st20240126_Project Proposal

Can sensory sensitivity and anxiety levels predict picky eating behaviours in
young adults?

Introduction

Picky eating is characterized by selective food preferences and reluctance to try new foods. People
who exhibit picky eating behaviour often have aversions to certain tastes, textures, or smells, which
can lead to limited dietary choices and potential nutritional deficiencies (Mascola et al., 2010). This
pattern of behaviour is typically first observed in childhood (Brown & Ogden,
2004); however research suggests that picky eating can continue into adolescence and adulthood,
having a long-term impact on dietary quality (Brown & Ogden, 2004). Picky eating is a complex
issue that has been attributed to a variety of factors (Brown et al., 2016), for example, genetic
variations can lead to differences in taste perception, such as the ability to detect bitter compounds
present in certain foods. The presence or absence of specific genes, such as the TAS2R38 gene, can
influence individuals' sensitivity to bitter tastes, potentially impacting their food choices and
aversions (Hayes et al., 2008). Individuals may be inherently more sensitive to taste and texture
variations, influencing their food experiences from early childhood. Children also naturally gravitate
towards sweet tastes for nourishment and comfort while exhibiting aversions to bitter tastes as a
protective mechanism against potential toxins (Mennella & Bobowski, 2015). This may extend to
rejecting certain foods like green vegetables which have a more bitter taste (Mennella & Bobowski,
2015).

Psychological factors also a role in shaping picky eating. Food neophobia is characterised by an
aversion to trying new foods (Pliner & Salvy, 2006). In a study by Marcontell et al. (2002), it was
found that approximately 25% of infants and children exhibited food neophobia to some degree.
Heightened levels of food neophobia are associated with anticipated dislike and perceived risks linked
to unfamiliar foods (Marcontell et al., 2002). Individuals affected by food neophobia may
experience feelings of discomfort or tension when confronted with novel foods, contributing to the
persistence of picky eating behaviours and limiting dietary variety and nutritional intake. Young
adults diagnosed with autism spectrum disorder (ASD) often exhibit sensory processing differences
which appear similar to food neophobia, hypersensitivity or hyposensitivity to sensory aspects of
food stimuli can also profoundly affect their food preferences and dietary habits (Green and Ben-
Sasson, 2010). These sensory sensitivities may also exacerbate mealtime stress and anxiety, posing
challenges in accepting new or unfamiliar foods (Cermak et al., 2010).

The eating behaviour of picky eaters has garnered increasing interest due to its potential impact on
health outcomes and quality of life (Mascola et al., 2010). While previously viewed as a transient
phase in childhood, it is now recognised as a complex dietary behaviour that can persist into
adulthood. The literature reviewed above indicates that picky eating behaviours are influenced by a
combination of intrinsic and extrinsic factors. To summarise, taste preferences are often
innate, and they influence eating behaviours as individuals tend to avoid foods with flavours they find
unpalatable (Green, S. A., & Ben-Sasson, A., 2010). However, several extrinsic factors can also
shape
eating behaviours; these include psychological influences such as anxiety and sensory sensitivity
(Green, S. A., & Ben-Sasson, A., 2010).

Green and Ben-Sasson (2010) proposed the“anxiety and sensory over-responsivity

overlap” model which outlines show three potential influences that can help understand the
connection between anxiety and sensory over-responsivity. Elevated anxiety levels may heighten
sensory sensitivity by increasing environmental awareness or interpreting benign stimuli as
potentially harmful. Conversely, sensory over-responsivity may contribute to anxiety by associating
harmless stimuli with unpleasant sensations or creating an uncomfortable environment conducive to
anxiety. Additionally, the third mechanism, other factors, such as amygdala over-activity, may
influence both anxiety and sensory sensitivity. The relationship between anxiety and sensory over-
responsivity is likely bidirectional, with anxiety amplifying attention to sensory information and
sensory discomfort intensifying experienced distress or anticipatory anxiety. Avoidance of distressing
sensory situations may further perpetuate anxiety, potentially leading to the manifestation of picky
eating behaviours (Green & Ben-Sasson, 2010).

The model proposed by Green and Ben-Sasson (2010) suggests that sensory over-responsivity can
lead to food aversions, prompting individuals to avoid certain foods based on their sensory
characteristics. Heightened sensory sensitivity may drive individuals to engage in picky eating
behaviours as a means of avoiding foods that provoke discomfort or distress. For example,
individuals with increased sensory sensitivity may find the slimy texture of certain fruits or the bitter
taste of leafy greens overwhelming or unpleasant, leading them to avoid these foods.

While Ben-Sasson et al.'s model has gained traction, it's essential to consider the counterarguments as
well. Some researchers argue that picky eating in young adults may not always stem from anxiety or
sensory sensitivity but could be a normal part of development. Young adults, exploring
new experiences, often exhibit caution and selectivity in their food choices. For example, Dovey et
al. (2008) suggest that being choosy about food is typical behaviour as young adults navigate novel
situations. Moreover, cultural and social factors play a role. Parental feeding practices, such as
coercion, can influence picky eating tendencies, as found by Hendy et al. (2009). Similarly, peer
pressure can also shape picky eating behaviours among young adults.

Despite advancements in the field, there are still notable gaps in the existing literature on picky eating;
much of the existing research primarily concentrates on picky eating behaviour among children and
adolescents, with limited attention directed specifically towards young adults aged 18-24 (Herle et
al., 2016). This age demographic signifies a crucial developmental phase marked by heightened
responsibility in making food choices, emphasising the importance of conducting more studies
targeting this population. Moreover, there is a lack of research that concurrently explores the
interconnections between anxiety, sensory sensitivity, and picky eating behaviour, indicating a
significant gap in the existing literature that necessitates further investigation. This current study aims
to investigate the relationship among anxiety, sensitivity to sensory stimuli, and picky eating in
young adults, aged 18-24. It will seek aim to examine the predictive relationship between anxiety
levels,

Sensory sensitivity, and picky eating behaviours in young adults. Based on existing research, the
study will explore whether sensory sensitivity and anxiety can predict the occurrence of picky eating
behaviours. Specifically, it will examine whether heightened sensory sensitivity and anxiety levels
are associated with an increased likelihood of experiencing picky eating tendencies. Conversely, it
will investigate whether individuals with lower levels of sensory sensitivity and anxiety demonstrate
greater flexibility in food choices and exhibit fewer picky eating behaviours. This research seeks to
deepen our understanding of picky eating in young adults and provide valuable insights for
interventions aimed at promoting healthier eating habits.

Method

Participants

This study will recruit 50 participants aged 18-24 through the Sona Systems platform. Individuals
with current eating disorders or who might be significantly distressed by discussions on this topic
will be excluded to prioritise participant well-being. The sampling method used will be convenience
sampling to ensure a diverse representation of young adults within the specified age range and any
gender, contributing to the generalisability of the findings.

Design

The study will employ a quantitative research design. Predictors will include self-reported anxiety
levels and sensory sensitivity, while picky eating behaviour will serve as the outcome variable.
Anxiety levels will be measured using the Hamilton Anxiety Rating Scale (HAM-A), a widely used
psychometric tool that assesses a range of psychological and physical symptoms associated with
anxiety (Hamilton, 1959). Sensory sensitivity will be assessed using the Sensory Over-Responsivity
Scale (sensOR), which covers various sensory domains and evaluates participants' sensitivity
to different stimuli (Schoen et al., 2008). Picky eating behaviour will be evaluated using the nine-
item Avoidant/Restrictive Food Intake Disorder (ARFID) screen (NIAS), designed to assess
neophobic tendencies related to food (Zickgraf & Ellis, 2018), and the Food Neophobia Scale (FNS),
which specifically measures reluctance to try new foods (Pliner & Hobden, 1992).

Materials

As part of the study, anxiety levels, sensory sensitivity, and picky eating behaviour will be
measured using validated scales and questionnaires.

The Hamilton Anxiety Rating Scale (HAM-A) will be used to assess anxiety levels. The scale consists
of 14 items that evaluate a wide range of psychological and physical symptoms (Hamilton, 1959).
The Sensory Over-Responsivity Scale (sensOR) will be used to evaluate sensory sensitivity. The
scale covers seven sensory domains, including taste, touch, smell, audition, vision, kinesthetic/body
positioning, and movement. It contains 57 items that assess the participants' sensitivity to various
sensory stimuli (Schoen et al., 2008).

To evaluate picky eating behaviour, we will use the nine-item ARFID screen (NIAS) which is a self-
report questionnaire designed to assess neophobic tendencies related to food. The
questionnaire consists of 35 items and measures the participants' willingness to try new foods, their
aversion to
unfamiliar foods, and their general food preferences (Zickgraf & Ellis, 2018). Additionally, the Food
Neophobia Scale (FNS) will be used to specifically measure the participants' fear of trying new foods.
The FNS is a 10-item questionnaire that assesses the participants' reluctance to try new foods due to
fear of the unknown (Pliner & Hobden, 1992).

Procedure

Participants will be recruited through an advert placed on Sona systems and will participate in the
study in exchange for course credit. The survey will be hosted on Qualtrics. After accessing the
survey, participants will complete the online survey. The survey will consist of several sections,
including demographic questions, followed by scales assessing anxiety levels, sensory sensitivity,
and picky eating behaviour. Participants will be asked to respond to each item honestly and to the
best of their ability. Upon completion of the survey, participants will submit their responses, and their
participation will be recorded and awarded with course credit.

Ethics

Ethical considerations include obtaining informed consent from all participants, ensuring informed
and voluntary participation, and protecting participants from potential distress during data
collection. To mitigate against the risk of distress, participants will be provided with a clear
explanation of the study's purpose and procedures before they begin the survey. They will also be
informed that they have the right to withdraw from the study at any time. Additionally, participants
will be assured that their responses will be kept confidential and used for research purposes only.

Furthermore, the study will gain approval from the School's ethics panel before data collection
commences. This ensures that the research adheres to ethical guidelines and safeguards the rights and
well-being of the participants.

Method of Analysis

Multiple regression analysis will be employed as a statistical tool to investigate the predictive
relationship between anxiety levels, sensory sensitivity, and picky eating behaviours in young adults.
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