DIAGNOSING INFANTILE ANOREXIA - THE OBSERVATION OF MOTHER-INFANT INTERACTIONS

Objective: This study has three objectives: (1) to delineate the diagn ostic criteria for infantile anorexia, including the onset of persiste nt food refusal during the infant's transition to spoon- and self-feed ing, acute and/or chronic malnutrition, parental concern about the inf ant's poor food intake, and mother-infant conflict, talk, and distract ion during feeding; (2) to determine the interrater agreement of child psychiatrists when diagnosing infantile anorexia based on these crite ria; and (3) to describe the use of the Feeding Scale as a diagnostic tool. Method: One hundred two toddlers, ranging in age from 12 to 37 m onths, were assessed by two child psychiatrists and assigned the diagn osis of infantile anorexia, picky eater, or good eater. In addition, o bservers who were masked to the toddler's diagnosis rated mother-infan t interactions with the Feeding Scale to permit objective evaluation o f those interactions. Results: Two child psychiatrists were able to as sign toddlers to infantile anorexia, picky eating, and healthy, good e ating groups with a high level of agreement. The objective scale for r ating mother-infant interactions showed a high level of agreement betw een two masked raters and a good level of agreement between masked rat ers and the child psychiatrists' diagnostic assessment. Conclusions: I nfantile anorexia can be diagnosed with high reliability by child psyc hiatrists. Evaluation of mother-infant interactions is a useful diagno stic tool.