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. 2025 May;58(5):878-889.
doi: 10.1002/eat.24376. Epub 2025 Feb 7.

Validating Online Parent- and Self-Report Screening Methods for Avoidant/Restrictive Food Intake Disorder

Shelby N Ortiz  1 , Jennifer P White  1 , Casey M MacDermod  1 , Lisa Dinkler  2 , Laura M Thornton  1 , Jessica Johnson  1 , Jerry D Guintivano  1 , Jessica H Baker  3 , Cynthia M Bulik  1   2   4 , Nadia Micali  5   6 , Emily M Pisetsky  1
Affiliations

Validating Online Parent- and Self-Report Screening Methods for Avoidant/Restrictive Food Intake Disorder

Shelby N Ortiz et al. Int J Eat Disord. 2025 May.

Abstract

Objective: Although several assessments have been developed to diagnose or measure avoidant/restrictive food intake disorder (ARFID) symptoms, few studies have validated these tools in nonclinical and adult samples. This study explored the validity of two self- and parent/guardian-report ARFID screening measures in identifying adults and children who may have ARFID within a large community sample.

Method: Fifty participants (divided into two groups: 25 adults and 25 parents/guardians of children) were selected from the ARFID Genes and Environment study, which enrolled over 3000 adults and parents/guardians of children who screened positive for ARFID on either the Pica, ARFID, and Rumination Disorder Interview-ARFID Questionnaire (PARDI-AR-Q) or the Nine Item ARFID Screen (NIAS) self- and parent/guardian-report measures. Participants then completed the ARFID portion of the Pica, ARFID, and Rumination Disorder Interview (PARDI) to determine ARFID diagnosis.

Results: Correlations between the PARDI-AR-Q and PARDI (r = 0.31-0.67) were weaker than the correlations between the NIAS and PARDI (r = 0.53-0.64) in both groups. The diagnostic positive predictive value for the PARDI-AR-Q was numerically higher (adults = 55.0%; parents/guardians = 76.0%) than the NIAS (adults = 45.8%; parents/guardians = 64.0%). Most PARDI-AR-Q dimensions and all NIAS dimensions were significant predictors of their corresponding PARDI dimensions in both groups.

Discussion: The PARDI-AR-Q more accurately identified adults and children with ARFID, whereas the NIAS was a better estimator of ARFID symptoms. These findings provide partial support for using these self- and parent/guardian-report screeners. Results highlight the need to better understand diagnostic presentations of ARFID within community samples, particularly in adults, and to refine these tools within those populations.

Keywords: ARFID; appetite; clinical assessment; eating disorders; fear; picky eating.

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Figures

Figure 1a.
Figure 1a.
The number of adult participants who did and did not meet PARDI-AR-Q and PARDI Interview criteria. The specific criteria of the PARDI that were not met are listed for those who did not meet ARFID diagnostic criteria.
Figure 1b.
Figure 1b.
The number of children who did and did not meet on parent/guardian reported PARDI-AR-Q and PARDI Interview criteria. The specific criteria of the PARDI that were not met are listed for those who did not meet ARFID diagnostic criteria.
See this image and copyright information in PMC

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