Preparing for the next pandemic by understanding the impact of COVID-19 mitigation measures on patients with eating Disorders: observations from an inpatient setting.

OBJECTIVE: The COVID-19 pandemic overwhelmed eating disorder (ED) services worldwide. Data suggests a worsening of psychopathology and an increased request for specialised treatments. Still, the studies are mostly based on experimental protocols with underpowered short-term opportunistic experimental designs. Thus, this study aims to assess the clinical and psychological differences between patients admitted to a specialised ED Unit before and after the COVID-19 breakout. METHODS: Consecutive patients admitted from June 2014 to February 2022 in a specialised EDs Unit were enrolled. A total sample of 498 individuals was enrolled in this retrospective study, collecting demographic and psychopathological data at admission. RESULTS: An increase in the admission of patients with anorexia nervosa has been reported, with lower age and higher levels of specific and general psychopathology, especially linked to body uneasiness. CONCLUSIONS: Results are put into the context of the preparation for the next pandemic that may require similar mitigation measures as COVID-19 to ensure the impact on existing and new patients. Covering an extended period with validated tools, our results might help psychiatric services to reassess their treatment pathways after the pandemic, helping clinicians to delineate future treatment interventions.KEYPOINTSAfter the COVID-19 breakdown, there was an increase in the admission of patients with anorexia nervosa to specialised services.More severe psychopathology was not accompanied by lower body mass index.Specialised eating disorders services should face sudden changes in patients' requests for treatment.Understanding the impact of the Covid-19 pandemic and the resulting mitigation measures taken can lead to better preparations for the next pandemic.

Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: Results from cross-lagged panel analyses among women and men.

The COVID-19 pandemic provided a context associated with negative consequences for body image and eating behavior. However, little is known about what factors helped to mitigate these consequences and build a positive body image. Previous research pointed to the significance of body image flexibility and perceived body acceptance by others in predicting body appreciation. However, as most of the studies have been cross-sectional, causal relationships are poorly understood. This longitudinal study tested the reciprocal association between body appreciation, body image flexibility, and perceived body acceptance by others during the COVID-19 pandemic in Germany. We analyzed data from a large community sample consisting of 1436 women and 704 men who were invited to complete the study measures (BAS-2, BI-AAQ-5, BAOS-2) at three time points, each approximately six months apart. Latent cross-lagged panel analyses revealed that greater T1 body appreciation predicted an increase in T2 body image flexibility among both genders, while for women, we additionally observed reciprocal effects between T2 and T3. Among both genders, we further found that greater body appreciation predicted increased perceived body acceptance by others over both measurement intervals (but not vice versa). Our findings are discussed in light of pandemical constraints during the studies' assessments.

Investigating the factors affecting adolescents' test anxiety in Greece during the COVID-19 pandemic

The most prevalent mental health challenges in teenagers are generalized anxiety disorder and depression. The (COVID-19) pandemic has added an extra negative effect on children's mental health.(1) This study focuses on the investigation of a specific form of adolescent anxiety, i.e. test anxiety (TA). TA in adolescents is associated with mental and behavioral comorbidities and may have adverse effects on students' academic performance as well as their physiological and psychological well-being. Therefore, this study examines the impact of family communication and body image dissatisfaction on adolescents' test anxiety in Greece. According to the results of the Structural Equation Model that was examined, family communication presented a minimal negative effect on students' TA. However, the main finding of this study was that body image dissatisfaction had an important direct and minimal indirect effect on students' TA. The indirect effect was via the physical activity hours that acted as a mediator between body image dissatisfaction and TA. As a result, examining body image concerns and enhancing family communication may be crucial in assisting adolescents at risk for severe TA symptoms. Implications of the findings are discussed.(1)

Effects of triple combination therapy on quality of life and psychosocial outcomes: A longitudinal study

Background: Cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulator triple combination therapy (TCT) is available to approximately 85% of the U.S. CF population. Clinical trials of TCT demonstrate numerous improvements in physical health and healthrelated quality of life (HRQoL), but fewstudies have examined the effects of TCTon mental health and psychosocial outcomes, and little is known about whether gains in HRQoL are sustained over time.We aimed to describe the HRQoL and psychosocial outcomes of people with CF (PwCF) initiating TCT and explored changes in these outcomes up to 1 year after starting TCT. Method(s): This longitudinal study enrolled PwCF aged 14 and older who were followed at a large, combined pediatric and adult CF center. Questionnaires were administered within 6 months of initiating TCT (baseline) and 3, 6, and 12 months later. Study self-report measures evaluated were HRQoL (Cystic Fibrosis Questionnaire-Revised;CFQ-R), optimism, self-efficacy, medication-related beliefs (Medication Beliefs Questionnaire;MBQ), perceived social stigma of illness, and body image. Data were also collected from medical charts on measures of health and mental health screening. Four open-ended questionswere included at each timepoint to elicit qualitative data on experiences starting TCT. Longitudinal data were analyzed using linear mixed-effects models for repeated measures. Result(s): Sixty-three adults and adolescents with CF completed the full set of surveys at baseline. Mean participant age was 30.0 +/- 14.2. Fifty-four percent identified as female, 43% as male, and 2% as nonbinary. Seventyfour percent had private insurance. Mean percentage predicted forced expiratory volume in 1 second (FEV1pp) at baseline was 76.0 +/- 24.1%, and mean body mass index (BMI) was 22.9 +/- 3.1 kg/m2. At 12 months, mean FEV1pp was 80.8 +/- 21.9%, and mean BMI was 24.5 +/- 4.1 kg/m2. On standard measures used in CF mental health screening, mean baseline Patient Health Questionnaire (PHQ-9) score was 3.4 +/- 3.5, and mean General Anxiety Disorder score was 3.4 +/- 3.7. Mean PHQ-9 (3.5 +/- 4.0) and GAD-7 (3.4 +/- 3.7) scores at 12 months were similar to baseline. We found no statistically significant differences between the survey time points in participants' physical, respiratory, or emotional functioning on the CFQ-R, but there was a significant change in social functioning ( p < 0.001). There was no statistically significant change over time in optimism or selfefficacy, but there was a significant difference in CF medication beliefs between the four survey time points ( p = 0.008 for MBQ Importance subscale), with a decrease in perceived importance from baseline to 12 months. Conclusion(s): Whereas lung function and BMI increased in our sample by 12 months, similar improvementswere not seen in standard mental health outcomes. There was no change over time in physical, respiratory, or emotional functioning, optimism, or self-efficacy. Only CFQ-R social functioning had changed by 12 months, perhaps reflecting decreased COVID-related social isolation. There was also a change in medicationrelated beliefs, with a decrease in perceived importance of taking CF medications at 12 months. Future directions include conducting qualitative analyses of open-ended questions and further examining data on social stigma, motivation to take medications, and body image, as well as examining relationships between outcome variables and baseline FEV1 and BMICopyright © 2022, European Cystic Fibrosis Society. All rights reserved

Development of an Individualized Responsive Feeding Coaching Intervention

OBJECTIVES/GOALS: Responsive infant feeding (RIF) promotes healthy dietary patterns and infant weight gain. Research is needed to assist caregivers recognize infant hunger/satiety cues and overcome barriers to using RIF. The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach to promote RIF. METHODS/STUDY POPULATION: Guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, this proof-of-concept study tests the feasibility and fidelity of the LEIFc intervention in mother-infant dyads (N=25). Study visits from the 3rd trimester of pregnancy to 4 months postpartum (PP) are conducted in family homes. Use of RIF via subjective (survey) and objective (video) measures is collected at 1 and 4 months PP. Prenatally written and video material on infant feeding and infant hunger/satiety cues is provided. At 2 and 3 months PP, coaching during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR (super, Setting the Stage, Observation & Opportunities, Problem Solving & Planning, Reflection & Review) approach. Qualitative data on LEIFc are provided by the interventionist and participants. RESULTS/ANTICIPATED RESULTS: To date 25 dyads have been enrolled and 4 have completed all study visits. Preliminary analyses showed that subjective measure of awareness of infant cues increased post intervention (pre, M=4.38 vs post, M=4.63). LEIFc has been well accepted by participants including use of the SS-OO-PP-RR approach. Data suggests refinement to LEIFc is needed to include breastfeeding and mental health support as well as a longer duration of intervention through at least 6 months PP. An experienced interventionist is key to success of the research. All lost to follow-up (n=7) have occurred before the first PP visit suggesting that at study visit closer to birth is needed. Enrollment will continue through December 2022 and data collection through April 2023. DISCUSSION/SIGNIFICANCE: After refinement, the LEIFc intervention will be tested in a pilot RCT. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs who serve vulnerable populations;those that often have infant feeding practices that do not align with recommendations and are less likely to use RIF.

"I'll never sacrifice my well-being again:" The journey from negative to positive body image among women who perceive their body to deviate from societal norms.

We conducted one-on-one interviews with 25 Canadian cisgender women who self-identified as having (a) a condition or characteristic causing their body to deviate from societal norms and (b) overcome a negative body image to develop a positive body image. Using coding reliability thematic analyses, we identified 12 themes (italicised) involving processes and experiences associated with shifts in body image. Women had moments that sparked and confirmed the importance of building positive body image (Enough is Enough). They experienced accepting Social Connections and Community and Accessed Critical Knowledge conducive to body positivity. They engaged in Joyful Movement, Adaptive Appearance Investment, and Joyful and Intuitive Eating. They identified how Changing Societal Norms, Becoming Older and Wiser, COVID-19 Pandemic, having Illnesses and Medical Conditions, Pregnancy and Motherhood, and Spirituality, Religion, and Nature affected their body image, values, and valued action. As women engaged in these processes and experiences, shifts occurred in their perceptions of their embodied selves in the world, represented by four "Bigger Lessons:" I Am More Than My Looks, I Am More Than My Body, I am More Than My Self, and I am Inherently Worthy of Love, Respect, and Joy. These findings can inform body image programmes and clinical interventions.

Factors associated with body image dissatisfaction in a Brazilian university sample during the COVID-19 pandemic

We investigated the prevalence of body image dissatisfaction (BID) and associated factors among professors and undergraduate students in Brazil during the COVID-19 pandemic. Using Stunkard's Figure Rating Scale, BID was analyzed in a sample of 2,220 adults. The independent variables were sociodemographic, lifestyle, mental health symptoms, COVID-19-related factors, disordered eating, experience of weight stigma, and weight change concerns. We used a multinomial logistic regression analysis. The overall prevalence of BID was 82.5% (69.0% due to excess weight), with more professors dissatisfied by excess weight than undergraduate students (78.9% vs. 61.2%, p < 0.001). In the adjusted model, being a young adult (PR, 1.201, 95% CI: 1.128;1.279), married or in a stable union (PR, 1.088, 95% CI: 1.027;1.152), reporting of binge eating episode (PR, 1.120, 95% CI: 1.068;1.173), concern about weight gain (PR, 1.394, 95% CI: 1.310;1,483), and experience of excess weight stigma (PR, 1.193, 95% CI: 1.141;1.248) increased the prevalence of BID due to excess weight. While males (PR, 1.578, 95% CI: 1.328;1.875), moderate to severe depressive symptoms (PR, 1.217, 95% CI: 1.011;1.465), the concern of losing weight (PR, 1.494, 95% CI: 1.221;1.830), and experience of low weight stigma (PR, 2.620, 95% CI: 2.093;3.280) increased the prevalence of BID due to low weight. Different factors associated with BID were observed between students and professors. Bearing in mind the complexity of body image, it is essential to consider different public health interventions and the COVID-19 pandemic's influence on reducing BID among Brazilian adults, especially susceptible groups. Copyright © 2023 de Magalhães Cunha, Pereira, Souto, de Sá, da Silva, de Brito and de Santana.

Women Facing Head and Neck Cancer: Psychosocial Implications and Protective Factors

Background/Purpose: In the United States, 26% of newly diagnosed head and neck cancer (HNC) patients are women (Siegel et al., 2022). New cases have remained steady for 20 years, but the mortality rate has increased 1.9% per year. Currently, oral cavity and pharyngeal cancers have the second highest mortality rate of all cancers in women (www.seer.cancer.gov/report-to-nation/). This is alarming considering overall cancer mortality in women has dropped 1.4% (www.seer.cancer.gov/report-to-nation/). HNC disrupts the social, emotional, and physical lives of patients. The literature highlights such concerns as depression, problems with speech, eating, and body image, and social support needs (Bond et al., 2014;Hodges & Humphris, 2009;Locher et al., 2010;Maguire et al., 2017;Nund et al., 2015). The purpose of this study was to investigate the unique experience of being a woman with HNC. Problem: The psychosocial impact of HNC is documented in the literature;however, studies include few women and do not report results by sex. Method(s): Women were recruited from two academic medical centers in the Midwest. Participants were interviewed twice for 30-60 min each session. Most were interviewed using a virtual platform, with some in person or by phone. Each semi-structured interview was recorded and transcribed. Transcripts were analyzed using grounded theory techniques to identify themes. Result(s): This study included 10 women, with a mean age of 62.9 years. Several themes emerged, including physical and emotional impact of HNC, adjustment to life with cancer, coping and control, and support needs. Most surprisingly, this study found having HNC helped women feel prepared to navigate the Covid-19 pandemic. Topics included mask wearing, social interactions, family implications, societal views about illness, and feeling prepared. Conclusions and Implications: This study offers insights about the non-medical needs of women with head and neck cancer and provides some guidance on care provision.

Going Virtual During Covid with the NCI-Connect Cares (Coping, Advocacy, Resources, Education, Support) Group for Rare Brain and Spine Tumor (RBST) Patients and their Families

Background/Purpose: RBST patients have limited supportive care resources and feel secluded as few healthcare providers have expertise in these diseases. The NCI-CONNECT specialized clinic for adults with RBSTs created a multidisciplinary approach with a genetic counselor, knowledgeable healthcare team, and group sessions with a health and wellness counselor (CARES). The CARES sessions created an educational and supportive space for patients to share their unique experiences. We report the adaptation of the CARES group that evolved from in-person to virtual during COVID. Method(s): Patients with RBSTs and their families attended weekly (1 h) groups at their clinic appointments. The CARES group leaders (A.A, S.S) led wellness/coping presentations (15-20 min) and a guided discussion on the topic. In 2021, the COVID pandemic shifted the group to monthly virtual meetings, and educational content was shared via a closed-Facebook group and NCI-CONNECT website. Six groups included presenters within Neuro-Oncology, shortened prerecorded presentations (10 min) allowing for more engagement opportunities, and a coping activity concluded the meeting. Emailed survey feedback was requested (5 out of 13 completed). Result(s): On average, six patients attended each group. Topics included mindfulness, distress, relational challenges, body image, and an educational series on symptom management. All presentations can be found on the NCI-CONNECT website. Patients reported enjoyment in the ability to connect with others, with 80% preferring monthly virtual meetings. Open-ended comments noted that hearing other patients' stories created connections patients expressed they needed. Conclusions and Implications: The virtual CARES group created an accessible space for RBST patients to build relationships and gain support to manage the uncertainties of coping with a rare disease during a time of physical isolation. Patient responses capture the need to continue the group further. Future work will focus on expanding the group based on patient needs and building metrics to understand the overall group benefits in a virtual world.

The experiences of individuals with body positive online social media content during recovery from disordered eating

Disordered eating behaviors and experiences of body image disturbance continue to affect individuals in Westernized society. The widespread use of social media that has increased since the COVID-19 pandemic presents a platform where body image and eating concerns are constantly discussed. Body positive social media content exists as media where individuals often explore themes of positive body image, society's influence on personal beliefs, and eating behaviors. Understanding the implications of body positive social media use during the disordered eating recovery process is important for counselors and individuals to increase positive behaviors. This study explored the experiences of individuals in recovery from disordered eating with body positive social media content on platforms such as InstagramTM and TikTokTM. A total of six participants were interviewed for this hermeneutic phenomenological qualitative study. This study resulted in the identification of five themes and 11 subthemes. The themes and corresponding subthemes identified were as follows: social media as a safe space to explore recovery (subthemes-(a) understanding the personal nature of recovery, (b) education on recovery), representation (subthemes-(a) everyday representation, (b) normalizing), intentionality in social media use (subthemes-(a) curating your feed, (b) social media for reinforcement), two sides of the same coin (subthemes-(a) negativity in "positive" spaces, (b) authentic BoPo vs. co-opted BoPo, (c) comparisons), and community (subthemes-(a) connection, (b) seeking support not found elsewhere). This study helped to identify what aspects of body positive social media use are both supportive and unhelpful during the recovery process for disordered eating behaviors. Implications for future research include exploring what factors contribute to positive and negative experiences of body positive social media use during recovery from disordered eating and analyzing the relationship between protective factors such as support systems, family experiences with disordered eating and dieting, and disordered eating history in relation to the efficacy of body positive social media content. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Ultrahypofractionated radiation therapy for breast cancer: two-year normal tissue effects

Introduction: Parallel with the emerging results of the FAST-Forward (FF) trial, we implemented ultrahypofractionated radiation therapy (RT) for early-stage breast cancer in our clinic at the beginning of the COVID-19 pandemic [Brunt 2020]. This scheme of 26 Gy in 5 consecutive fractions, was given to all breast cancer patients referred for postoperative RT of the breast only. Uniquely, in view of the pandemic, we also gave a single ultrahypofractionated sequential tumourbed boost of 6 Gy, if indicated according to our local protocol. The aim of this prospective study was to assess 2-year late normal tissue effects in this cohort of breast cancer patients. Method(s): Data was recorded in a prospective database. Early results were published before [Machiels 2020]. A sequential boost of 6 Gy in 1 fraction was delivered to all patients <70 y. Late normal tissue effects were patient-assessed using EORTC QLQ-BR23 breast cancer module, body image scale questionnaire and the FF protocol-specific questions relating to changes to the affected breast (breast appearance, size, induration, and skin appearance) 24 months after treatment. Patient assessments used a four-point scale (i.e., not at all, a little, quite a bit, very much). We performed this 24-month assessment using tele-medicine follow-up as we did during the pandemic. Descriptive statistical analysis of late normal tissue effects was performed;differences were assessed using Pearson chi-square test and p-values <0.05 were considered significant. Result(s): All 68 patients from our earlier cohort were contacted 2 years after completion of RT, of which all but two were available. Forty-two patients received a boost and 24 did not. Median follow-up was 24 months (range;22- 27). Prevalence of the most-reported mild late normal tissue effects was 53% for mild increase in induration, 50% for mild appearance changes and 48% for mild sensitivity (Table 1). Most-reported moderate normal tissue effects was 13% for sensitivity. The only reported marked effects was 3% change in breast appearance. No significant differences between patients receiving a boost and no boost were seen. Conclusion(s): Our findings are similar to the late normal tissue effects reported in the FF trial and endorse the use of ultrahypofractionated RT for early-stage breast cancer. An ultrahypofractionated tumourbed boost did not result in increased late normal tissue effects, which is being further investigated in a randomised trial. No conflict of interest.Copyright © 2022 Elsevier Ltd. All rights reserved

Pengaruh Media Sosial terhadap Perubahan Tingkah Laku Kecelaruan Pemakanan dan Imej Badan Sebelum dan Sewaktu Penularan Wabak Covid-19 terhadap Pelajar Wanita Pengajian Tinggi di Selangor

Media sosial adalah salah satu medium komunikasi yang paling penting dalam kehidupan seseorang. Apabila berlakunya penularan wabak Covid-19, kebergantungan kepada media sosial menjadi tinggi terutamanya bagi menjalani kehidupan seharian. Pengenalan kepada kawalan pergerakan dan perintah berkurung menjadikan media sosial sebagai medium perhubungan utama antara seorang individu dengan individu yang lain. Oleh yang demikian, kajian ini dijalankan bagi melihat perkaitan antara media sosial dengan ketidakpuasan imej badan dan perubahan tingkah laku kecelaruan pemakanan sebelum dan sewaktu penularan wabak Covid-19 terutamanya dalam kalangan pelajar wanita institusi pengajian tinggi di Selangor. Kajian dijalankan melibatkan 172 orang responden wanita yang berumur 19 hingga 24 tahun dan sedang belajar di Institusi Pengajian Tinggi Malaysia di Selangor. Metod kajian yang digunakan adalah menggunakan jenis persampelan bukan kebarangkalian dengan menggunakan kaedah persampelan mudah dan kaedah bola salji bagi mengedarkan soal selidik secara atas talian. Hasil kajian mendapati bahawa hampir tiada hubungan yang signifikan bagi media sosial dan ketidakpuasan imej badan dengan media sosial dan perubahan tingkah laku kecelaruan pemakanan. Perbandingan data primier dan data sekunder juga mempunyai sedikit perbezaan dapat kajian iaitu hampir tiada hubungan signifikan bagi data primier dan hubungan signifikan yang lemah bagi data sekunder. Dapatan kajian ini diharap dapat membantu memberi kesedaran dan membuka mata masyarakat tentang pengaruh media sosial terhadap ketidakpuasan imej badan dan perubahan gaya pemakanan jika ia tidak dibendung.Alternate :Social media is one of the most important things in one's life. Outbreak of the Covid- 19 pandemic makes reliance on social media become high especially for daily living. The introduction to movement control and lockdown makes social media a main medium of communication between one individual and another. Therefore, this study was conducted to see the relationship between social media, body dissatisfaction and disordered eating before and during Covid-19 outbreak, especially among female students of higher learning institutions in Selangor. The study was conducted involving 172 female respondents aged 19 to 24 years old and currently studying at Malaysian Institutions of Higher Learning in Selangor. The research method used was a non - probability sample and snowball method to distribute the online questionnaire. Results showed there was almost no significant relationship for social media and body dissatisfaction, social media and disordered. The comparison of primary data and secondary data also recorded slight differences with almost no significant relationship for primary data and a weak significant relationship for secondary data. The findings of this study are hoped to help raise awareness and open the eyes of the public about the influence of social media on body dissatisfaction and disordered if it is not curbed.

The impact of social media use on body image and disordered eating behaviors: Content matters more than duration of exposure.

Social media use is rapidly expanding in terms of frequency, duration, and the diversity of platforms available. Given evidence for associations between social media use, body image disturbances, and disordered eating it is important to identify potentially harmful aspects of social media use that could serve as intervention targets. This study surveyed two demographically diverse undergraduate student cohorts in 2015 and 2022 to compare patterns in social media use, body image, and disordered eating behaviors between samples, including as a function of the COVID-19 pandemic, and to test the hypothesized moderating role of specific content consumed in the association between social media use and maladaptive outcomes. Participants in 2022 reported greater body image disturbances, more frequent vomiting and laxative use, and more time spent on a greater number of social media accounts, with significantly greater use of image-based platforms such as Snapchat, TikTok, and YouTube. Moderated regression analyses suggest that type of content consumed, but not the amount of time spent on social media or diversity of platforms utilized, is associated with body image disturbances and disordered eating behaviors after controlling for gender and body mass index. Specifically, exposure to weight loss content was associated with lower body appreciation, greater fears of negative appearance evaluation, and more frequent binge eating. Contrary to initial hypotheses, exposure to body positivity/neutrality content did not have protective effects. Findings suggest that interventions targeting negative consequences of social media use should focus on addressing content consumed, rather than time spent on social media platforms.

Body-related predictors of depression: a cross-sectional study among adults during COVID-19

The aim of our study was to identify body-related predictors (quality of life, negative emotions, body dissatisfaction) of depression during the COVID-19 pandemic while controlling for sex, age and BMI. Participants (N = 167, Mage = 37.70 years ± 11.37) completed: the Beck Depression Inventory-II, the Body Image Quality of Life Inventory, the short form of the Situational Inventory of Body Image Dysphoria, the Contour Drawing Rating Scale and the socio-demographic survey. Body-related quality of life had the most credible and negative association among the included predictors. Body-related negative emotions and body dissatisfaction were both positively and credibly related, with similar strength. Our outcomes mean that body image attitudes and emotions, and the extent to which these impact on quality of life during COVID-19 are important in predicting the level of depression symptoms. Expanding the scope of knowledge in this field will help to understand the mechanisms generating relationships between depression and body image, especially in the context of the effects of the COVID-19 pandemic and will allow for more effective assistance in the treatment of depression. [ABSTRACT FROM AUTHOR] Copyright of Advances in Mental Health is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Skills Training in Affective and Interpersonal Regulation Narrative Therapy Delivered via Synchronous Telehealth: A Case Study of a Rural Woman Veteran With Complex Posttraumatic Stress Disorder

The International Classification of Diseases-11 th Revision (ICD-11) includes the diagnosis of complex posttraumatic stress disorder (CPTSD). Clinical practice guidelines support the use of phased care for individuals with CPTSD. This case study illustrates the use of synchronous telehealth to deliver phased treatment to a rural woman veteran with CPTSD. Mrs. A experienced sexual, physical, and emotional abuse throughout her life, perpetrated by family members, intimate partners, and military authority figures. She sought treatment for posttraumatic nightmares and body image issues;she also had pain related to fibromyalgia and chronic migraine headaches. Mrs. A participated in 19 sessions of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative therapy via synchronous telehealth. Trauma and eating disorder symptoms were assessed before and after treatment and the patient demonstrated clinically significant improvement on measures of these disorders. Patient-provider working alliance and quality of life were assessed post-treatment. Synchronous telehealth use drastically increased with the onset of COVID-19;however, little information on treating CPTSD via synchronous video teleconferencing is available. This case study illustrates an evidence-based, phased therapy for CPTSD while highlighting the feasibility and value of in-home delivery of psychotherapy for CPTSD via synchronous telehealth.Copyright © The Author(s) 2023.

Parent and child influence in body image dissatisfaction: The moderating effect of parent acceptance of the COVID-19 pandemic.

The present study investigated the influence of parent and child-driven effects on body image dissatisfaction during the COVID-19 pandemic. The moderating effect of parents' acceptance of the COVID-19 pandemic and child gender were also investigated. The participants were 175 Canadian parents (mothers = 87.4%, fathers = 12%, unspecified = 0.6%) of children aged between 7 and 12 years old (M = 9.2; boys = 48.9%, girls = 51.1%). Two cohorts of parents were asked to complete a questionnaire in June 2020 and January 2021, respectively, followed by a second questionnaire approximately five months later. At both time points, the questionnaires addressed the parents' body image dissatisfaction and acceptance of the COVID-19 pandemic. In addition, parents reported on their child's body image dissatisfaction at both time points. Path analysis models were used to examine parent-driven and child-driven effects. Parents' acceptance of the pandemic significantly moderated both parent and child-driven effects such that parents with low levels of acceptance were more likely to negatively influence, and be negatively influenced by, their perception of their child's body image dissatisfaction. Child gender significantly moderated child-driven effects, as mothers' perception of their son's body image dissatisfaction predicted their own dissatisfaction over time. Our findings suggest that child-driven effects should be considered in future studies on body image dissatisfaction.

Lifestyle Behavior Changes and Associated Risk Factors During the COVID-19 Pandemic: Results from the Canadian COVIDiet Online Cohort Study.

BACKGROUND: The COVID-19 pandemic and related lockdowns have impacted lifestyle behaviors, including eating habits and physical activity; yet, few studies have identified the emerging patterns of such changes and associated risk factors. OBJECTIVE: This study aims to identify the patterns of weight and lifestyle behavior changes, and the potential risk factors, resulting from the pandemic in Canadian adults. METHODS: Analyses were conducted on 1609 adults (18-89 years old; n=1450, 90.1%, women; n=1316, 81.8%, White) of the Canadian COVIDiet study baseline data (May-December 2020). Self-reported current and prepandemic weight, physical activity, smoking status, perceived eating habits, alcohol intake, and sleep quality were collected through online questionnaires. Based on these 6 indicator variables, latent class analysis (LCA) was used to identify lifestyle behavior change patterns. Associations with potential risk factors, including age, gender, ethnicity, education, income, chronic diseases, body image perception, and changes in the stress level, living situation, and work arrangement, were examined with logistic regressions. RESULTS: Participants' mean BMI was 26.1 (SD 6.3) kg/m2. Of the 1609 participants, 980 (60.9%) had a bachelor's degree or above. Since the pandemic, 563 (35%) had decreased income and 788 (49%) changed their work arrangement. Most participants reported unchanged weight, sleep quality, physical activity level, and smoking and alcohol consumption, yet 708 (44%) reported a perceived decrease in eating habit quality. From LCA, 2 classes of lifestyle behavior change emerged: healthy and less healthy (probability: 0.605 and 0.395, respectively; Bayesian information criterion [BIC]=15574, entropy=4.8). The healthy lifestyle behavior change group more frequently reported unchanged weight, sleep quality, smoking and alcohol intake, unchanged/improved eating habits, and increased physical activity. The less healthy lifestyle behavior change group reported significant weight gain, deteriorated eating habits and sleep quality, unchanged/increased alcohol intake and smoking, and decreased physical activity. Among risk factors, body image dissatisfaction (odds ratio [OR] 8.8, 95% CI 5.3-14.7), depression (OR 1.8, 95% CI 1.3-2.5), increased stress level (OR 3.4, 95% CI 2.0-5.8), and gender minority identity (OR 5.5, 95% CI 1.3-22.3) were associated with adopting less healthy behaviors in adjusted models. CONCLUSIONS: The COVID-19 pandemic has appeared to have influenced lifestyle behaviors unfavorably in some but favorably in others. Body image perception, change in stress level, and gender identity are factors associated with behavior change patterns; whether these will sustain over time remains to be studied. Findings provide insights into developing strategies for supporting adults with poorer mental well-being in the postpandemic context and promoting healthful behaviors during future disease outbreaks. TRIAL REGISTRATION: ClinicalTrials.gov NCT04407533; https://clinicaltrials.gov/ct2/show/NCT04407533.

Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature.

From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one's body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts-perceptual disturbances and dysfunctional eating attitudes and behaviors-in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.