Predictors of Outcome in Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder

Objective: Cognitive-behavioral therapy for avoidant/restrictive food intake disorder (ARFID; CBT-AR) shows promise in improving clinical outcomes in children/adolescents and adults. We aimed to identify predictors of outcomes in CBT-AR. We hypothesized that younger age, non-underweight status, and presence of the fear of aversive consequences profile of ARFID would predict greater likelihood of remission post-treatment, and that presence of the lack of interest in eating/food and sensory sensitivity profiles would predict greater likelihood of persistence post-treatment. We included sex as an exploratory predictor.

Method: Individuals (N = 94, ages 10-55 years) were offered 20-30 outpatient sessions of CBT-AR. We collected clinical and demographic data at pre-treatment, and remission status at post-treatment.

Results: Consistent with our hypothesis, presence (versus absence) of the fear profile predicted an almost three-fold increased likelihood of remission. Presence of the sensory profile, lack of interest profile, age, weight status, and sex were not predictors of ARFID outcome.

Discussion: The fear of aversive consequences profile of ARFID may be more amenable to treatment with CBT-AR. This is the first study to identify predictors of treatment outcome following CBT-AR. Randomized controlled trials are needed to confirm these findings and examine moderators.