9/11/2023 0 Comments Pica eating disorder neurobiology![]() Analysis of blood (or other biochemical markers) can also identify poisoning due to pica ingestion. Pica related obstructions can be identified via scanning methods such as radiography or ultrasounds. Without self-report, assessment for pica can be very difficult. Another exemption stipulates that with a co-occurring mental disorder (such as IDD or ASD) a formal diagnosis is only warranted if the behavior is “sufficiently severe”. Not included within this diagnosis are developmental behaviors (children’s explorative habits) or culturally sanctioned activities. Formal diagnostic criteria are stipulated in the DSM-V as the “persistent” consumption of non-nutritive items for a minimum period of one month. 46-51įor the general public, assessment of pica is greatly dependent on self-report (or caregiver report) of cravings and/or consumption of inappropriate items. 20,45 At present, environmental enrichment is the treatment modality for pica with the most potential for individuals with ASD and IDD. In other studies, presentation of pica has also been correlated to adults with IDD who lack day programs or work, that is low levels of stimulation. Among this subpopulation, a dearth of social contact was noted as well as low levels of participation in favorite activities. 21 A study from Ontario, Canada of individuals with IDD found that pica was identified in 21.8% of the population and was associated with absence of strong or supportive family relationships. One of the most compelling aspects of research on pica for those with ASD and IDD is the recent effort to correlate this behavior to reduced social and recreational opportunities. Since these types of behaviors can serve as coping mechanisms for environmentally-induced anxiety, 43 eradicating the pica behavior may not necessarily address the underlying problem and can even contribute to an increase in other destructive behaviors or result in aggression. 42 Such sensory abnormalities likely play a significant, though incompletely understood, role in the presentation and/or onset of pica. 41 Further, many individuals with ASD and IDD experience atypical sensory processing which is manifested in disordered eating, sleep pathologies, toe walking, stereotypy, challenging behaviors, self-injurious behavior (SIB), muscular hypotonia, and irregularities in tactile processing. 40Īside from nutrition-related deficiencies, mental health, environmental causes and sensory abnormalities have also been proposed as mechanisms for onset of pica. 39 Further, it is reported that the longer the behavior is manifested in this cohort the greater the likelihood of multiple causative factors. When pica is hypothesized as a response to nutritional deficiencies for those with ASD and IDD, it is usually considered to be iron, 33,36 calcium, 25 zinc, 33,36,37 or phosphorous, 38 though nutritional supplementation and dietary adjustment have generally been ineffective as a treatment modality. 33 However, the directionality of the relationship between pica and nutrient deficiencies remains unclear. 31,32 Still, a 2015 meta-analysis of studies related to pagophagy, amylophagy and geophagy found that pica behavior was correlated with 2.4 times increased odds for anemia as well as reduced hemoglobin concentration and hematocrit and deficient plasma zinc when compared to controls. ![]() While a handful of case studies have demonstrated cessation of pica following treatment for iron deficiency, 15 two double-blind studies assessing the effect of iron supplementation on geophagy concluded that it was not effective. 5 Indeed, iron supplementation is often the default treatment option when pica behavior is identified within the general population (pregnant women and otherwise). The most commonly hypothesized trigger for pica amongst pregnant women is iron deficiency, 30 though calcium insufficiency has also been proposed. Part III continues in the February 2019 E-Newsletter and can be found by clicking here.) Part I was posted in the December 2018 E-Newsletter and can be found by clicking here). Contrasting Pica Behavior for Individuals with ASD and IDD Against Presentation in the General Population Part II
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |