# Neurobiological and Behavioral Risk Mechanisms of Youth Avoidant/Restrictive Eating Trajectories

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $40,938

## Abstract

ABSTRACT
 Avoidant and restrictive eating is common across youth mental health disorders, and is prospectively
associated with poor growth, nutritional deficiencies, psychiatric symptoms, and psychosocial impairment.
The newly introduced DSM-5 Avoidant/Restrictive Food Intake Disorder includes some (but not all)
avoidant and restrictive eating presentations. Initial evidence suggests that avoidant and restrictive eating is
highly heterogeneous, with poor intake characterized by choking or vomiting phobias; loss of interest in
feeding; and/or extreme food selectivity. Moreover, very little is known about its pathophysiology or long-
term outcomes. Our study will leverage unique and complementary contributions of an international team
with expertise in clinical psychology, child psychiatry, pediatrics, endocrinology, biostatistics and functional
neuroimaging to investigate risk mechanisms and longitudinal outcomes of avoidant and restrictive eating.
 We will establish a clinical cohort of children aged 8-18 years (n=100) and healthy controls (n=50)
matched for sex, age, and Tanner stage to investigate how, across units of analysis, RDoC constructs
contribute to avoidant and restrictive eating. First, we hypothesize that Negative Valence (acute threat/fear)
over-activity (circuits: amygdala activation during a validated fear paradigm; hormones: cortisol and
oxytocin; physiology: heart rate and skin conductance; self report: fear and trait anxiety) will correlate with
phobic features. Second, we hypothesize that Arousal/Regulatory (homeostasis) dysfunction (circuits:
hypothalamus and insula hypoactivation during a validated food paradigm; hormones: PYY, CKK, BDNF;
self report: hunger and fullness) will correlate with low-appetite features. Third, we will explore Cognitive
Systems (perception) over-sensitivity (circuits: hyperactivation in primary taste cortex during a taste
paradigm; hormones: PYY; self report: sensory profile; behavior: taste and odor threshold, discrimination,
and detection; physiology: taste perception) and its correlation with sensory features. We expect that the
clinical cohort will have greater dysfunction across these 3 constructs than controls. We will then use latent
class factor models to determine whether avoidant/restrictive eating comprises multiple distinct phenotypes
(as prior literature assumes) or a single phenotype with 3 overlapping dimensions (as we hypothesize). We
will follow our clinical cohort for 2 years to evaluate a) the persistence of avoidant/restrictive eating, growth,
and psychopathology outcomes; and b) if dysfunction in all 3 RDoC constructs predicts outcomes.
 This study will be innovative and unique in 3 ways: 1) by providing an empirical investigation of an
understudied clinical presentation; 2) by providing the first investigation of pathophysiology and risk
mechanisms; and 3) by characterizing poorly understood longitudinal outcomes. In sum, conceptualizing
avoidant/restrictive eating within an R...

## Key facts

- **NIH application ID:** 9967323
- **Project number:** 3R01MH108595-04S1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Elizabeth Austen Lawson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $40,938
- **Award type:** 3
- **Project period:** 2016-03-15 → 2021-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9967323

## Citation

> US National Institutes of Health, RePORTER application 9967323, Neurobiological and Behavioral Risk Mechanisms of Youth Avoidant/Restrictive Eating Trajectories (3R01MH108595-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9967323. Licensed CC0.

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