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Thesis
Gastrointestinal symptoms and disorders of gut-brain interaction (DGBIs) in adults with avoidant/restrictive food intake disorder (ARFID)
Master of Science (M.S.), Drexel University
Jun 2025
DOI:
https://doi.org/10.17918/00011049
Abstract
Avoidant/Restrictive Food Intake Disorder (ARFID) is the extreme avoidance and/or restriction in dietary intake motivated by (1) low interest/appetite in food, (2) sensory sensitivity, and/or (3) fear of aversive consequences related to eating. These motivators of avoidance/restriction are known as the ARFID dimensions. Although these dimensions are theorized to have distinct etiologies, few studies have explored these differences. One possible etiological difference may be related to gastrointestinal (GI) symptoms. The current study is a large-scale investigation (N = 1073) study of GI symptoms in adults with ARFID. We used the following measures: Nine-Item ARFID Screen (NIAS) to assess ARFID dimensions, the Gastrointestinal Symptom Questionnaire (GISQ) to assess presence of GI symptoms and DGBIs, the Generalized Anxiety Disorder Assessment (GAD-7) to assess anxiety, the Patient Health Questionnaire (PHQ-9) to assess depression, and self-reported body mass index (BMI). A total of 25 generalized linear models (GLZM) were applied for each dimension (n=3) on all outcomes (18 GI symptoms, 1 GI total score, 6 disorders of gut brain interaction), resulting in 75 models. Covariates in the GLZMs were as follows: depression, anxiety, and BMI for lack of interest/low appetite models; BMI for sensory sensitivity models; and anxiety and depression for fear of aversive consequences models. We corrected p-values for multiple testing using the False Discovery Rate. We then conducted a latent class analysis (LCA) with split-half validation to assess latent classes of participants using the presence of the 18 individual GI symptoms as the indicator variables. Findings reveal distinct patterns between GI symptoms and ARFID dimensions. Upper GI track symptoms were associated with higher lack of interest/low appetite symptoms, whereas the absence of GI symptoms were associated with higher sensory sensitivity symptoms, and all GI symptoms were associated with greater fear of aversive consequences symptoms. Overwhelmingly, results support meaningful differences in how GI symptoms relate to each ARFID dimension.
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Details
- Title
- Gastrointestinal symptoms and disorders of gut-brain interaction (DGBIs) in adults with avoidant/restrictive food intake disorder (ARFID)
- Creators
- Laura Grace Rubino
- Contributors
- Stephanie M. Manasse (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Master of Science (M.S.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- ix, 54 pages
- Resource Type
- Thesis
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991022058734004721