A mixed-studies systematic review of the experiences of body image, disordered eating, and eating disorders during the COVID-19 pandemic.

OBJECTIVES: This systematic review assessed the influence of the COVID-19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. METHODS: After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). RESULTS: Data from 75 qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID-19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder-related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID-19. DISCUSSION: There is large variability in individuals' responses to COVID-19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID-19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. PUBLIC SIGNIFICANCE: This review of 75 studies highlights the widespread negative impacts that the COVID-19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.

OBJETIVOS: Esta revisión sistemática evaluó la influencia de la pandemia de COVID-19 y las restricciones asociadas en los resultados en imagen corporal, la alimentación disfuncional y los trastornos alimentarios. MÉTODO: Después del registro en PROSPERO, se realizó una búsqueda de artículos publicados entre el 1 de diciembre de 2019 y el 1 de agosto de 2021, utilizando las bases de datos PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley y ProQuest (disertaciones y tesis). RESULTADOS: Los datos de 75 estudios cualitativos, cuantitativos y de métodos mixtos se sintetizaron utilizando un enfoque integrado convergente y se presentaron narrativamente dentro de cuatro temas: (1) interrupciones debidas a la pandemia de COVID-19; (2) variabilidad en la mejoría o exacerbación de los síntomas; (3) factores asociados con resultados de la imagen corporal y alimentarios disfuncional; (4) desafíos únicos para los grupos marginados y subrepresentados. Las interrupciones debidas a la pandemia incluyeron restricciones sociales y funcionales. Aunque la mayoría de los estudios informaron un empeoramiento de las preocupaciones, algunos participantes también informaron una mejoría de los síntomas o ningún cambio como resultado de la pandemia. Los factores asociados con peores resultados incluyeron variables psicológicas, individuales, sociales y relacionadas con el trastorno alimentario. Las personas que se identificaron como LGBTQ + informaron preocupaciones únicas durante COVID-19. DISCUSIÓN: Existe una gran variabilidad en las respuestas de los individuos a COVID-19 y una investigación limitada que explora el efecto de la pandemia en los resultados de la imagen corporal, la alimentación disfuncional y los trastornos de la conducta alimentaria utilizando diseños de estudios longitudinales y experimentales. Además, se requiere más investigación para investigar el efecto de la pandemia de COVID-19 en la imagen corporal y las preocupaciones alimentarias entre los participantes minoritarios, racializados, subrepresentados o marginados. Basados en los hallazgos de esta revisión, se hacen recomendaciones para individuos, investigadores, médicos y mensajes de salud pública.

Associations between parent-child relationship, and children's externalizing and internalizing symptoms, and lifestyle behaviors in China during the COVID-19 epidemic.

To investigate associations between parent-child relationships, children's externalizing and internalizing symptoms, and lifestyle responses to the COVID-19 epidemic, we conducted an online survey of a random, representative sample of residents with children aged 3-17 years during mid-March 2020 in Wuhan and Shanghai, China. A total of 1655 parents and children were surveyed with a response rate of 80.1% in the survey. During the epidemic, the frequency of children enquiring about the epidemic (AOR = 1.46, 95% CI: 1.04, 2.06), parents explaining the epidemic to them (AOR = 2.87, 95% CI: 1.80, 4.58), parents expressing negative emotions in front of them (AOR = 2.62; 95% CI = 2.08-3.30), and parents with more irritable attitudes (AOR = 1.93; 95% CI = 1.33-2.81) were significantly associated with children's externalizing symptoms. For internalizing symptoms, significant associations were found with worse parent-child closeness (AOR = 2.93; 95% CI = 1.80-4.79), the frequency of parents expressing negative emotions in front of them (AOR = 2.64; 95% CI = 1.68, 4.12), and more irritable attitudes (AOR = 2.24; 95% CI = 1.42-3.55). We also found that each indicator of parent-child relationships had the significantly similar associations with children's lifestyle behaviors. These findings suggest that improving parents' attitudes towards their children and parent-child closeness during the epidemic, especially among parents with lower educational levels, are important to ensure the wellbeing of children.

Factors mediating the psychological well-being of healthcare workers responding to global pandemics: A systematic review.

This paper reviewed mediators of psychological well-being among healthcare workers responding to pandemics. After registration on PROSPERO, a systematic review was performed in four databases and 39 studies were included. Worse mental health outcomes, such as stress, depressive symptoms, anxiety and burnout were related to demographic characteristics, contact with infected patients and poor perceived support. Self-efficacy, coping ability, altruism and organisational support were protective factors. Despite limitations in the quality of available evidence, this review highlights the prevalence of poor mental health in healthcare workers and proposes target mediators for future interventions.

The impact of inequality on mental health outcomes during the COVID-19 pandemic: A systematic review

Previous research on pandemics and emergencies has shown that such events often widen health inequalities in society and have a greater impact on socially disadvantaged groups. No review has so far looked at the impact of inequality factors on mental health outcomes during the novel coronavirus outbreak (COVID-19). The aim of the current review was therefore to assess the impact of inequality factors on mental health outcomes during COVID-19. After registration on PROSPERO, a systematic review was conducted for papers published up to July 31, 2020, using the databases Google Scholar, PsycINFO, PubMed (MEDLINE), and Web of Science. The following inequality factors were considered: education, income, employment, occupation, material and social deprivation, age, immigrant status, sexual orientation, functional health, cultural/racial background, sex, gender, and place of residence. Out of 1,931 references, 117 studies (300,061 participants) were included. Female sex, being of a younger age, financial insecurity, lack of access to clear messaging/information about the pandemic, proximity to large infection sites, having existing physical and/or psychological health conditions, and being subjected to abuse/stigma because of one's identity as a member of an ethnic or sexual marginalized group predicted mental health inequalities. More research is required on how inequality affects mental health in less studied vulnerable populations, such as ethnic, sexual, and gender marginalized participants, as well as how inequality factors interact to affect mental health in the long term. Recommendations for researchers, mental health practitioners, and public health authorities for mitigating adverse mental health outcomes in vulnerable populations are outlined. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (French) Des recherches anterieures sur les pandemies et les urgences ont montre que de tels evenements augmentent souvent les inegalites en matiere de sante dans la societe et ont une incidence plus grave sur les groupes socialement defavorises. A ce jour, aucune etude n'a examine l'incidence des facteurs d'inegalite sur les resultats en matiere de sante mentale lors de l'epidemie du nouveau coronavirus (COVID-19). L'objectif de la presente etude etait donc d'evaluer l'incidence des facteurs d'inegalite sur les resultats en matiere de sante mentale pendant la COVID-19. Apres inscription sur PROSPERO, un examen systematique a ete effectue pour les articles publies jusqu'au 31 juillet 2020, en utilisant les bases de donnees Google Scholar, PsycINFO, PubMed (MEDLINE) et Web of Science. Les facteurs d'inegalite suivants ont ete pris en consideration : education, revenu, emploi, profession, privation materielle et sociale, age, statut d'immigrant, orientation sexuelle, sante fonctionnelle, origine culturelle/raciale, sexe, genre et lieu de residence. Sur 1 931 references, 117 etudes (300 061 participants) ont ete incluses. Le sexe feminin, le jeune age, l'insecurite financiere, le manque d'acces a des messages/renseignements clairs sur la pandemie, la proximite d'importants sites d'infection, les conditions de sante physique et/ou psychologique existantes et le fait d'etre victime d'abus/stigmatisation en raison de son identite en tant que membre d'un groupe ethnique ou sexuel marginalise ont permis de predire les inegalites en matiere de sante mentale. Des recherches supplementaires sont necessaires sur la maniere dont les inegalites affectent la sante mentale dans les populations vulnerables moins etudiees, telles que les participants marginalises sur le plan ethnique, sexuel et sexospecifique, ainsi que sur la maniere dont les facteurs d'inegalite interagissent pour affecter la sante mentale a long terme. Des recommandations sont formulees a l'intention des chercheurs, des praticiens de la sante mentale et des autorites de sante publique pour attenuer les effets nefastes sur la sante mentale des populations vulnerables. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement <strong xmlns:lang="en">Public Significance Statement-The findings of this review suggest that several inequality factors, such as female sex, younger age, financial insecurity, having existing chronic health conditions, and being in an ethnic or sexual marginalized group predict worse mental health outcomes during the ongoing COVID-19 pandemic. There is an urgent need for mental health services to support vulnerable populations at this time, to reduce mental health inequalities and improve long-term psychological functioning. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Contact tracing apps for the COVID-19 pandemic: a systematic literature review of challenges and future directions for neo-liberal societies.

PURPOSE: The COVID-19 pandemic has spread with increased fatalities around the world and has become an international public health crisis. Public health authorities in many countries have introduced contact tracing apps to track and trace infected persons as part of measures to contain the spread of the Severe Acute Respiratory Syndrome-Coronavirus 2. However, there are major concerns about its efficacy and privacy which affects mass acceptance amongst a population. This systematic literature review encompasses the current challenges facing this technology and recommendations to address such challenges in the fight against the COVID-19 pandemic in neo-liberal societies. METHODS: The systematic literature review was conducted by searching databases of Google Scholar, Web of Science, PubMed, IEEE Xplore Digital Library, PsycInfo and ScienceDirect using the search terms ("Contact Tracing" OR "Contact Tracing apps") AND ("COVID-19" OR "Coronavirus") to identify relevant literature. The searches were run against the title, keywords, or abstract, depending on the search platforms. The searches were conducted between January 1, 2020, through 31st January 2021. Further inputs were also taken from preprints, published government and technical reports. We explore and discuss from the selected literature, the key challenges and issues that influence unwillingness to use these contact tracing apps in neo-liberal societies which include the plausibility of abuse of user privacy rights and lack of trust in the government and public health authorities by their citizens. Other challenges identified and discussed include ethical issues, security vulnerabilities, user behaviour and participation, and technical constraints. RESULTS AND CONCLUSION: Finally, in the analysis of this systematic literature review, recommendations to address these challenges, future directions, and considerations in the use of digital contact tracing apps and related technologies to contain the spread of future pandemic outbreaks are presented. For policy makers in neo-liberal societies, this study provides an in-depth review of issues that must be addressed. We highlight recommendations to improve the willingness to use such digital technologies and could facilitate mass acceptance amongst users.