ARFID Test (NIAS)

Avoidant/Restrictive Food Intake Disorder was introduced as a formal diagnostic category in the DSM-5 by the American Psychiatric Association (2013). Unlike anorexia nervosa or bulimia nervosa, ARFID is not motivated by concerns about body shape, weight, or a desire for thinness. Instead, individuals with ARFID experience severe restrictions in the amount or variety of food they consume, which can result in significant weight loss, nutritional deficiencies, reliance on oral supplements, or marked impairment in everyday social activities. To help identify these patterns, Hana F. Zickgraf and Jordan M. Ellis (2018) developed the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS). The NIAS provides a brief, focused questionnaire designed to evaluate the distinct manifestations of avoidant and restrictive eating in adults.

The test breaks restrictive eating down into three distinct facets, reflecting the primary presentations identified in clinical criteria. Picky Eating captures sensory-based avoidance, where foods are rejected due to their taste, texture, smell, or appearance, often leaving a person with a very narrow range of acceptable foods. Appetite reflects a general lack of interest in eating or food in general; on this scale, a higher score indicates a smaller appetite and a frequent need to push oneself to eat sufficient volume or regular meals. Fear assesses the avoidance of food stemming from worries about aversive consequences, such as choking, vomiting, or severe gastrointestinal discomfort. Together, these three subscales provide a comprehensive snapshot of how avoidant or restrictive eating manifests in daily routines. If you came looking for a picky eater test, the Picky Eating score is the part that measures it.

Validation research demonstrates that these three dimensions capture meaningful differences in how people relate to food. Zickgraf and Ellis (2018) demonstrated that the NIAS subscales show strong reliability and uniquely relate to specific eating-related difficulties, such as low body mass index, reduced intake of fruits and vegetables, and elevated social interference. Further research by Burton Murray et al. (2021) confirmed that the subscales accurately differentiate clinical ARFID presentations. However, studies also highlight that elevated scores can occur across diverse clinical profiles. For instance, Presseller et al. (2024) observed that individuals with anorexia nervosa frequently score high on the NIAS, demonstrating that while the screen detects restrictive patterns effectively, it cannot distinguish ARFID from other eating disorders without a broader clinical assessment.

Your results include comparison markers displayed alongside your scores to offer helpful context. These reference values are approximate benchmarks rescaled from published data gathered by Presseller et al. (2024) from 795 Swedish adults with no history of an eating disorder; most participants in that study were women. Because this website utilizes a five-point agreement scale rather than the original six-point format used by the NIAS, these population markers serve as estimated reference points rather than validated percentiles or standardized norms. They simply indicate typical response levels observed in nonclinical research samples to help you orient your individual profile.

This test is provided solely for educational and self-reflection purposes and does not constitute medical advice or a clinical diagnosis. An elevated score indicates stronger avoidant or restrictive eating patterns, but it cannot determine the presence of a clinical disorder. This assessment is based on the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) but is independent and not affiliated with or endorsed by Hana F. Zickgraf, Jordan M. Ellis, or their respective academic institutions. If your eating habits cause significant distress, nutritional deficiency, weight loss, or interference with your daily life, please consult a qualified physician, registered dietitian, or mental health specialist for professional support.

References

• Zickgraf, H. F. & Ellis, J. M. (2018). Initial validation of the Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS): A measure of three restrictive eating patterns. Appetite, 123, 32-42.
• Burton Murray, H., Dreier, M. J., Zickgraf, H. F., Becker, K. R., Breithaupt, L., Eddy, K. T., & Thomas, J. J. (2021). Validation of the nine item ARFID screen (NIAS) subscales for distinguishing ARFID presentations and screening for ARFID. International Journal of Eating Disorders, 54(10), 1782-1792.
• Presseller, E. K., Cooper, G. E., Thornton, L. M., Birgegård, A., Abbaspour, A., Bulik, C. M., Forsén Mantilla, E., & Dinkler, L. (2024). Assessing Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms Using the Nine Item ARFID Screen in >9000 Swedish Adults With and Without Eating Disorders. International Journal of Eating Disorders, 57(11), 2143-2155.
• American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Association.

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