Category: Eating Disorders
Keywords: Eating Disorders | ERP (Exposure and Response Prevention) | Child
Presentation Type: Symposium
Exposure and response prevention (ERP) is effective in treating fear and anxiety in a variety of contexts. Patients with avoidant restrictive food intake disorder (ARFID) present with restricted nutritional intake without body image distortion or fear of weight gain. Like other manifestations of anxiety, avoidance of perceived harm is a key element of the disorder. Patients with ARFID avoid eating foods that they fear will harm them (e.g., cause vomiting, choking, illness or disgust) resulting in malnourishment and/or low weight. In the current study, a heterogeneous group of 80 children and adolescents with ARFID were treated at a family-centered partial hospital program using cognitive behavior therapy with ERP. The treatment protocol consisted of examining and challenging beliefs that led to food avoidance and instructing on anxiety-reduction techniques. An individualized list of easy, medium, and hard foods for graded exposures was also developed for each patient. Exposure sessions were applied in the treatment setting and then generalized to the home environment. Both positive and negative reinforcers were used to increase compliance with exposure targets. Comparisons of data at intake and discharge indicated statistically significant (p < .01) improvements in weight and the number of foods eaten, as well as significant reductions in anxiety and eating disorder psychopathology. This treatment study provides evidence that a protocol utilizing ERP at a partial hospital level of care contributed to positive treatment outcomes. Limitations of this study include its retrospective nature and the absence of a control condition, preventing conclusions about the specific efficacy of ERP as a treatment element. Further study of this treatment protocol for ARFID under more controlled conditions and at different levels of care is warranted.
Pennsylvania State University Milton S. Hershey Medical Center
Saturday, November 18
8:30 AM – 10:00 AM
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