Exploring the relationship of avoidant restrictive food intake disorder with cognitive flexibility and autism spectrum: a systematic review.

This systematic review focuses on the relationship between avoidant/restrictive food intake disorder (ARFID) and cognitive flexibility, set shifting, and autism spectrum disorder (ASD) or autistic traits. ARFID, newly defined in the DSM-5, is characterized by restrictive eating not driven by body image concerns but often linked to sensory sensitivities and fear of adverse consequences from eating. The review of 12 recent studies, mostly involving children and adolescents, indicates that ARFID patients commonly exhibit cognitive rigidity and impaired set shifting, with significant overlap in sensory sensitivity and restricted food interests seen in ASD. Comorbidity between ARFID and ASD is frequent, associated with more severe food selectivity, social difficulties, and poorer treatment outcomes. However, research on ARFID's neurocognitive profile, especially in adults, remains limited, underscoring the need for further cross-cultural and longitudinal studies to inform tailored clinical interventions.