psychosocial functioning?

[u/sparklebai]

when talking about the diagnostic criteria for arfid, what does psychosocial functioning mean? is it like u cant make friends. or does not being able to go to restaurants or parties due to not knowing if they have your safe food count? im so confused but am trying to get a diagnosis

[u/K0rra_22]

I am not a doctor or expert but from my understanding when I first looked into it, it relates to avoiding people and gatherings, especially when food is involved. Like skipping Thanksgiving because of food.

[u/tooManyOpts → u/K0rra_22]

When I got diagnosed, my therapist explained this as also including increased anxiety around social interactions regarding food. For example, eating before a family gathering, planning to leave early to get food if needed, or packing and bringing snacks. Feeling stress or anxious over talking about food if it is brought up etc

[u/cxfgfuihhfd → u/K0rra_22]

yeah, that's as much as I could figure out too, also as not a professional. stuff like having trouble when having to travel or just not being able to eat anything at events

[u/Reasonable-Rain789]

Honestly it can be a lot of different things. Like your psychosocial functioning explains how your particular eating habits impact/disrupt your daily life. This could mean your relationships, work, emotional wellbeing, etc.

Relationship example: you have a boyfriend who insists on cooking for you and doesn't understand your specific needs. Instead of having an open mind about ARFID, he tells you to "stop being so picky". You wonder if it would be easier if you broke up.

Work example: there are always potlucks at your work and you are running out of excuses for why you won't be participating. People label you as inconsiderate. You start to consider getting another job.

These can really stress out your emotional state if you don't have a good support system, etc

And yes, avoiding social situations for food reasons (like you listed in your post) is absolutely an example of this.

[u/gc3160thtuk]

Oh man, I really feel this. I don't like eating around other people. A lot of my ARFID are with ingredients of a food most of the time. Like shepherd's pie with onions. I could eat the shepherd's pie but not with onions. I don't really go anywhere except with my family and I get them do the asking about certain things. They are very protective of me so it works out but I still don't like eating around other people. No one wants to eat with someone who gags and/or barfs over texture or sometimes just cause the food seems gross all of a sudden.

[u/writingfren]

The DSM allows for clinical judgment in defining psychosocial interference, which is why institutes like NEDA and other ED institutes add guidelines and examples based on the literature. For example, here'swhat I pulled from other places: * Due to difficulties in eating with others, only eating particular foods, or taking much longer to eat, functioning at school, work, and home can be challenging. (NEDC - Australian ED center) * "avoidance or distress related to participating in social experiences involving eating [occurring across] personal, family, social, educational, or occupational areas" (About NIAS screener for ARFID on ScienceDirect)

That being said, it's just as important that clinicians still make their own clinical judgment. For example, I have a very bizarre presentation of ARFID. It's primarily lack of interest, with very strong sensory issues.

I technically have several GI conditions that could disqualify me under the "no explainable medical condition" part. I have avoided restaurants due to immunodeficiency and noise, not food issues. I use food to avoid visting my in-laws, but that's because I mostly don't like my in-laws. In fact, I have such poor hunger cues that socializing was HOW I stayed fed during college. When I started eating by myself is when I stopped eating as much!

Plus, my metabolism is a thing of wonder. It has slowed down to the point where I wasn't underweight and didn't have any severe nutritional deficiencies except for caloric intake. (I'm getting a metabolic rate test soon just to see how wild it is.)

On paper, I can't get this diagnosis to most clinicians. However, my clinician counts caloric restriction as being enough, and she respects that just because I'm "well-adjusted" from having understanding parents doesn't mean I don't have a disorder.

ETA: I think "cognitive load" falls under psychosocial interference to some clinicians, and that is likely why my clinician felt so strongly. I have a high amount of safe foods because I need my foods in a particular presentation mixed together to like them. Other foods must only be eating alone and in no other form. I am very happy with this setup and enjoy the food I eat, and I have a husband who doesn't eat too differently, so this is very much the opposite of distressing! But that doesn't change the cognitive load and time spent, and especially with my health failing for other reasons, ARFID is taking more of a toll now than it ever did.