Exploring the role of maternal-adult-child relationship, early maladaptive schemas, and difficulties in emotion regulation in symptoms of avoidant/restrictive food intake disorder among Iranian students.

Abstract

Purpose: Avoidant Restrictive Food Intake Disorder (ARFID) is a relatively new diagnostic classification, and the DSM-5 has called for further studies and evidence in this field. This study explored the role of maternal-adult-child relationship, early maladaptive schemas, and difficulties in the emotion regulation of ARFID symptoms and their presentations, such as sensory sensitivity, lack of interest in eating and food, and fear of aversive consequences. We also investigated the role of demographic characteristics in predicting ARFID symptoms.

Methods: In this cross-sectional study, 791 college students (females = 74.8%, mean age = 21.3, SD = 2.26, male = 25.2%, mean age = 21.1, SD = 1.97) were selected through cluster random sampling in 2024 from a major university in the northwest of Iran (Urmia University). ARFID symptoms was assessed using the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS), the quality of parent-adult-child relationship (PACR) was evaluated using the Parent-Child Relationship Questionnaire (PCRS), difficulties in emotion regulation (DER) were measured using the Difficulty in Emotion Regulation Scale (DERS) and early maladaptive schemas (EMS) through the Young Schema Questionnaire-Short Form (YSQ-SF).

Results: Hierarchical regression analysis revealed that gender and field of study 3.9%, maternal-adult-child relationship (MACR) (1.3%), DER 7.3% and EMS 7.6% were identified as factors in predicting ARFID symptoms. The field of study and EMS predicted 11.3% variance of sensory sensitivity. Gender, field of study, DER, and EMS were significant in predicting lack of interest in food or eating, with a variance of 14.2%. The field of study, MACR, and EMS predicted 12.6% variance of fear of adverse consequences.

Discussion: Our findings suggest that ARFID symptoms is related to parental and emotional factors. EMS formed during development, along with adverse parent-child relationships and psychological factors, such as difficulty in emotion regulation, may be associated with ARFID symptoms. In addition, DER played the biggest role in predicting ARFID symptoms, fewer variables were able to predict sensory sensitivity, demographic characteristics, SEM, and DER had the biggest role in predicting the presentation lack of interest in eating or food. Effective treatment and collaborative support are essential to address ARFID.