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Ramjan LM, Smith BW, Miskovic-Wheatley J, Pathrose SP, Hay PJ. Social support for young people with eating disorders-An integrative review. Int J Ment Health Nurs 2024. [PMID: 38812085 DOI: 10.1111/inm.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/30/2024] [Accepted: 05/12/2024] [Indexed: 05/31/2024]
Abstract
Eating disorder treatment should be underpinned by a recovery-oriented approach, be therapeutic, personalised and trauma informed. Within such models of care, social support is an important factor to explore in terms of its influence in supporting hope for recovery, reducing stigma, and mitigating life stressors. Limited research has been conducted to understand the types of social support that are available to young people formally diagnosed with an eating disorder, their feasibility and acceptability and the positive outcomes. This integrative review sought to explore the positive outcomes of social support or social support programs for young people with eating disorders. An integrative review was conducted based on a search of five electronic databases from inception to 31 March 2023. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools and findings have been narratively synthesised and presented in accordance with the review's aims and questions. Seven studies (total 429 individuals, range 3-160) published between 2001 and 2023 were included in the final synthesis. Overall social support interventions showed promising preliminary evidence as a feasible and acceptable adjunct to treatment for young people with an eating disorder motivated to change, with some clinical improvements in psychopathology. Social support augmented existing relationships, providing a human element of open dialogue, friendship and a sense of hope for recovery. Despite the small number and heterogeneity of the studies, this review has highlighted some promising preliminary benefits. Future treatment for eating disorders should embrace adjunct modalities that enhance psychosocial recovery for young people with eating disorders.
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Affiliation(s)
- Lucie M Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Brandon W Smith
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jane Miskovic-Wheatley
- InsideOut Institute, University of Sydney, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sheeja Perumbil Pathrose
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- New South Wales Centre for Evidence Based Health Care: A JBI Affiliated Group, Sydney, New South Wales, Australia
| | - Phillipa J Hay
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Campbelltown Hospital, Mental Health Services, South Western Sydney Local Health District, Sydney, New South Wales, Australia
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Leahy D, McNicholas F. Systematic review of effectiveness and satisfaction evaluation in child and adolescent mental health services in Ireland. Ir J Psychol Med 2024; 41:107-118. [PMID: 33757610 DOI: 10.1017/ipm.2021.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Increasing numbers of youth experience mental illness, and also require and benefit from specialist child and adolescent mental health services (CAMHS). Worldwide, such services are underfunded and under-resourced, and services in Ireland are no different. It is vital that existing services are regularly reviewed for both efficacy and acceptability. Our objective was to review published studies evaluating service user satisfaction with CAMHS in Ireland and CAMHS therapeutic efficacy. METHODS MEDLINE, PsycINFO and CINAHL databases were systematically searched. Studies were included if they reported on service user satisfaction or an evaluation of CAMHS in Ireland. RESULTS From an initial 125 articles identified, 15 studies meet the inclusion criteria: four reporting on overall CAMHS satisfaction, three on satisfaction where a specific diagnosis was present, while eight evaluated various interventions offered. Whilst most service users perceived services to be satisfactory, important issues relating to accessibility were present. Evidence of efficacy was present for a small number of interventions, but studies were limited by methodological issues. CONCLUSIONS There is a dearth of studies evaluating CAMHS in Ireland. The extant literature suggests a positive experience once accessed, but long waiting times and poor collaboration are seen to limit services users' experience. More robust methodologically sound studies are urgently required. Given the expected increased demand linked to the current COVID-19 pandemic, coupled with the resultant compromised financial position, it is essential that scant resources are appropriately directed.
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Affiliation(s)
- D Leahy
- Department of Child and Adolescent Psychiatry North Lee North, Unit 9 St Stephen's Hospital, Glanmire, Cork, Ireland
| | - F McNicholas
- Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Lucena CAMHS, SJOG, Rathgar, Dublin 6, Ireland
- CHI Crumlin, Dublin 12, Ireland
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Murray F, Houghton S, Murphy F, Clancy E, Fortune D, McNicholas F. A Qualitative Exploration of Prominent Factors Contributing to the Aetiology of Child and Adolescent Eating Disorder Presentations during the COVID-19 Pandemic: The Perspectives of Patients, Parents and Clinicians. J Clin Med 2024; 13:615. [PMID: 38276121 PMCID: PMC10816259 DOI: 10.3390/jcm13020615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
AIM The aim of this study was to explore the prominent factors that contributed to the development of child and adolescent eating disorder presentations during the COVID-19 pandemic. METHODS This was achieved through a qualitative analysis of interviews gathered from (1) adolescent patients diagnosed with an eating disorder (ED) during the COVID-19 pandemic (aged 13-18) (n = 4), (2) parents of patients attending an ED service (n = 7) and (3) clinicians working within a specialist child and adolescent ED support service (n = 7). Reflexive thematic analysis was used to analyse the data and establish the most prominent aetiological factors reported. RESULTS The most prominent aetiological factors reported were (1) the accumulation of risk factors; (2) seeking control amid increased anxiety, stress and uncertainty; (3) social isolation; (4) an increased focus on exercise and "healthy eating"; (5) increased social media use promoting unhelpful attention towards ED triggers; and (6) a lack of both awareness and support services. CONCLUSION During the COVID-19 pandemic, the quantity and severity of ED presentations increased. The current study uncovered six themes perceived by patients, parents and clinical staff that contributed to the aetiology of ED presentations during the COVID-19 pandemic. It is hoped that the insight gained through this research study into ED aetiology may act as a basis for further research and support ED awareness, prevention and intervention in the future.
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Affiliation(s)
- Finán Murray
- Department of Psychology, University of Limerick, V94 T9PX Limerick, Ireland
| | - Sharon Houghton
- Clinical Psychology Programme, Department of Psychology, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Fay Murphy
- Lucena Clinic Child & Adolescent Mental Health Services, 59 Orwell Road, Rathgar, D06 HX93 Dublin, Ireland; (F.M.); (F.M.)
| | - Emma Clancy
- Lucena Clinic Child & Adolescent Mental Health Services, 59 Orwell Road, Rathgar, D06 HX93 Dublin, Ireland; (F.M.); (F.M.)
| | - Dónal Fortune
- Department of Psychology, University of Limerick, V94 T9PX Limerick, Ireland
| | - Fiona McNicholas
- Lucena Clinic Child & Adolescent Mental Health Services, 59 Orwell Road, Rathgar, D06 HX93 Dublin, Ireland; (F.M.); (F.M.)
- Children’s Health Ireland Crumlin, D12 N512 Dublin, Ireland
- School Medicine & Medical Sciences, University College Dublin, D04 V1W8 Dublin, Ireland
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Nicula M, Pellegrini D, Grennan L, Bhatnagar N, McVey G, Couturier J. Help-seeking attitudes and behaviours among youth with eating disorders: a scoping review. J Eat Disord 2022; 10:21. [PMID: 35164872 PMCID: PMC8845232 DOI: 10.1186/s40337-022-00543-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Maria Nicula
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | | | - Laura Grennan
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - Neera Bhatnagar
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
| | - Gail McVey
- University Health Network, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Jennifer Couturier
- McMaster University, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada. .,McMaster Children's Hospital, Hamilton, ON, Canada.
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Parsons H, Murphy B, Malone D, Holme I. Review of Ireland's First Year of the COVID-19 Pandemic Impact on People Affected by Eating Disorders: 'Behind Every Screen There Was a Family Supporting a Person with an Eating Disorder'. J Clin Med 2021; 10:3385. [PMID: 34362170 PMCID: PMC8347427 DOI: 10.3390/jcm10153385] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 01/14/2023] Open
Abstract
Irish society went into one of the most stringent lockdowns in March 2020 due to the COVID-19 pandemic, and barring a few weeks, remains highly restricted at time of writing. This has produced a wide range of challenges for those affected by eating disorders, as well as treatment services and Bodywhys, The Eating Disorders Association of Ireland. Current research indicates that COVID-19 has impacted across three key areas-the experience of those with an eating disorder, the experience of service provision, and the impact on the family situation. Drawing on monitoring and evaluation data gathered by Bodywhys, this paper details the challenges faced by those affected by eating disorders in Ireland and how the organisation responded to these challenges, providing support in various forms to people with eating disorders and their families.
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Affiliation(s)
- Harriet Parsons
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Barry Murphy
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Deirbhile Malone
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Ingrid Holme
- School of Sociology, University College Dublin, Dublin, Ireland;
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Hastings A, McNamara N, Allan J, Marriott M. The importance of social identities in the management of and recovery from 'Diabulimia': A qualitative exploration. Addict Behav Rep 2016; 4:78-86. [PMID: 29511728 PMCID: PMC5836517 DOI: 10.1016/j.abrep.2016.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 10/02/2016] [Accepted: 10/14/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION A significant barrier to recovery for individuals with co-morbid eating disorders and type 1 diabetes is the way in which group members self-categorise. Nonetheless, identity issues are neglected during the recovery process. The aim of this paper is to explore how group memberships (and the associated identities) both contribute to and hinder recovery in this cohort. METHOD Transcripts from five online focus groups with 13 members of an online support group for individuals with 'Diabulimia' were thematically analysed. RESULTS Findings suggested that those with whom one shares a recovery identity can be well placed to provide psychological resources necessary for successful recovery although such connections can be damaging if group norms are not managed. Members recognised that other important relationships (including family and friends and health professionals) are also key to recovery; these other group memberships (and the associated identities) can be facilitated through the recovery identity group membership, which allows for external validation of the recovery identity, provides encouragement to disclose the illness to supportive others, and provides information to facilitate positive service interactions. CONCLUSIONS While clinical interventions typically focus on eliminating disordered behaviours, we suggest that these should also include strengthening important group memberships that promote recovery.
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Affiliation(s)
- Amy Hastings
- Department of Psychology, University of Bedfordshire, University Square, Luton, LU1 3JU, United Kingdom
| | - Niamh McNamara
- Division of Psychology, Nottingham Trent University, Chaucer Building, Burton Street, Nottingham, NG1 4BU, United Kingdom
| | - Jacqueline Allan
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London, WC1E 7HX, United Kingdom
| | - Mike Marriott
- Division of Psychology, Nottingham Trent University, Chaucer Building, Burton Street, Nottingham, NG1 4BU, United Kingdom
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