Vuillier L, May L, Greville-Harris M, Surman R, Moseley R L
Department of Psychology, Bournemouth University, Poole, UK.
Dorset Healthcare University NHS Foundation Trust, Poole, UK.
J Eat Disord. 2021 Jan 12;9(1):10. doi: 10.1186/s40337-020-00362-9.
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.
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.
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.
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.
新冠疫情对日常生活和服务造成了干扰，新出现的证据表明，患有饮食失调症（ED）的人可能会经历明显的痛苦，其症状也会加重。然而，对于症状变化的最相关因素、某些情绪调节和应对策略是否与更好的结果相关，以及患有饮食失调症的人如何适应在线心理干预，我们所知甚少。
在一项混合方法设计中，我们从207名（76名男性）自我选择的英国居民那里收集了定性和定量数据，这些居民自述患有饮食失调症，他们描述并对疫情对其症状的影响进行了排名。回归分析检验了情绪调节策略是否与自我报告的症状变化、饮食失调症状和负面情绪状态相关。主题分析探讨了参与者在疫情中的经历，特别是影响其饮食失调症的因素、所采用的应对策略以及心理干预的经历。
大多数参与者（83.1%）报告饮食失调症状恶化，尽管影响症状变化的因素在特定的饮食失调症之间有所不同。情绪调节，如策略较少、情绪清晰度较差以及不接受情绪，解释了疫情期间近一半的情绪困扰差异。定性研究结果表明，困难情绪（如恐惧和不确定性）、日常生活的改变以及无益的社会信息在疫情期间对参与者起到了触发作用。虽然一些参与者描述采用了积极的应对策略（如限制社交媒体曝光），但许多人报告使用饮食失调行为（以及其他适应不良策略，如饮酒）来应对疫情。最后，失去治疗支持、觉得不值得获得支持以及在网上体验到“脱节的联系”对这些参与者来说是进一步加剧病情的因素。
虽然我们的样本是自我选择的，可能不代表所有患有饮食失调症的人，但我们的结果表明，患有饮食失调症的人受到了疫情的强烈影响。发现在线治疗的某些方面是有益的，但我们的研究结果表明它也需要一些改进。我们的论文讨论了在线治疗的意义，例如考虑个人情况，以及在人们对负面情绪的前因控制有限的时期，需要培养情绪出现时管理情绪的技能。
