Nicula Maria, Pellegrini Danielle, Grennan Laura, Bhatnagar Neera, McVey Gail, Couturier Jennifer
McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
University Health Network, Toronto, ON, Canada.
J Eat Disord. 2022 Feb 14;10(1):21. doi: 10.1186/s40337-022-00543-8.
Although early intervention is crucial in interrupting the development of eating disorders, little is currently known about help-seeking behaviours among individuals experiencing eating disorder symptoms. Given that eating disorders typically begin early in life, it is necessary to investigate the processes employed by children, adolescents, and emerging adults when seeking services for troubling symptoms. This is a growing concern as the COVID-19 pandemic has resulted in an increase in the number of individuals engaging in disordered eating behaviours. This scoping review explores the current state of the literature for evidence on how youth with eating disorder symptoms seek help, with the aim of better understanding how to identify and treat more individuals earlier.
Using scoping review methodology, we searched seven databases for studies published from January 2000 to April 2021 that reported on help-seeking attitudes, behaviours, and healthcare utilization patterns for children and adolescents (< 18 years), emerging adults (18-25 years), and a mixture of these groups (< 25 years). Seven thousand, two hundred, and eighteen articles were identified for review. After duplicates were removed, three reviewers independently screened titles and abstracts and reviewed full-text articles. Findings related to help-seeking activity were extracted from the 62 articles that were ultimately included in this scoping review.
Study findings were summarized into help-seeking patterns (i.e., rates, types) as well as factors ranging from the individual level to society that influenced help-seeking behaviour. Many youth meeting eating disorder criteria were not seeking help. Notable barriers to help-seeking included poor mental health literacy, experiences with healthcare providers who failed to detect and lacked knowledge about eating disorders, minimal support from family and friends, and stigma surrounding eating disorders and help-seeking for mental health concerns.
The results of this scoping review can be used to inform early intervention and health promotion program development. Future research should focus on the help-seeking attitudes and activities among underrepresented groups with eating disorders (e.g., men, ethnic and gender minorities), the perspectives of family and other supporters in the help-seeking process for youth, and retrospective accounts from adults with lived experience of an eating disorder. Plain English summary Addressing and interrupting eating disorder-related thoughts and behaviours as soon as possible, with the help of a mental health professional, leads to better outcomes for youth struggling with an eating disorder. However, little is known about what prompts youth to talk about their weight, body, or eating concerns with someone-like their parent, friend, teacher, guidance counsellor, or primary care practitioner. This review explores the available published research on help-seeking patterns and preferences among youth with eating disorder concerns. Our team followed a standardized process to find 62 relevant articles for this paper. Of note, many young people who reported eating disorder concerns were not seeking help for themselves. Feeling supported by family and their primary care provider, understanding the signs of an eating disorder, and not feeling shame for reaching out for help reportedly led youth to speak up about their concerns. The findings have clinical implications for learning effective ways to help youth feel safe to speak freely about their eating disorder-related concerns, which enhances the chances of intervening early and catching symptoms before they worsen.
尽管早期干预对于阻断饮食失调的发展至关重要，但目前对于有饮食失调症状的个体的求助行为知之甚少。鉴于饮食失调通常在生命早期开始，有必要调查儿童、青少年和刚成年的人在为困扰他们的症状寻求服务时所采用的过程。随着新冠疫情导致饮食行为紊乱的个体数量增加，这一问题日益受到关注。本范围综述探讨了关于有饮食失调症状的青少年如何寻求帮助的文献现状，目的是更好地了解如何更早地识别和治疗更多个体。
采用范围综述方法，我们在七个数据库中搜索了2000年1月至2021年4月发表的研究，这些研究报告了儿童和青少年（<18岁）、刚成年的人（18 - 25岁）以及这些群体的混合群体（<25岁）的求助态度、行为和医疗保健利用模式。共识别出7218篇文章以供审查。去除重复项后，三名评审员独立筛选标题和摘要，并审查全文文章。与求助活动相关的研究结果从最终纳入本范围综述的62篇文章中提取。
研究结果总结为求助模式（即比率、类型）以及从个体层面到社会层面影响求助行为的因素。许多符合饮食失调标准的青少年并未寻求帮助。求助的显著障碍包括心理健康素养差、与未能察觉且缺乏饮食失调知识的医疗保健提供者的经历、家人和朋友的支持极少，以及围绕饮食失调和因心理健康问题寻求帮助的污名化。
本范围综述的结果可用于为早期干预和健康促进项目的发展提供信息。未来的研究应关注饮食失调的代表性不足群体（如男性、少数族裔和少数性别群体）的求助态度和活动、家庭和其他支持者在青少年求助过程中的观点，以及有饮食失调生活经历的成年人的回顾性叙述。通俗易懂的总结在心理健康专业人员的帮助下，尽早解决和阻断与饮食失调相关的想法和行为，对于与饮食失调作斗争的青少年会产生更好的结果。然而，对于是什么促使青少年与父母、朋友、老师、指导顾问或初级保健医生等谈论他们的体重、身体或饮食问题，我们知之甚少。本综述探讨了关于有饮食失调问题的青少年的求助模式和偏好的现有已发表研究。我们团队遵循标准化流程为本文找到了62篇相关文章。值得注意的是，许多报告有饮食失调问题的年轻人并未为自己寻求帮助。据报道，得到家人和初级保健提供者的支持、了解饮食失调的迹象以及不因寻求帮助而感到羞耻，促使青少年说出他们的担忧。这些发现对于学习有效的方法来帮助青少年放心地自由谈论与饮食失调相关的担忧具有临床意义，这增加了早期干预并在症状恶化之前发现症状的机会。
