{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:40:15Z","timestamp":1791484815685,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK120945"],"award-info":[{"award-number":["K23 DK120945"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK131334"],"award-info":[{"award-number":["K23 DK131334"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK121003"],"award-info":[{"award-number":["R01 DK121003"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["U01 DK112193"],"award-info":[{"award-number":["U01 DK112193"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K23MH125143"],"award-info":[{"award-number":["K23MH125143"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Avoidant\/restrictive food intake disorder (ARFID) symptoms are common (up to 40%) among adults with disorders of gut\u2010brain interaction (DGBI), but treatments for this population (DGBI + ARFID) have yet to be evaluated. We aimed to identify initial feasibility, acceptability, and clinical effects of an exposure\u2010based cognitive\u2010behavioral treatment (CBT) for adults with DGBI + ARFID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients (<jats:italic>N<\/jats:italic>\u00a0=\u00a014) received CBT as part of routine care in an outpatient gastroenterology clinic. A two\u2010part investigation of the CBT included a retrospective evaluation of patients who were offered a flexible (8\u201310) session length and an observational prospective study of patients who were offered eight sessions. Feasibility benchmarks were \u226575% completion of sessions, quantitative measures (for treatment completers), and qualitative interviews. Acceptability was assessed with a benchmark of \u226570% patients reporting a posttreatment satisfaction scores \u22653 on 1\u20134 scale and with posttreatment qualitative interviews. Mixed model analysis explored signals of improvement in clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All feasibility and acceptability benchmarks were achieved (and qualitative feedback revealed high satisfaction with the treatment and outcomes). There were improvements in clinical outcomes across treatment (all p's\u2009&lt;\u2009.0001) with large effects for ARFID fear (\u221252%; Hedge's <jats:italic>g<\/jats:italic>\u00a0=\u00a01.5; 95% CI\u00a0=\u00a00.6, 2.5) and gastrointestinal\u2010specific anxiety (\u221242%; Hedge's <jats:italic>g<\/jats:italic>\u00a0=\u00a01.0; 95% CI\u00a0=\u00a00.5, 16). Among those who needed to gain weight (<jats:italic>n<\/jats:italic>\u00a0=\u00a010), 94%\u2013103% of expected weight gain goals were achieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Initial development and testing of a brief 8\u2010session CBT protocol for DGBI + ARFID showed high feasibility, acceptability, and promising clinical improvements. Findings will inform an NIH Stage 1B randomized control trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public significance<\/jats:title><jats:p>While cognitive\u2010behavioral treatments (CBTs) for ARFID have been created in outpatient feeding and eating disorder clinics, they have yet to be developed and refined for other clinic settings or populations. In line with the recommendations for behavioral treatment development, we conducted a two\u2010part investigation of an exposure\u2010based CBT for a patient population with high rates of ARFID\u2014adults with disorders of gut\u2013brain interaction (also known as functional gastrointestinal disorders). We found patients had high satisfaction with treatment and there were promising improvements for both gastrointestinal and ARFID outcomes. The refined treatment includes eight sessions delivered by a behavioral health care provider and the findings reported in this article will be studied next in an NIH Stage 1B randomized controlled trial.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23874","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T05:40:33Z","timestamp":1671774033000},"page":"616-627","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Development of a brief cognitive\u2010behavioral treatment for avoidant\/restrictive food intake disorder in the context of disorders of gut\u2013brain interaction: Initial feasibility, acceptability, and clinical outcomes"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2059-3256","authenticated-orcid":false,"given":"Helen","family":"Burton Murray","sequence":"first","affiliation":[{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Center for Neurointestinal Health, Division of Gastroenterology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imani","family":"Weeks","sequence":"additional","affiliation":[{"name":"Center for Neurointestinal Health, Division of Gastroenterology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8946-9977","authenticated-orcid":false,"given":"Kendra R.","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Eating Disorders Clinical and Research Program Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brj\u00e1nn","family":"Lj\u00f3tsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Division of Psychology Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth N.","family":"Madva","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Center for Neurointestinal Health, Division of Gastroenterology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1586-0930","authenticated-orcid":false,"given":"Kamryn T.","family":"Eddy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Eating Disorders Clinical and Research Program Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Staller","sequence":"additional","affiliation":[{"name":"Center for Neurointestinal Health, Division of Gastroenterology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Braden","family":"Kuo","sequence":"additional","affiliation":[{"name":"Center for Neurointestinal Health, Division of Gastroenterology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2601-581X","authenticated-orcid":false,"given":"Jennifer J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Eating Disorders Clinical and Research Program Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"e_1_2_9_2_1","article-title":"Prevalence of exclusion diets and relationship with avoidant\/restrictive food intake disorder in adult and pediatric neurogastroenterology patients","author":"Atkins M.","journal-title":"Neurogastroenterology & Motility"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0149-7189(82)90074-X"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.05.049"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17111"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2018.03.006"},{"key":"e_1_2_9_7_1","unstructured":"Bryant\u2010Waugh R. Stern C. Dreier M. Micali N. Cooke L. Kuhnle M. Burton Murray H. Wang S. Breithaupt L. Becker K. Lawson E. Eddy K. &Thomas J.(in press).Preliminary validation of the Pica ARFID and Rumination Disorder Interview ARFID Questionnaire (PARDI\u2010AR\u2010Q). Journal of Eating Disorders."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.10.030"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001766"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23520"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13931"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23414"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2022.06.011"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003369"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14258"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.09.017"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.04.001"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000161"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00349-0"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.032"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23053"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.0051"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0853-y"},{"key":"e_1_2_9_24_1","volume-title":"Avoidant\/restrictive food intake disorder in the adult gastroenterology population: An under\u2010recognized diagnosis?","author":"Harer K.","year":"2018"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000273"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2009.05.002"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i22.5260"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.09.015"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.02007.x"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.03.063"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.11.020"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2020.110287"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm17116"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2019.01.003"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.01.007"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2018.09.003"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6663(92)90014-W"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-39330-4"},{"key":"e_1_2_9_39_1","unstructured":"Recovery Record. (2022).https:\/\/www.recoveryrecord.com\/."},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-004-9567-x"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.09.043"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.00900.x"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbct.2020.10.004"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23355"},{"key":"e_1_2_9_46_1","volume-title":"Cognitive\u2010behavioral therapy for avoidant\/restrictive food intake disorder: Children, adolescents, and adults","author":"Thomas J. J.","year":"2019"},{"key":"e_1_2_9_47_1","unstructured":"Viechtbauer W.(2021).Conducting meta\u2010analyses in {R} with the {metafor} package. In (Version 3.8\u20101) CRAN.https:\/\/www.metafor-project.org\/doku.php\/metafor"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2012.05.010"},{"key":"e_1_2_9_49_1","doi-asserted-by":"crossref","unstructured":"Zickgraf H. F. & Ellis J. M. (2018). Initial validation of the Nine Item Avoidant\/Restrictive Food Intake Disorder Screen (NIAS): A measure of three restrictive eating behaviors. Appetite(123) 32\u201342.","DOI":"10.1016\/j.appet.2017.11.111"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2021.105808"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.23874","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/eat.23874","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.23874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T11:08:16Z","timestamp":1692356896000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.23874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,22]]},"references-count":50,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1002\/eat.23874"],"URL":"https:\/\/doi.org\/10.1002\/eat.23874","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,22]]},"assertion":[{"value":"2022-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}