TESTED QUESTIONS WITH RATIONALE
◉ increased risk for ARFID. Answer: -Children with mental health
conditions including:
• anxiety disorders
• OCD
• autism spectrum disorder
• ADHD
• intellectual disabilities
-presence of a maternal eating disorder
-Hx of:
• GERD
• vomiting
• other medical problems
◉ Avoidant/restrictive food intake disorder (ARFID) DSM-5-TR dx.
Answer: requires each of the following:
-an eating or feeding disturbance that is not due to a food shortage
or cultural practice and is associated with one or more of the
following:
• significant weight loss
,• significant nutritional deficiency
• dependence on enteral feeding or oral nutritional supplements
• impaired psychosocial functioning
-does not occur exclusively during the course of anorexia nervosa or
bulimia nervosa, and is not attributable to a concurrent medical
condition or mental disorder.
◉ Lillian is a 9-year-old who presents with her mother after a
referral from the pediatrician. Lillian is 54 inches tall and currently
weighs 55 pounds (lbs). As a toddler, Lillian ate most of the foods
offered to her. When she was 6, she witnessed her grandmother
choke on a piece of meat and receive the Heimlich maneuver; her
grandmother survived, but since then, Lillian refused to eat meat.
Over the past three years, her eating has become more restricted;
she will no longer eat anything that requires chewing. Her mother
has been offering soups, purees, and nutritional supplements, but
Lillian has failed to gain weight as she grows taller. Lillian endorses
that she is frequently bullied at school for her refusal to eat at lunch
and during classroom parties.
Does Lillian meet the diagnostic criteria for ARFID?
yes
no
unable to determine. Answer: Yes
, Rationale: Lillian meets the diagnostic criteria for ARFID. She
presents with avoidance of eating food based on the sensory
characteristics of the food and failure to meet expected weight gain
appropriate for age and height. The behavior interferes with her
psychosocial functioning and is not better explained by cultural
practice, lack of available food, or anorexia nervosa.
◉ David is a 14-year-old who presents with his mother who voices
concerns about his behavior. David is 65 inches tall and weighs 102
lbs.
David has been active in competitive wrestling since age 9 and
dreams of joining the U.S. Olympic team. Since starting high school,
David has become preoccupied with his body shape and body fat
percentage. He constantly worries about "making weight" for
wrestling meets. Rather than eating lunch at school, he goes to the
weight room to exercise. David's mom endorses that when he gets
home from wrestling practice, he eats "huge amounts" of food.
Typically, David will eat an entire frozen pizza before dinner and
then have second helpings during the family meal. He eats dessert
and then "disappears" into the bathroom immediately following
dinner. David's parents became concerned after hearing retching
sounds in the bathroom. Upon interview, David admits that when he
start. Answer: bulimia nervosa
Rationale: David meets the diagnostic criteria for bulimia nervosa.
He eats excessive amounts of food in a discrete period and has a loss
of sense of control over his eating. After bingeing, he purges and