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回避限制型食物摄入障碍(ARFID)——超越饮食障碍的视角?

Avoidant Restrictive Food Intake Disorder (ARFID)-Looking beyond the eating disorder lens?

机构信息

School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland.

NHS Lothian Child and Adolescent Mental Health Services, Royal Edinburgh Hospital, Edinburgh, Scotland.

出版信息

Eur Eat Disord Rev. 2024 Jul;32(4):824-827. doi: 10.1002/erv.3093. Epub 2024 Apr 2.

Abstract

Avoidant Restrictive Food Intake Disorder (ARFID) was first included as a diagnostic category in 2013, and over the past 10 years has been adopted by the international eating disorder community. While greater awareness of these difficulties has increased identification, demand and enabled advocacy for clinical services, the heterogeneous nature of ARFID poses unique challenges for eating disorder clinicians and researchers. This commentary aims to reflect on some of these challenges, focussing specifically on the risk of viewing ARFID through an eating disorder lens. This includes potential biases in the literature as most recent research has been conducted in specialist child and adolescent eating disorder clinic settings, bringing in to question the generalisability of findings to the broad spectrum of individuals affected by ARFID. We also consider whether viewing ARFID predominantly through an eating disorder lens risks us as a field being blinkered to the range of effective skills our multi-disciplinary feeding colleagues may bring. There are opportunities that may come with the eating disorder field navigating treatment pathways for ARFID, including more joined up working with multi-disciplinary colleagues, the ability to transfer skills used in ARFID treatment to individuals with eating disorder presentations, and most notably an opportunity to provide more effective treatment and service pathways for individuals with ARFID and their families. However, these opportunities will only be realised if eating disorder clinicians and researchers step out of their current silos.

摘要

回避限制型进食障碍(ARFID)于 2013 年首次被纳入诊断类别,在过去的 10 年中,已被国际进食障碍领域所采用。尽管对这些困难的认识提高了识别率、需求,并为临床服务提供了倡导,但 ARFID 的异质性给进食障碍临床医生和研究人员带来了独特的挑战。本评论旨在反思其中的一些挑战,特别是关注通过进食障碍视角看待 ARFID 的问题。这包括文献中存在的潜在偏见,因为最近的研究大多是在专门的儿童和青少年进食障碍诊所进行的,这使得研究结果是否可以推广到受 ARFID 影响的广泛人群中受到质疑。我们还考虑了通过进食障碍视角主要看待 ARFID 是否会使我们作为一个领域对我们多学科喂养同事可能带来的一系列有效技能视而不见。进食障碍领域为 ARFID 探索治疗途径可能会带来一些机会,包括与多学科同事更紧密地合作、将 ARFID 治疗中使用的技能转移到有进食障碍表现的个体身上的能力,以及最重要的是为 ARFID 患者及其家人提供更有效治疗和服务途径的机会。然而,如果进食障碍临床医生和研究人员不能走出目前的孤立状态,这些机会将无法实现。

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