Development of the Pica, ARFID, and Rumination Disorder Interview, a Multi-Informant, Semi-Structured Interview of Feeding Disorders Across the Lifespan: A Pilot Study for Ages 10-22

Int J Eat Disord. 2019 Apr;52(4):378-387. doi: 10.1002/eat.22958. Epub 2018 Oct 12.

Abstract

Objective: Avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder (RD) were added to the revised DSM-5 Feeding and Eating Disorders chapter in 2013. We developed a structured interview-the Pica, ARFID, and Rumination Disorder Interview (PARDI)-to assess the presence and severity of these diagnoses for evaluation and treatment planning in clinical and research settings. Here, we describe the development of the PARDI and provide a preliminary report on feasibility, acceptability, reliability, and validity in relation to ARFID.

Method: We created an initial item pool from existing measures of similar constructs and clinical experience. The PARDI includes items assessing the level of endorsement and overall severity of common ARFID features organized into profiles (i.e., sensory sensitivity, lack of interest in eating, and fear of aversive consequences) and algorithms for diagnosing ARFID, pica, and RD. We collected initial psychometric data from participants (10-22 years) with ARFID (n = 39), clinically significant avoidant/restrictive eating (n = 8), and healthy controls (n = 10).

Results: On average, the PARDI took 39 min to complete and was acceptable to participants. All subscales achieved internal consistency greater ≥0.77, and inter-rater reliability for the ARFID diagnosis was moderate (κ = 0.75). Individuals with ARFID scored significantly higher than healthy controls on ARFID severity and ARFID profiles.

Discussion: The PARDI appears acceptable to respondents and preliminary evidence of reliability and validity has been demonstrated in an initial sample. Larger-scale validation studies are currently underway. The PARDI is freely available to clinicians and researchers.

Keywords: ARFID; assessment; avoidant/restrictive food intake disorder; clinical interview; pica; rumination disorder.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Feeding and Eating Disorders of Childhood / psychology*
  • Feeding and Eating Disorders of Childhood / therapy
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Pica / psychology*
  • Pilot Projects
  • Reproducibility of Results
  • Young Adult