The impact of Facebook use on self-reported eating disorders during the COVID-19 lockdown

A multi-school study in England, to assess problematic smartphone usage and anxiety and depression

AIM

To assess the association between problematic smartphone usage and anxiety and depression in adolescents.

METHODS

A cross-sectional study in five schools in the UK were included. The primary outcome was moderate anxiety (GAD-7 ≥10) symptoms and secondary outcomes were moderate depression symptoms (PHQ-9 ≥10) and insomnia. Problematic smartphone usage was assessed using screentime and the Smartphone Addiction Scale. A multi-level logistic regression was fitted and adjusted Odds Ratio (aOR) with 95% confidence intervals (95% CI) reported. A mediation analysis was conducted.

RESULTS

Of the five included schools, 657 adolescents aged 16-18 years were enrolled. The median age was 17.5 years (17-18 [IQR]) and 508 (77.3%) were female. Of these 188 (28.6%) exhibited moderate anxiety and 226 (34.4%) moderate depression symptoms. Almost two thirds (421, 64.1%) have tried to cut down their smartphone use and 81 (12.5%) wanted help to reduce use. Problematic smartphone use was associated with increased anxiety (aOR = 2.03, 95% CI 1.28-3.23); depression (aOR = 2.96, 95% CI 1.80-4.86); and insomnia (aOR = 1.64, 95% CI 1.08-2.50). Screentime was not associated with anxiety (β = 0.99, 95% CI 0.91-1.08); or depression (β = 0.98, 95% CI 0.89-1.07). Problematic smartphone use had a significant direct, indirect and total effect on both anxiety and depression.

CONCLUSION

Problematic smartphone usage was associated with anxiety and depression, independent of screentime. Interventions are needed to reduce problematic use.

The impact of the pandemic on psychophysical well-being and quality of learning in the growth of adolescents (aged 11-13): a systematic review of the literature with a PRISMA method

Introduction

This study examines the social impact and psychological effects of the COVID-19 pandemic on the growth of adolescents students, aged 11-13, on well-being and learning.

Methods

Said review, therefore, will consider all the report of scientific works published since 2020 on the following platforms: SCOPUS, PsycoInfo, and Web of Science. Specifically, the research has selected all studies concerning students aged 11-13. Furthermore, the authors have restricted the scope of the study to two fundamental aspects of the above-mentioned subjects, such as their physical and psychological well-being and didactic learning following the COVID-19 pandemic. The justification for choosing such themes lies in the fact that the SARS-CoV-2 pandemic and the ensuing measures adopted to curb its spread have had -and very likely will continue having- sizable repercussions in the life of each individual, especially in students considered, whose psychological and physical well-being has been considerably affected.

Results

In particular, during the peak of the pandemic and its subsequent phases, the various measures issued to limit contagion have completely compromised and disregarded the rights of children and youngsters. Suddenly, leisure, sport, play, relations, and socialization disappeared from their lives. Besides, in the early stages of the pandemic, remote teaching replaced face-to-face teaching, later to become an intermittent system in the red- and orange-labelled areas of the country. Consequently, such measures have severely limited opportunities for learning, growth, curiosity and creating relationships that are typical of both a school and outside environment. Concerning the well-being of the subjects considered, a review of the target literature indicates a wide range of psychological and physical disorders, such as malaise, eating and sleep disorders, addiction to games, internet, alcohol, and drugs. For what regards, instead, the realm of learning, most studies highlight a diminished school performance as the main implication of remote teaching. Furthermore, a remarkable number of studies reveals substantial social inequalities; specifically, students coming from middle class families have managed to maintain higher quality educational standards in a critical context such as the pandemic, while those students coming from socially disadvantaged families have had fewer learning opportunities both in terms of time and range of experiences (due to lack of electronic devices, Internet connectivity, homework, continuity of after-school activities). In summary, if the school system pre-COVID-19 already presented significant limitations in its ability to reduce existing social inequalities, school closures during lockdowns pose enormous challenges in developing effective policies to compensate learning losses and inequalities.

Discussion

Therefore, based on the results shown, the necessity arises of an emergency plan with social and educational objectives to restore those social, emotional, and cognitive abilities that are compromised. In general, it is the responsibility of countries and governments to guarantee the right to education in these difficult times, while avoiding any type of inequalities and establishing a digital learning system, that allows to face situations such as those generated by the Coronavirus, thus preventing those situations of serious anxiety and stress that have affected most subjects.

Latent profiles of emotion regulation among university students: links to repetitive negative thinking, internet addiction, and subjective wellbeing

Recent years have seen a deterioration in the mental health of university students and notable surge in the need for psychological support. Due to its links to psychopathology and high-risk behaviors, difficulty in emotion regulation frequently serves as a transdiagnostic dimension. This cross-sectional study used a person-centered analytical approach (latent profile analysis; LPA) to identify groups of Portuguese university students with similar profiles of emotion regulation difficulties (N = 261; Mage = 22.5 ± 1.2 years; n = 213 female) and describe how these groups differ in their presentation of repetitive negative thinking, internet addiction, and subjective wellbeing. The analyses identified four latent profiles: 14.5% of students showed global dysregulation (the Low Emotion Regulation Profile), 23% were moderately dysregulated with elevated problems in goal-directed behavior (the Moderate Emotion Regulation Profile), 8% showed specific difficulties with low emotional awareness and clarity (the Low Insight Profile), and 54.4% showed adaptive emotion regulation (the High Emotion Regulation Profile). As anticipated, the Low Emotion Regulation Profile had the lowest subjective wellbeing and the highest prevalence of repetitive negative thinking and internet addiction. Students with a Low Insight Profile also showed low subjective wellbeing, but less repetitive negative thinking compared to the Low Emotion Regulation Profile. Our findings suggest that interventions aimed at improving health and wellbeing among university students should consider each student's unique set of emotion regulation difficulties, rather than focusing on particular strategies. Further research may help determine whether emotion regulation profiles can serve as predictive indicators of varying mental health trajectories and subjective wellbeing in university students.

The relationship between social media use and pregnancy-related body image

BACKGROUND

Social media negatively affects body image, but few have investigated its impact on pregnancy-related body image. Pregnancy represents a vulnerable period for body image, and poor body image has negative implications for health.

OBJECTIVES

We aimed to (1) understand relations of social media and pregnancy-related body image variables, (2) examine differences in social media use and body image based on demographic characteristics, and (3) evaluate whether type of social media use (i.e., active versus passive) was differentially related with body image based on time spent on social media.

DESIGN

This was a cross-sectional study.

METHODS

We recruited an online sample of women (N = 154) experiencing early motherhood, as defined by giving birth within the past 5 years. We examined social media use (e.g., amount of time, type of use) on Facebook, Instagram, and Twitter in relation to pregnancy-related body image questionnaires.

RESULTS

Passive use (e.g., viewing others' content rather than creating original content) and greater time on Facebook were independently related to lower positive body image. Those who passively used Facebook for the longest amount of time had the lowest positive body image. No significant effects were found for Instagram or Twitter.

CONCLUSION

Spending more time passively viewing others' content may facilitate social comparison, reducing positive feelings about one's own body. Social media may constitute a source of pressure and scrutiny for women, resulting in lowered pregnancy-related body image.

The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis

BACKGROUND

The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak.

METHOD

We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria.

RESULTS

The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms.

CONCLUSION

This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.

Negative psychological and physiological effects of social networking site use: The example of Facebook

Social networking sites (SNS), with Facebook as a prominent example, have become an integral part of our daily lives and more than four billion people worldwide use SNS. However, the (over-)use of SNS also poses both psychological and physiological risks. In the present article, we review the scientific literature on the risk of Facebook (over-)use. Addressing this topic is critical because evidence indicates the development of problematic Facebook use ("Facebook addiction") due to excessive and uncontrolled use behavior with various psychological and physiological effects. We conducted a review to examine the scope, range, and nature of prior empirical research on the negative psychological and physiological effects of Facebook use. Our literature search process revealed a total of 232 papers showing that Facebook use is associated with eight major psychological effects (perceived anxiety, perceived depression, perceived loneliness, perceived eating disorders, perceived self-esteem, perceived life satisfaction, perceived insomnia, and perceived stress) and three physiological effects (physiological stress, human brain alteration, and affective experience state). The review also describes how Facebook use is associated with these effects and provides additional details on the reviewed literature, including research design, sample, age, and measures. Please note that the term "Facebook use" represents an umbrella term in the present work, and in the respective sections it will be made clear what kind of Facebook use is associated with a myriad of investigated psychological variables. Overall, findings indicate that certain kinds of Facebook use may come along with significant risks, both psychologically and physiologically. Based on our review, we also identify potential avenues for future research.

Fear of COVID-19, insomnia, and eating disorder symptoms among Iranian college students

Objective

Eating disorders (EDs), fear of COVID-19, and insomnia have all increased during the COVID-19 pandemic in Western societies. Additionally, fear of COVID-19 and sleep disturbances relate to ED symptoms in Western societies. However, it is unknown whether fear of COVID-19 and insomnia relate to ED symptoms in non-Western countries, such as Iran. Thus, this study examined the relation between fear of COVID-19, insomnia, and ED symptoms among Iranian college students. Specifically, we hypothesized that insomnia and fear of COVID-19 would each uniquely relate to ED symptoms and the interaction between insomnia and fear of COVID-19 would also associate with increased ED symptoms.

Method

College students (N =1,043) filled out measures assessing fear of COVID-19, insomnia, and ED symptoms. We ran moderation analyses using linear regression for global ED symptoms and negative binomial regressions for binge eating and purging.

Results

Fear of COVID-19 and insomnia had unique effects on global ED symptoms and binge eating. Insomnia, but not fear of COVID-19, had a unique effect on purging. No significant interaction effect was found.

Discussion

This study was the first to examine the association between fear of COVID-19 and insomnia on ED symptoms in Iran. Fear of COVID-19 and insomnia should be incorporated into novel assessments and treatments for EDs.

Social media and dating app use are differentially related to same- and next-day disordered eating pathology in young men with loss of control eating

OBJECTIVE

To evaluate whether social networking site (SNS) and dating app use is associated with disordered eating in young men.

METHODS

42 men (18-35y) who reported ≥4 loss of control (LOC) eating episodes in the prior month completed a 14-day ecological momentary assessment (EMA) protocol. Five times throughout the day, participants responded to prompts regarding their dietary restraint, body dissatisfaction, and LOC eating. Each night at ~10 pm, participants reported their total time spent on SNSs and dating apps/websites within the last day.

RESULTS

39 out of 42 cisgender men (M_age = 25.1 ± 5.3 years; 47 % non-Hispanic White, 29 % Black or African American; 63 % non-students; 87 % heterosexual) reported using SNSs and/or dating apps. Neither SNS nor dating app use was associated with body dissatisfaction. Dating app use with associated with higher same- (r² equivalent = 0.022, p = .003) and next-day dietary restraint (r² equivalent = 0.016, p = .02); SNS use was not. More SNS use was associated with lower odds of same- (OR [95 % CI] = 0.86 [0.75, 0.99], p = .044) and next-day LOC eating (OR [95 % CI] = 0.82 [0.71, 0.96], p = .011); links with dating app use were non-significant.

DISCUSSION

Non-significant links for SNS and dating app use with body dissatisfaction, and inverse associations with LOC eating, are contrary to research conducted with girls and women. Research is needed to evaluate whether the quality of SNS and dating app engagement (e.g., specific sites) are more closely related to men's disordered eating, and this work should consider muscularity concerns.

Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature

From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one’s body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts—perceptual disturbances and dysfunctional eating attitudes and behaviors—in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.

Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic

OBJECTIVES

The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations.

METHOD

We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately.

RESULTS

Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic.

CONCLUSION

Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.

Rapid Onset Functional Tic-Like Disorder Outbreak: A Challenging Differential Diagnosis in the COVID-19 Pandemic

During the COVID-19 pandemic, several countries have observed an unexpected increase in the number of adolescents and young adults presenting with rapid onset functional tic-like behaviours after being exposed to social media content of others displaying a similar pattern of functional tics. Many of these patients have been referred to Movement Disorders Clinics with misdiagnoses of late-onset refractory Tourette Syndrome after failing different pharmacological treatments for tics. Tourette Syndrome is a well-known condition with clear clinical diagnostic criteria and which presents with the insidious onset of simple motor and phonic tics in a rostro-caudal evolution starting in early childhood. Clinical and demographic aspects can differentiate rapid onset functional tic-like behaviours from Tourette Syndrome, including the former having abrupt and explosive presentation of severe symptoms, later age of onset, female gender predominance, lack of suppressibility, comorbid anxiety and depression, atypical premonitory urge and history of exposure to social media content displaying tic-like behaviours. This new presentation of a functional neurological disorder may be explained in part by the relationship between social media exposure to tic-like behaviours, and maladaptive response to anxiety caused by life stressors (e.g. COVID-19 pandemic), especially in young individuals. Rapid onset functional tic-like behaviours may be considered a spreading neuropsychiatric disorder that is potentially fostered by the psychosocial impact caused by the COVID-19 pandemic.