. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_470 · Cited by 3 · see citing works
Karvay, Y. (2025) · European Eating Disorders Review · doi:10.1002/erv.3180 · Cited by 4 · see citing works
Miles, S., Phillipou, A., Neill, E., Newbigin, A., Kim, H. W., Eddy, K. T., & Thomas, J. J. (2024) · Contemporary Clinical Trials · doi:10.1016/j.cct.2024.107756 · Cited by 2 · see citing works
Mack, R. A., & Stanton, C. E. (2025) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2025.2475306 · Cited by 2 · see citing works
“…hypersensitivity). inpatient, partial, & Outpatient interoception (Becker et al., 2020; Białek-Dratwa et al., 2022; Khalsa et al., 2022; nicholas et al., 2021; Schmitt et al., 2024; Zucker et al., 2019) refers to the communication that occurs between one’s internal organs via internal sensations.”
Interoception in Eating Disorders
Choquette, E. M., & Khalsa, S. S. (2025) · doi:10.1093/9780197675212.003.0009 · Cited by 3 · see citing works
Avoidant/Restrictive Food Intake Disorder: Comorbidities and Longitudinal Course
Kambanis, P. E., Rozzell‐Voss, K. N., Lawson, E. A., Thomas, J. J., & Eddy, K. T. (2023) · Springer eBooks · doi:10.1007/978-3-030-97416-9_91-1 · Cited by 2 · see citing works
Avoidant Restrictive Food Intake Disorder in Pediatric Liver Transplant Patients
Crest, P., Stacey, P., Accurso, E. C., et al. (2024) · Pediatric Transplantation · doi:10.1111/petr.70014 · Cited by 1 · see citing works
Bhadra, K., Janakiram, A. A., Marco, S., Micali, N., Hüppi, P. S., & Berchio, C. (2025) · Brain Topography · doi:10.1007/s10548-025-01149-4 · Cited by 1 · see citing works
“This imbalance between internal and external control, potentially present even at rest, could lead some individuals with ARFID to avoid food in order to prevent experiencing certain internal sensations (Zucker et al. 2019).”
Kambanis, P. E., Cai, K., Thomas, J. J., Eddy, K. T., Freestone, D. M., Baker, J. H., Menzel, J. E., & Boucher, E. M. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70098 · Cited by 1 · see citing works
Kipping, M., Schulz, A., & Pollatos, O. (2026) · Scientific Reports · doi:10.1038/s41598-026-48641-w · Cited by 2 · see citing works
“Approaches being explored in this area include interoceptive exposure adopted for eating disorders 126–128 , intuitive eating programs 129, 130 , and vagus nerve stimulation 131–134 .”
Lukens, C. T., Dempster, R. M., Eddy, K. T., Estrem, H., Menzel, J. E., Noel, R. J., Pederson, J. L., Ramirez, A. L., Romeo, C., Sharp, W. G., et al. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70101 · Cited by 1 · see citing works
Self-citationAvoidant/Restrictive Food Intake Disorder
Menzel, J. E., & Luo, T. J. (2021) · Springer eBooks · doi:10.1007/978-3-030-67127-3_6 · Cited by 1 · see citing works
Avoidant/Restrictive Food Intake Disorder in Children
Shimshoni, Y., & Lebowitz, E. R. (2022) · Springer eBooks · doi:10.1007/978-3-030-67929-3_74-1 · Cited by 1 · see citing works
Risk Factors Related to Eating Disorders in a Romanian Children Population
Ciurez, B.-T., Cobilinschi, O.-C., Luca, A.-R., Ţincu, I. F., & Pleşca, D. A. (2023) · Nutrients · doi:10.3390/nu15132831 · Cited by 1 · see citing works
“Children were provided frameworks whereby they could perceive food sensations with curiosity but not with fear, in order to achieve food tolerance, and the focus is on describing the food’s texture and visual perception [17].”
BackgroundCognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR)
Kambanis, P. E., Breithaupt, L. E., Zayas, L. V., Eddy, K. T., & Thomas, J. J. (2023) · Current clinical psychiatry · doi:10.1007/978-3-031-29368-9_17 · Cited by 2 · see citing works
Avoidant restrictive food intake disorder (ARFID) in children and adolescents
Kapphahn, C. J., & Rosania, K. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818872-9.00017-0
Avoidant/Restrictive Food Intake Disorder in Children
Shimshoni, Y., & Lebowitz, E. R. (2023) · Springer eBooks · doi:10.1007/978-3-031-16691-4_74
Mulkens, S., Neimeijer, R. A. M., Dumont, E. L. M., & Kroes, D. (2024) · doi:10.1007/978-90-368-3033-1_1
Avoidant/Restrictive Food Intake Disorder: Comorbidities and Longitudinal Course
Kambanis, P. E., Rozzell‐Voss, K. N., Lawson, E. A., Thomas, J. J., & Eddy, K. T. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_91
Zucker, N. L. (2025) · doi:10.1093/9780197675212.003.0021
Self-citationRichson, B. N., Breiner, C. E., & Zickgraf, H. F. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.08.002
More than Picky Eaters: What is Avoidant/Restrictive Food Intake Disorder?
Miller, M. G. B., Clancy, O. M., Lusich, R., et al. (2025) · Frontiers for Young Minds · doi:10.3389/frym.2025.1494899
“Approaching these behaviors with curiosity, rather than fear, can help a person with ARFID feel safer in their body [5].”
Psychological Assessment and Treatment
Derenne, J. L. (2025) · Springer eBooks · doi:10.1007/978-3-031-92232-9_2
Pizzoli, S. F. M., & Rabarbari, E. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-36741-0.00004-8
Avoidant/Restrictive Food Intake Disorder: A Narrative Review
Eddy, K. T., Holsen, L. M., Lawson, E. A., et al. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70197
Ilg, J., Merz, A.-K., Kramer, L., Nettlau, A., Hilbert, A., & Schmidt, R. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-026-01765-w
“Incorporating acceptance-based strategies [75] to deal with one’s own eating behaviors due to longstanding sensory sensitivities and lack of interest in eating may be valuable [76, 77], alongside cognitive-behavioral treatment emphasizing, for example, food exposure [5, 78–80].”
Developing interoception: From caregiving to clinical outcomes
Tünte, M. R., Rapp, L., Villegas, C., Ilan, N. B., Fotopoulou, A., Manos Tsakiris, A., Hoehl, S., & Pollatos, O. (2026) · Child Development Perspectives · doi:10.1093/cdpers/aadag020
Pliatsika, C., Vasileiadou, O., Avgerinou, K., Lazi, N., Pergantis, P., Konstantinos, G., Kalogirou, G., Petropoulos, A., Tsigaras, G., & Drigas, A. S. (2026) · Pediatric Reports · doi:10.3390/pediatric18050122
- Authors
- Zucker, N. L., LaVia, M. C., Craske, M. G., Foukal, M., Harris, A. A., Datta, N., Savereide, E., & Maslow, G. R.
- Affiliations
- Duke University (US)
- University of North Carolina at Chapel Hill (US)
- University of California, Los Angeles (US)
- Corresponding author
- Zucker, Nancy L.
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2018-12-31
- Volume
- 52
- Issue
- 4
- Pages
- 466-472
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC6511273
- OpenAlex
- W2908356430
- Cited by
- 88
- References
- 17
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 21 · 2023: 15 · 2022: 11 · 2021: 10 · 2020: 9 · 2019: 3
- FWCI
- 6.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Duke Institute for Brain Sciences, Duke University
- National Institute of Mental Health (R33‐MH‐097959)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- avoidant/restrictive food intake disorder, interoceptive exposure, children, self-regulation, self-awareness, bodily sensations, food avoidance, somatic symptoms, irritable bowel syndrome, panic disorder, developmental sensitivity
- MeSH terms
- Appetite, Feeding and Eating Disorders, Child, Preschool, Emotions, Female, Humans
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
