I-ARFID ayikho nje isidlo sokutya

Ukuphepheka kweMithintelo yokuThengisa ukutya

Ngaba wena okanye umntu omaziyo uyidla? Abanye abadlileyo kakhulu banokuba ne-disorder disorder, eyaziwa ngokuba yi-Avoidant / Restrictive Disake Disorder Disorder (ARFID). Kwiimeko ezininzi, ukutya okukhethiweyo akuphazamisi isimo somzimba, ukukhula, okanye ukusebenza kwansuku zonke. Nangona kunjalo, abantu abafumana iziphumo ezifana nalezi ngenxa yokutya okukhethileyo banokufuna unyango.

Abadli be-Picky ngabantu abaphephe ukutya abaninzi ngenxa yokuba abayithandi indlela yabo, ukunuka, ukuthungwa okanye ukubonakala. Ukutya okukhethiweyo kuqhelekileyo ebuntwaneni, nokuba naphi phakathi kweepesenti ezingama-13 kunye neepesenti ezingama-22 zabantwana abaphakathi kweminyaka emithathu kunye neshumi elinanye bafunyaniswa ukuba bangabatha ukutya ngexesha elithile. Ngelixa abantwana abaninzi abancinci behle kakhulu, phakathi kweepesenti ezingama-18 kunye ne-40 ekhulwini baqhubeka bekhetha ukuya ebusheni.

Ukwahlula i-ARFID kwi "Ukutya okuqhelekileyo kwe-Picky"

Ekuphuhliseni abantwana, uluhlu lweentlobo, iimpawu, kunye nesantya sokutya esidliwa ngokubanzi kuya kufikelela kwiminyaka emithandathu ukuya kweyesixhenxe. Ngeli xesha, abantwana abaneminyaka engamawaka esikolweni baya kuba "bathebile" kwaye baqala ukuthanda i-carbohydrates, ekhuthaza ukukhula. Ngokuqhelekileyo ngokutshatyalaliswa kweminyaka, kokubili ukutya kunye nokutya ukunyuka kokuguquguquka, kuhambisane nokubuyela kwintlobo ebanzi yokutya kunye nokulinganisela okukhulu ngaphakathi kunye nokutya. Abazali abaninzi baxela uxhalabo malunga nokutya komntwana xa beselula, kodwa baxelelwa ngabanye ukuba "kuyinto evamile" kwaye bangakhathazeki ngako.

Abazali bezingane abane-ARFID baqaphela iingxaki kumbandela wengane yabo ekutheni bangeneminyaka eli-1 ubudala. Aba bantwana bangabonisa ukhetho oluqinileyo lokutya oluncinci lokutya kwaye banokuthi bangatye nantoni na ngaphandle kwesi sihlomelo. Abazali bavame ukubika ukuba abantwana babo abane-ARFID banenkathazo yokuguqula ukutya okuxutywe kubantwana abangabodwa.

Kananjalo bavame ukunika ingxelo yokuba babe novelwano oluthile kumagama afana ne "mushy" okanye "adibeneyo."

Kungaba nzima kubazali kunye nabaqeqeshi bezempilo ukuba bahlule "ukukhetha okuqhelekileyo" kumntwana ekuxilongweni kwe-ARFID. Ukuziphatha kokuziphatha kunye nokuguquguquka kunokuba khona ekuqhubekeni phakathi kwabo banomdla ekuzameni ukutya okutsha kunye nalabo abakhetha ukutya okuqhelekileyo. Uninzi lwabantwana lusakwazi ukuhlangabezana neemfuno zabo zondlo naphezu kokukhethwa.

Ngokutsho kukaDkt. Fitzpatrick kunye noogxa bakhe, "Nangona abantwana abaninzi bebonisa ukukhetha okutya kwaye abaninzi baya kuba nokutya okunzulu kwiindawo ezithile zokutya," i-ARFID "ibonakala ngokukhanyela ukuzama into entsha kwaye, ngoko ke kukugqithiseleyo kunye neklinikhi ngokuphathelele inguqulelo 'isidlo sokutya'. "I-ARFID ichazwa ngabanye ngokuthi" ukuphazamiseka kokutya, "apho ubunzima obunokutsha bubangela ukutya okuncinci.

Ukutya okuNtsha kunye nokuPhala kweMpilo kwi-DSM-5

I-ARFID iyicatshulwa esitsha esasungulwa ngokupapashwa kweNcwadana yokuHlola kunye neStatistical, i-5 ^th Edition (DSM-5) ngo-2013 . Ngaphambi kwesi sigaba esitsha, abantu abane-ARFID babeya kufumaniswa ukuba bayidla ingxaki ngaphandle kokuchazwa ngenye indlela (EDNOS) okanye bawa phantsi koxilongo lwe-disorder of childhood or childhood.

Ngenxa yoko, i-ARFID ayiyaziwa njenge- anorexia nervosa okanye i- bulimia nervosa . Nangona kunjalo, kunokuba nemiphumo emibi.

Abantu abane-ARFID abazidli ngokwaneleyo ukuhlangabezana namandla abo kunye neemfuno zondlo. Nangona kunjalo, ngokungafani nabantu abane-anorexia nervosa, abantu abane-ARFID abakhathazeki malunga nesisindo sabo okanye ukuma okanye batyebile kwaye abayithinteli ukutya kwabo kwesi sizathu. I-ARFID ayinakuvela emva kwimbali yokutya ngokuqhelekileyo njengoko yenza i-anorexia nervosa kunye ne-bulimia nervosa. Abantu ngabanye abane-ARFID badla ngokutya okuthintela yonke imihla.

Ukuhlangabezana nemigangatho ye-ARFID, umqobo wokutya awukwazi ukuchazwa ngokungabikho kokutya, isenzo esivunyelwe ngumthonyama (njengesizathu sonyango sokuthintela ukutya), okanye enye ingxaki yonyango enokuthi iphathwe ngayo iya kuxazulula ingxaki yokutya.

Ukongeza koko kufuneka kukhokele kwenye yezi zinto zilandelayo:

• Ukulahleka kwesisindo esiphambili (okanye ukuhluleka ukwenza uzuzo olulindelekileyo kubantwana)
• Ukunqongophala okunomsoco
• Ukuxhomekeka kwindlela yokutya ityhubhu okanye izondlo zomlomo
• Ubunzima obubandakanyeka kubomi bemihla ngemihla ngenxa yehlazo, ukuxhalabisa okanye ukuphazamiseka

Ngubani Ofumana i-ARFID?

Asinayo idatha efanelekileyo malunga namazinga e-ARFID. Kuqheleke ngakumbi kubantwana nakwishumi elivisayo, kwaye abaqhelekanga kubantu abadala kunye nabantu abadala. Nangona kunjalo kwenzeka kuyo yonke imihla kwaye ichaphazela bonke abafana. Ukusetyenzwa kudla ngokuqhelekileyo ebuntwaneni. Uninzi lwabantu abadala abane-ARFID babonakala bephethe iimpawu ezifanayo ukususela ebuntwaneni. Ukuba i-ARFID iqala ukukhula okanye ikhulile, ihlala iquka amava anxulumene nokutya okunjengokukhahla okanye ukuhlanza.

Esinye isifundo esikhulu (uFisher et al., 2014) safumanisa ukuba iipesenti ezili-14 zazo zonke izigulane zentsholongwane yezidlo eziye zanikwa iikhompyutyisi ezisixhenxe zonyango zidla iiprogram zeengxaki ze-ARFID. Ngokwalolu cwaningo, inani labantwana kunye nabaselula kunye ne-ARFID selula selula, lunexesha elide lokugula ngaphambi kokuxilongwa, kwaye luquka inani elikhulu lamadoda kunabemi bezigulane ezine-anorexia nervosa okanye i-bulimia nervosa. Izigulane ezine-ARFID ngokomyinge zinomzimba ophantsi ophantsi kwaye ngenxa yoko zisesichengeni esifana neengxaki zonyango njengezigulane ezine-anorexia nervosa.

Izigulane ezine-ARFID zininzi ngaphezu kwezigulane ezine-anorexia nervosa okanye i-bulimia nervosa ukuba zibe neyonyango okanye imeko. UFitzpatrick kunye noogxa baqaphele ukuba izigulane ze-ARFID zidla ngokubhekiselele kwi-gastroenterology kunezigulane ezinezinye izifo zokutya. Kwakhona banokuba nengxaki yokuxhalabisa, kodwa bancinci kunokuba banesifo se-anorexia nervosa okanye i-bulimia nervosa ukuba baxineke. Abantwana abaza kunye ne-ARFID bavame ukuchaza inani eliphezulu leengxaki, ezifana nezo zifumaneka kubantwana abanenkinga yokunyanzeliswa kunye nokukhathazeka okuqhelekileyo . Ngokuqhelekileyo babonisa ukukhathazeka ngakumbi malunga neempawu zomzimba ezinxulumene nokutya, njengento yesisu esicasulayo.

Iintlobo

I-DSM-5 inikeza imizekelo yeentlobo ezahlukeneyo zokuphepha okanye ukuthintela okungaba khona kwi-ARFID. Ezi zibandakanya umdalelo ohambelana nokungabikho komdla wokutya okanye ukutya; ukukhusela ukutya (umzekelo, umntu uyala ukutya okuthethiweyo kusekelwe kwintshisi, umbala, okanye ukuthungwa); kunye nokuphepha okuphathelele kwimiphumo eyoyikayo yokutya okanye ukuhlanza, ngokuqhelekileyo kusekelwe kumava amaninzi adlulileyo.

Abadobi kunye noogxa bacebisa iintlobo ezi-6 ezahlukeneyo zentetho ye-ARFID ngamanani alandelayo okukhula phakathi kwesampula:

• Ukutya okukhethiweyo ukususela ebuntwaneni (iipesenti ezingama-28.7)
• Ukuba neengxaki ezixhalabisayo (21.4 ekhulwini)
• Ukuba neempawu zesisu (19.4 ekhulwini)
• Ukwesaba kokutya ngenxa yokwesaba ukukhahlela okanye ukuhlanza (iipesenti ezingama-13.1)
• Ukutya kokutya (4.1 ipesenti)
• Ukutya okunqandekileyo "kwezinye izizathu" (13.2 ekhulwini)

UDkt. Bermudez ucebise iintlobo ezi-5 ze-ARFID:

• Abaphepheyo ngabanye bayenqaba ukutya ngokusekelwe kwiimeko ezintle okanye ezinokwesaba, ezifana nokukhahlela, isicathulo, ukuhlanza, intlungu okanye ukugwinya.
• Abantu abavumileyo bayamkela ukutya okuncinciweyo ngokusekelwe kwimpawu zengqondo. Bangaba ne-disorder processing disorder.
• Abantu abanqandekayo ngabo bangadli ngokwaneleyo kwaye babonisa umdla omncinci wokutya. Basenokukhetha, abaphazamisekiyo kwaye bayayikhohlwa, kwaye banqwenela ukuba badla ngaphezulu.
• Udidi oluxubile luquka iinkalo zezona zinto zingaphephekiyo, ezinobungqina, kunye nezithintelo. Umntu ngokuqhelekileyo unikezela ngeempawu zesigaba esinye kuqala kodwa emva koko ufumana iimpawu ezongezelelweyo ezivela kwelinye uhlobo.
• I-ARFID "I-Plus" yabantu abakhona kunye neentlobo ze-ARFID ekuqaleni, kodwa ke uqale ukuhlakulela iimpawu ze-anorexia nervosa ezifana nesisindo kunye nesimo sokuxhalabisa, isimo somzimba esingathandekiyo, okanye ukuphepha kokutya okunamandla okomzimba.

U vavanyo

Ngenxa yokuba i-ARFID yinkinga engaziwayo, abaqeqeshi bezempilo abanakuyiqonda kwaye izigulane zinokubakho ukulibaziseka ekufumaneni unyango kunye nokuphathwa. Ukuxilongwa kwe-ARFID kudinga uvavanyo olupheleleyo olufanele lubandakanye imbali ecacileyo yokutya, ukuphuhliswa, iitshathi zokukhula, imbali yentsapho, ukuzama ukuphazamiseka kwangaphambili, kunye nomxholo opheleleyo weengqondo kunye novavanyo. Ezinye izizathu zonyango zokulahleka kwesondlo kufuneka zikhishwe ngaphandle.

URachel Bryant-Waugh uye uchaze uluhlu lokuhlola uluhlu lwe-ARFID ukulungiselela ukuqokelela ulwazi olufanelekileyo:

1. Yintoni ekhoyo ngokutya (ububanzi)?
2. Yintoni ekhoyo ngokutya (umlinganiselo)?
3. Kude kube nini ukuphepha kokutya okuthile okanye ukuthintela ekutheni kuyenzeka?
4. Yintoni ubukhulu kunye nokuphakama okwangoku kwaye kuye kwaba khona ukulahla kobunzima nokukhula kwama-percentile?
5. Ngaba kukho iimpawu kunye neempawu zokunqongophala kwesondlo okanye ukungondleki?
6. Ingeniso isongezwa nayiphi na indlela ukuqinisekisa ukutya okwaneleyo?
7. Ngaba kukho uxinzelelo okanye ukuphazamiseka kwemisebenzi yemihla ngemihla enxulumene nomzekelo wokutya?

Unyango

Kwiigulane kunye neentsapho, i-ARFID ingaba ngumngeni omkhulu. Iintsapho zihlala zixhalaba xa abantwana befumana ubunzima bokutya kwaye banokuthi banamathele kwimigudu yamandla phezu kokutya. Kubantwana abaselula kunye nabadala, i-ARFID inokuchaphazela ubudlelwane njengokuba ukutya kunye noontanga banokungabonakali.

Ikhohlo elingaphendulwanga, i-ARFID ayisoloko isisombulula. Iinjongo zonyango ziyakwandisa ukuguquguquka kwesigulane xa kunikwa ukutya okungakhethiweyo kwaye kubancedise ukwandisa iintlobo zabo kunye nokutya kokutya ukuze banelise iimfuno zabo zondlo. Izigulane ezininzi ezine-ARFID zidla ukutya okufanayo ngokuphindaphindiweyo de zide zize zifune ukuyidla kwakhona. Ngaloo ndlela, izigulane zikhuthazwa ukuba zijikeleze iintetho zokutya ezikhethiweyo kwaye ngokukhawuleza zivelise ukutya okutsha.

Okwangoku, akukho zikhokelo zonyango ezisekelwe kwi-ARFID. Ngokuxhomekeka kubukrakra bokungondleki, ezinye izigulane ezine-ARFID zingadinga amanqanaba aphezulu okunyamekela, njengonyango lokuhlala okanye ukulaliswa kwezibhedlele , ngamanye amaxesha kunye nokuncedisa okanye ukuthambisa ityhubhu.

Emva kokuba isiguli sigxininiswe ngemithi, unyango lwe-ARFID ludla luquka ukufundisa izakhono zokulawula uxinzelelo kunye nokuqaliswa kokutya ngokutsha ngokutya "kokutya": ngokuqala ngokutya okufana nokutya abaye batya kwaye baqhubela phambili ngokuthe ngcembe kwintsimi ukutya. Umntu oqhelekileyo ufuna iimboniselo ezininzi phambi kokuba ukutya akukaze kube namava. Kubantu abanesifo se-ARFID, amaxesha amaninzi amaxesha ngaphambi kokuba ukutya kungeke kube namava ongaqhelekanga.

Ngokomzekelo, isigulane esinye somntu omdala kunye ne-ARFID asidli imifuno eluhlaza kwaye akukho siqhamo. Iinjongo zakhe kwakunokwandisa amandla akhe okutya izityalo kunye nemifuno. Wadla iidroti xa besesobho. Ngaloo ndlela, unyango luqaliswe ngamakhekhethi akhe abilayo kwintambo yenkukhu kwaye uyinqumle ibe yincinci encinane kwaye uyidle. Emva koko, waqala ukutya iziqhezu ezinkulu zeeqatyi eziphekiweyo emthonjeni kwaye ekugqibeleni izaqathe ziphekwe ngamanzi. Emva koko, waqala ukusebenza kwiipelisi zeeqathi ezintsha.

Waqala nokusebenza kwiziqhamo. Waqala nge-strawberries jelly kwi-toast, into eyayiyinto efanelekileyo yokutya. Emva koko wazisa i-strawberries jelly kunye nembewu ukuze asebenze ekusebenzeni. Emva koko, wazisa ama-strawberries amnandi (axutywe noshukela ukuze abanciphise). Ekugqibeleni, waqala ukutya amaqabunga amancinci amancinci. Emva koko, ezinye izityalo kunye nemifuno kwandiswa ngokuthe ngcembe ngendlela efanayo.

Kubantwana kunye nabaselula kunye ne-ARFID, kukho ubungqina bokukholelwa ukuba unyango olusekelwe kwintsapho, olunenkxaso enamandla kunyango lwe-anorexia nervosa kubantu abaselula, lunokusetyenziswa ngempumelelo.

Ukuba wena (okanye umntu owaziyo) ubonisa iimpawu ze-ARFID, kucetyiswa ukufuna uncedo kumfundi owazi kakuhle izidlo zokutya.

> Imithombo

> Bermudez, O, Easton E, kunye nePikus C, "ARFID: Ukukhusela okuKhuselekileyo / okukhuselayo Ukuphazamiseka kokungena kwi-Intake: I-In-Depth View," i-Keynote Presentation kwi-International Association for Disaster Disorder Professionals Symposium, ngoMatshi 25, 2017, eLas Vegas.

> Bryant-Waugh, R. 2013. "Ukukhusela ingxaki yokuLungisa ukutya: Umzekelo woMzekelo woMzekelo." I- International Journal of Disorders 46 (5): 420-23. i-doi: 10.1002 / idle.22093.

> Fisher, MM., Rosen DS, Ornstein RM, Mammel KA, Katzman DK, Rome ES, et al, 2014. "Iimpawu zoKhusela / Ukukhusela ukuCandwa kweNtlupheko kuBantwana nakwi-Adolescents: 'I-Disorder New' kwi-DSM-5. "I- Journal ye-Health Adolescent 55 (1): 49-52. i-doi: 10.1016 / j.jadohealth.2013.11.013.

> I-Fitzpatrick, iKK, i-Forsberg SE, kunye ne-Colborn D. 2015. "Ulwaphulo oluxhomekeke kwintsapho Ukugwema ukutya okuthintela ukutya Ukuphazamiseka kwengxaki: Imindeni ibhekane nokutya kweNophobias." KwiNyango yoLuntu kwi-Adolescent Eating and Distressing Disorders: Izicelo ezintsha , ezihlelwe nguCatherine L. ULoeb, uDaniel Le Grange, noJacob Lock, 256-276. ENew York: uRoutledge.

> Njalo, TA., Lane-Loney S, uMasciulli E, Hollenbeak CS, kunye no-Ornstein RM. 2014. "Ukuxhaphaka kunye neendlela zokugwema izifo zokugula ezikhuselekileyo kwiqela labathathi abancinci kwi-Day Treatment for Distressing Disorders." I- Journal of Disorders 2: 21. nyanzela: 10.1186 / s40337-014-0021-3.

> Zickgraf, HF., Franklin ME, kunye neRozin P. 2016. "Izidlo ezidumileyo zabantu abadala kunye nezibonakaliso zokugwema / ukukhawulelana nokutya Ukuphazamiseka Kweengxaki: Ukuxhatshazwa Kokuxhatshazwa kunye nokuKhatyathwa koMzimba ngaphandle kokutya okuMahlukileyo okuthelekiswa nelabo abanezifo eziphazamisayo zokutya." I- Journal of Disorders Disorders 4: 26. i-doi: 10.1186 / s40337-016-0110-6.