Date Approved

2023

Degree Type

Campus Only Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School

Psychology

Committee Member

Renée Lajiness-O’Neill, PhD, Chair

Committee Member

Catherine Peterson, PhD, Co-Chair

Committee Member

Chong Man Chow, PhD

Committee Member

Jamie Lawler, PhD

Committee Member

Amy Hahn, PhD

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin-E-mediated food allergy characterized by severe gastrointestinal symptoms within hours of food trigger ingestion. FPIES typically presents in infancy, and some babies have multiple triggers that are difficult to identify, resulting in significant stress surrounding feeding. FPIES is associated with parent psychosocial burden, but the few studies to date have examined only anxiety, stress, and quality of life. Management of FPIES requires careful “trialing” of new foods and strict allergen avoidance, which can limit diets and heighten risk of feeding issues and nutritional deficiencies. Despite the impact of a limited diet on nutrition, no research has examined developmental outcomes in children with FPIES. The present study aimed to describe patterns of problematic feeding, parental psychosocial functioning, and infant neurodevelopment in a sample of infants and toddlers FPIES age 6-18 months and to examine predictors of neurodevelopment. Findings suggested that infants with FPIES are at-risk for problematic feeding concerns with 68.19% reporting clinically at-risk or elevated ratings. Parent-report of social/communication/cognitive and motor neurodevelopment indicated below average ratings compared to same aged peers (M = -0.74, SD = 1.30 and M = -1.08, SD = 1.57, respectively). Results of this study suggested that parents of children with FPIES experience a wide range of psychological symptoms, but that sample averages were within normal limits or fell in the mild range. There is a considerable subset of parents who endorsed psychological symptoms that meet clinical cut-offs, depending on the measure examined. Parents were most likely to report concerns related to post-traumatic stress symptoms and parenting stress. Problematic feeding and parent education predicted social/communication/cognitive development, with greater feeding concerns and lower parental educational attainment correlating to lower neurodevelopmental ratings, but parent psychological functioning and FPIES reactions did not predict social/communication/cognitive developmental ratings. The only predictor of motor neurodevelopment was parent educational attainment with greater education predicting higher ratings of motor ability. Further implications for this study as well as limitations and future directions are discussed.

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