Perspectives of e-health interventions for treating and preventing eating disorders: descriptive study of perceived advantages and barriers, help-seeking intentions, and preferred functionality

Linardon, Jake; Messer, Mariel; Lee, Sohee; Rosato, John

doi:10.1007/s40519-020-01005-3

Cited by 52 publications

(48 citation statements)

References 41 publications

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“…Nascent data in the field of COVID‐19 and eating disorders suggests continued resistance to non‐traditional delivery modes (Brothwood et al, 2021 ). Recent efforts to understand who prefers and is most likely to benefit from digital health (Linardon, Messer, Lee, & Rosato, 2020 ; Linardon, Shatte, Tepper, & Fuller‐Tyszkiewicz, 2020 ) provide necessary data to facilitate online triage systems to safely divert some individuals from face‐to‐face to online services. However, infrastructure gaps and the lack of centralized, consolidated systems to help individuals navigate through different treatment options and routinely monitor progress remain a glaring need in this field.…”

Section: Discussionmentioning

confidence: 99%

A systematic scoping review of research on COVID‐19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field

Linardon

Messer

Rodgers

et al. 2021

Intl J Eating Disorders

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115

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Objective Research investigating the effects of COVID‐19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature. Method Empirical research on COVID‐19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings ( n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID‐19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic‐related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID‐19. Results Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during―and due to―the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at‐risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID‐19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective. Discussion Evidence for COVID‐19 effects is mostly limited to participant self‐report or retrospective recall, cross‐sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.

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Section: Discussionmentioning

confidence: 99%

A systematic scoping review of research on COVID‐19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field

Linardon

Messer

Rodgers

et al. 2021

Intl J Eating Disorders

Self Cite

127

115

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“…Furthermore, their scalability, flexibility, and cost advantages over traditional facetoface services indicate that smartphone app technologies could offer a potential solution to many exist ing helpseeking barriers and the widespread treatment gap re ported in this clinical group 162 . Importantly, recent survey data show that a significant proportion of individuals with an eating disorder report a preference for, and willingness to use, smart phone apps and other DHTs 163,164 , indicating that their demand is high.…”

Section: Eating Disordersmentioning

confidence: 99%

The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality

et al. 2021

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As the COVID-19 pandemic has largely increased the utilization of telehealth, mobile mental health technologies -such as smartphone apps, virtual reality, chatbots, and social media -have also gained attention. These digital health technologies offer the potential of accessible and scalable interventions that can augment traditional care. In this paper, we provide a comprehensive update on the overall field of digital psychiatry, covering three areas. First, we outline the relevance of recent technological advances to mental health research and care, by detailing how smartphones, social media, artificial intelligence and virtual reality present new opportunities for "digital phenotyping" and remote intervention. Second, we review the current evidence for the use of these new technological approaches across different mental health contexts, covering their emerging efficacy in self-management of psychological well-being and early intervention, along with more nascent research supporting their use in clinical management of long-term psychiatric conditions -including major depression; anxiety, bipolar and psychotic disorders; and eating and substance use disorders -as well as in child and adolescent mental health care. Third, we discuss the most pressing challenges and opportunities towards real-world implementation, using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to explain how the innovations themselves, the recipients of these innovations, and the context surrounding innovations all must be considered to facilitate their adoption and use in mental health care systems. We conclude that the new technological capabilities of smartphones, artificial intelligence, social media and virtual reality are already changing mental health care in unforeseen and exciting ways, each accompanied by an early but promising evidence base. We point out that further efforts towards strengthening implementation are needed, and detail the key issues at the patient, provider and policy levels which must now be addressed for digital health technologies to truly improve mental health research and treatment in the future.

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“…It is however important to note that for some, using video may be upsetting, so a recent paper recommended starting with audio if the patient has concerns about seeing their own image, and/or asking them to not look at parts of their own image they find distressing, although the therapist and patient should ideally work together to accept switching to video [31]. Another important aspect concerned the convenience of online treatment which reduced lengthy travel timescurrently considered as a barrier to successful treatment [71,72]. The positive appraisals around convenience and ease of access, found in our participants and in those of the previous study [10] were actually identified as advantages of telehealth interventions prior to Covid-19 [29,73,74] and suggest a future for online treatment beyond the COVID-19 pandemic.…”

Section: Experience Of Online Treatmentmentioning

confidence: 99%

The impact of the COVID-19 pandemic on individuals with eating disorders: the role of emotion regulation and exploration of online treatment experiences

et al. 2021

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Objective The Covid-19 pandemic has wrought disruption to everyday life and services, and emerging evidence suggests that those with eating disorders (EDs) are likely to experience marked distress and exacerbation of their symptoms. However, little is known around the most relevant factors to symptom change; whether certain emotion regulation and coping strategies are linked to better outcomes; and how people with EDs are adjusting to psychological interventions moving online. Method In a mixed-method design, we collected qualitative and quantitative data from 207 (76 males) self-selected UK residents with self-reported ED, who described and ranked impacts of the pandemic on their symptoms. Regression analysis examined whether emotion regulation strategies were associated with self-reported symptom change, ED symptomatology, and negative emotional states. Thematic analysis explored participants’ experiences of the pandemic, particularly factors affecting their ED, coping strategies used, and experiences of psychological intervention. Results Most participants (83.1%) reported worsening of ED symptomatology, though factors affecting symptom change differed between specific EDs. Emotion regulation, such as having fewer strategies, poorer emotional clarity, and non-acceptance of emotions, explained nearly half of the variance in emotional distress during the pandemic. Qualitative findings indicated that difficult emotions (such as fear and uncertainty), changes to routine, and unhelpful social messages were triggering for participants during the pandemic. While some participants described employing positive coping strategies (such as limiting social media exposure), many reported using ED behaviours (among other maladaptive strategies, like alcohol use) to cope with the pandemic. Finally, loss of treatment support, feeling underserving of support and experiencing a ‘detached connection’ online were further exacerbating factors for these participants. Discussion While our sample was self-selected and may not represent all people with EDs, our results suggest that people with EDs have been strongly affected by the pandemic. Some aspects of online treatment were found to be beneficial but our findings suggest it also needs some improvement. Our paper discusses implications for online treatment such as taking into account personal circumstances and, in a time where people have limited control over the antecedents of negative emotion, the need to develop skills to manage emotions when they arise.

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Perspectives of e-health interventions for treating and preventing eating disorders: descriptive study of perceived advantages and barriers, help-seeking intentions, and preferred functionality

Cited by 52 publications

References 41 publications

A systematic scoping review of research on COVID‐19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field

A systematic scoping review of research on COVID‐19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field

The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality

The impact of the COVID-19 pandemic on individuals with eating disorders: the role of emotion regulation and exploration of online treatment experiences

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