What are the long-term holistic health consequences of COVID-19 among survivors? An umbrella systematic review.

Many people who have survived COVID-19 have experienced negative persistent impacts on health. Impacts on health have included persistent respiratory symptoms, decreased quality of life, fatigue, impaired functional capacity, memory deficits, psychological impacts, and difficulties in returning to paid employment. Evidence is yet to be pooled to inform future directions in research and practice, to determine the physical, psychological, social, and spiritual impacts of the illness which extend beyond the acute phase of COVID-19 survivors. This umbrella review (review of systematic reviews) critically synthesized physical (including abnormal laboratory parameters), psychological, social, and spiritual impacts which extended beyond the acute phase of COVID-19 survivors. The search strategy was based on the sample, phenomena of interest, design, evaluation, research model and all publications were double screened independently by four review authors for the eligibility criteria. Data extraction and quality assessment were conducted in parallel independently. Eighteen systematic reviews were included, which represented a total of 493 publications. Sample sizes ranged from n = 15 to n = 44 799 with a total of n = 295 455 participants. There was incomplete reporting of several significant data points including the description of the severe acute respiratory syndrome coronavirus 2 variant, COVID-19 treatments, and key clinical and demographic data. A number of physical, psychological, and social impacts were identified for individuals grappling with post-COVID condition. The long term sequalae of acute COVID-19 and size of the problem is only beginning to emerge. Further investigation is needed to ensure that those affected by post-COVID condition have their informational, spiritual, psychological, social, and physical needs met in the future.

The effect of self-focused attention and mood on appearance dissatisfaction after mirror-gazing: An experimental study.

BACKGROUND AND OBJECTIVES: Self-focused attention is hypothesized to be a maintenance factor in body dysmorphic disorder (BDD). The aim of this study was to use an experimental paradigm to test this hypothesis by studying the effect of self-focused attention during mirror-gazing on appearance dissatisfaction. METHODS: An experimental group design was used, in which 173 women were randomly allocated to one of three conditions before mirror-gazing for 2 min: (a) external focus of attention, (b) self-focus of attention, and (c) self-focus of attention with a negative mood induction. RESULTS: After mirror-gazing, participants across all groups rated themselves as being more dissatisfied with their appearance. In both the self-focus conditions, there was an increase in sadness from pre to post mirror gazing, and there was a significant difference in focus of attention for participants in the self-focused, mood-induced group from pre to post manipulation, suggesting mood induction had more of an effect than focus of attention. LIMITATIONS: (1) there was no condition involving an external focus with a negative mood induction, and (2) due to the level of information provided to patients on the nature of the task, we cannot rule out demand characteristics as an influencing factor on our results. CONCLUSIONS: Self-focused attention during mirror-gazing may act indirectly to increase appearance dissatisfaction via the effect of negative mood. Further studies are required to establish the relative contribution of self-focused attention and negative mood to increases in appearance dissatisfaction as a function of mirror-gazing.

Attachment disorders versus more common problems in looked after and adopted children: comparing community and expert assessments.

BACKGROUND: Attachment disorders in adopted and fostered children may be overdiagnosed and could obscure more common disorders. METHODS: A case note review of 100 referrals to a specialist adoption and fostering service compared community referrals with the specialist assessments of attachment disorders. RESULTS: Attachment disorders were identified four times more often in community referrals versus the specialist service, but this only partly explained the significant under-identification of more common disorders in the community, especially for neurodevelopmental factors and conduct disorder by up to 10-fold. CONCLUSIONS: The relevant practice parameters are discussed and implications for service models for adopted and fostered children reviewed.

The stopping criteria for mirror-gazing in body dysmorphic disorder.

OBJECTIVES: To investigate whether prolonged compulsive mirror-gazing in body dysmorphic disorder (BDD) is characterized by the prioritization of internally referenced (internal) goals for the mirror session, such as feeling right about one's make-up or shaven face, over externally referenced (external) goals, such as seeing that one's make-up is applied, or seeing that there is no more stubble on one's face. DESIGN: Cross-sectional case control. METHODS: Twenty-one participants with BDD and 18 community controls (CCs) recalled a recent mirror session in a semi-structured interview and then completed the Mirror-Gazing Goals and Terminating Factors Questionnaire (MGGTFQ), an instrument developed for the present study. RESULTS: Internal goals were rated as more important in the BDD group than the CC group, but there was no difference between groups in the importance of external goals. The BDD group identified internal goals significantly more frequently than the CC group among their three most important goals. The BDD group reported significantly lower achievement ratings for the three most important goals and were more likely to terminate the session for reasons unrelated to their goals (e.g., frustration). For all participants, the importance of internal goals was positively correlated with the length of the mirror session. CONCLUSIONS: The findings support current recommendations for targeting internal goals in interventions for problematic mirror use. Limitations and future directions are discussed, including the need to establish whether the use of internal goals is causally related to the length of the mirror session. PRACTITIONER POINTS: • BDD patients prioritize internal goals defined by feeling states when they look in the mirror (e.g., they aim above all to feel right about their make-up or shaven face), and then tend not to achieve their goals and end the mirror session for reasons unrelated to their goals (e.g., distress or time constraints). • Educating patients about these potentially problematic 'internal' goals, and encouraging them to aim for alternative goals (e.g., a fixed length of time, or an external goal defined by visual cues) might help patients to reduce the time they spend looking in the mirror. • The study is limited by the correlational design, the reliance on retrospective reporting, and the lack of a clinical control group.