Reconceptualizing feeding and feeding disorders in interpersonal context: the case for a relational disorder.
The feeding of young children is fundamentally a relational and multisystemic process. Successful treatment of clinically significant feeding problems involves careful assessment of the full range of influences on the feeding relationship and integrated treatment approaches. However, current diagnostic approaches to feeding disorders tend to be reductionistic, exclusively focused on the child as an individual, and overly concerned with exclusionary criteria. Criteria are proposed for "Feeding Disorder Between Parent and Child" that address these limitations and embrace the complexity of feeding problems. A multiaxial diagnosis that describes the child (including medical, developmental, and behavioral characteristics); the parent; the parent-child relationship; and the social and nutritional context of feeding will more accurately speak to treatment planning in this population. The proposed diagnostic criteria were developed and refined on the basis of the available literature and many years of treatment experience across the authors of this article. The proposed diagnosis will support the development and evaluation of treatment packages with components specifically targeted to issues of the child, parent, parent-child interaction, and the broader environment.
Davies
W Hobart
WH
Department of Psychology, University of Wisconsin-Milwaukee, and Psychiatry and Behavioral Medicine Center, Children's Hospital of Wisconsin, Milwaukee, WI 53201-0413, USA. whdavies@chw.org
Satter
Ellyn
E
Berlin
Kristoffer S
KS
Sato
Amy F
AF
Silverman
Alan H
AH
Fischer
Elizabeth A
EA
Arvedson
Joan C
JC
Rudolph
Colin D
CD
D002675:Child, Preschool; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D010287:Parent-Child Relations