#EatingDisorderRecovery: a qualitative content analysis of eating disorder recovery-related posts on Instagram

Healing is a community: an exploratory study of #TraumaticBrainInjury content on Instagram

PURPOSE

Traumatic Brain Injury (TBI) can result in reduced social participation due to changes in cognition and communication. This study explored Instagram #TraumaticBrainInjury posts to determine how the platform was being used by people with brain injury and how TBI was discussed.

MATERIALS AND METHODS

Exploratory, qualitatively-driven, mixed-methods research design. Content analysis was conducted on the top 100 #TraumaticBrainInjury posts that met the study criteria. From each category identified in content analysis, two-three posts were further analysed using visual data analysis, then reflexive thematic analysis was used on this data to gain deeper understanding.

RESULTS

Content analysis generated four categories: Promotional, Motivational, Educational, and Life Experiences. Thematic analysis of nine visual data narratives generated four themes: Sharing their Stories, Navigating Challenge, Anticipating More, and Building Community.

CONCLUSIONS

Community groups and people with TBI facilitated social connections and exchange about symptoms, recovery, struggles, and day-to-day life. Organisations and health professionals used the platform to provide information and promote their services to people with TBI. However, health professionals are under-utilised Instagram to promote social interactions and advocacy. The overall sentiment of the #TraumaticBrainInjury community was supportive and positive, suggesting integration of the platform into TBI rehabilitation would be beneficial for targeting social isolation.

Reviewing the Evidence Base for Topical Steroid Withdrawal Syndrome in the Research Literature and Social Media Platforms: An Evidence Gap Map

BACKGROUND

Within the dermatological community, topical steroid withdrawal syndrome (TSWS) is a medically contested condition with a limited research base. Published studies on TSWS indicate that it is a distinct adverse effect of prolonged use of topical corticosteroids, but there is a paucity of high-quality research evidence. Among the "patient community," awareness has been increasing, with rapid growth in social media posts on TSWS and the introduction of online communities such as the International Topical Steroid Awareness Network. This evidence gap map (EGM) was developed in response to recent calls for research to better understand TSWS and aims to be an important resource to guide both researchers and clinicians in the prioritization of research topics for further research.

OBJECTIVE

This study aims to identify the range, extent, and type of evidence on TSWS in the research literature and social media platforms using an EGM.

METHODS

The MEDLINE and Embase (Ovid), CINAHL (EBSCOhost), and ProQuest Dissertations & Theses and Conference Proceedings Citation Index (CPCI-Science and CPCI-Social Science & Humanities via Web of Science) databases were searched. The final search was run in November 2023. Study titles, abstracts, and full texts were screened by 2 reviewers, and a third was consulted to resolve any differences. Blogging sites WordPress, Medium, and Blogspot and Google were searched; Instagram and Reddit were searched for the 100 most recent posts on specific dates in February 2023. Blog titles, Instagram posts, and Reddit posts were screened for relevance by 2 reviewers. A data extraction tool was developed on EPPI-Reviewer, and data extraction was undertaken by one reviewer and checked by a second; any inconsistencies were resolved through discussion. We did not undertake quality appraisal of the included studies. EPPI-Reviewer and EPPI-Mapper were used to generate the interactive EGM.

RESULTS

Overall, 81 academic publications and 223 social media posts were included in the EGM. The research evidence mainly addressed the physical symptoms of TSWS (skin), treatments, and, to a lesser extent, risk factors and disease mechanisms. The social media evidence primarily focused on the physical symptoms (skin and nonskin), mental health symptoms, relationships, activities of everyday living, beliefs and attitudes, and treatments.

CONCLUSIONS

The EGM shows that research evidence is growing on TSWS but remains lacking in several important areas: longer-term prospective observational studies to assess the safety of prolonged use of topical corticosteroids and to prevent addiction; qualitative research to understand the lived experience of TSWS; and longitudinal research on the patient's "TSWS journey" to healing. The inclusion of social media evidence is a methodological innovation in EGMs, recognizing the increased presence of #topicalsteroidwithdrawal on social media and how it can be used to better understand the patient perspective and ultimately, provide better care for people with TSWS.

The experience of treatment for eating disorders as told by content creators on TikTok

TikTok, a social media platform with substantial youth engagement, has been used to examine eating disorder (ED) recovery; however, no studies have described the experience of ED treatment as told on TikTok. The purpose of this study was to describe content related to ED treatment using the hashtag #EDtreatment. The 100 most-viewed videos using #EDtreatment were downloaded, transcribed verbatim, and coded. Using qualitative thematic analysis, a coding framework was created; themes were generated and reviewed by coauthors until consensus was reached. Ultimately, 55 videos were included in the analysis. The videos included in the analysis had, in total, 15.6 million views, 3 million "likes", 36647 comments, and were shared by users 26,673 times. Themes generated included Aspects of Treatment, Interpersonal Relationships, Emotions and Psychiatric Comorbidities, and ED Experiences. Content ranged from uplifting and encouraging to negative and serious. Videos used dramatic reenactments, music, humor, and other entertainment methods, suggesting that creators attempted to generate high volume viewer consumption. When combined with TikTok's brief video format, users may consume large amounts of content rapidly. Individuals considering treatment may be influenced by viewing TikTok content. When clinically engaging individuals with EDs, the perceived significance of this content is a topic of consideration.

Adaptation of mental health first aid guidelines for eating disorders for Iran

BACKGROUND

This study aimed to adapt mental health first aid guidelines to support individuals with or at risk of developing eating disorders in Iran. This adaptation seeks to enhance the support available for the Iranian population dealing with these disorders.

METHODS

We employed the Delphi expert consensus method, utilizing two panels: health professionals (n = 37 in the first round; n = 29 in the second) and individuals with lived experience (n = 20 in the first round; n = 18 in the second). The health professionals panel was selected from the graduates of various eating disorders associated scientific fields who had a history of providing services to or conducting research on people with eating disorders, and the lived experience panel had a history of eating disorders themselves or in their family. The panel of individuals with lived experience included those who had personal or familial histories of eating disorders. Efforts were made to ensure cultural, gender, and age diversity in the selection of panel members. Panellists rated the importance of each item for inclusion in the guidelines for Iran based on the English-language Mental Health First Aid guidelines for eating disorders. Items deemed essential by at least 80% of both panels were included in the final guideline. Additionally, panel members were invited to suggest any missing items.

RESULTS

A total of 57 participants took part in the first round of the survey, and 47 participated in the second round. In the first round, 204 items across 11 categories were assessed, with 174 items endorsed by the panels. Thirteen items were re-scored in the second round, and 17 items were rejected. Participants suggested 11 new items in the first round. In the second round, 18 out of 24 items were endorsed, while six were rejected. Ultimately, 192 items were incorporated into the Iranian guidelines.

CONCLUSIONS

The adaptation process considered Iran's social and cultural characteristics, including the stigma associated with mental health disorders, religious beliefs and rituals such as fasting, linguistic differences between English and Farsi, distrust of strangers, the influence of friends and family, differences in food access, and low mental health literacy. We recommend piloting the adapted guidelines in high schools, universities, and non-governmental organizations to evaluate their feasibility and effectiveness in real-world settings. Furthermore, it is essential to establish mechanisms for feedback, update content based on the latest evidence, and collaborate with the media to promote educational programs and public participation.

Motives for using social networking sites: a uses & gratifications perspective amongst people with eating disorder symptoms

Studies investigating motives for social networking sites (SNS) use amongst people with eating disorder (ED) symptoms are scarce. The uses and gratifications theory states that people actively select media content to gratify their individual needs and this may help to explain why individuals with eating disorder symptoms choose to expose themselves to specific media content and how they choose to respond. Some evidence exists that readiness to change may be a factor related to SNS use patterns in this population. The aim of the present study was to investigate the potential relationship between readiness to change ED cognitions/behaviors and SNS use motives in individuals with current or past ED symptoms, employing a uses and gratifications theory perspective. Participants were recruited from ED recovery websites; 103 individuals (16-55 years old) provided complete data. As hypothesized, ED symptom severity was inversely associated with readiness to change and time spent on (specific) SNS was not associated with ED symptom severity. The results of hierarchical regression analyses further suggested that if individuals felt less capable of overcoming their dysfunctional cognitions/behaviors about their body/eating (i.e., were less ready to change), they were more likely to be motivated to use SNSs for the purpose of impressing others and reputation management. The clinical implication is that high amounts of SNS use may not necessarily be harmful for people with EDs or recovering from EDs, whereas using SNSs for the purposes of impression management could potentially be related to being less ready to recover.

Social media and eating disorder recovery: An exploration of Instagram recovery community users and their reasons for engagement

OBJECTIVE

Online recovery communities offer support for people with eating disorders who may not otherwise seek professional help. Instagram is a popular platform that is widely used for eating disorder recovery, but little is known about the population that uses it or its potential benefits.

METHOD

A mixed-methods study surveyed 163 users of the Instagram recovery community to identify their descriptive characteristics, their reasons for using the community, and what they perceived to be helpful or unhelpful about the platform.

RESULTS

The community included users who were diverse in gender, ethnicity and eating disorder presentation and severity, with cases of potential anorexia nervosa, bulimia nervosa and binge eating disorder identified. Reasons for engaging in the community included to see representations of diverse individuals and as an alternative to professional treatment. Results indicate that the community may provide benefits for recovery such as social support and validation, but that its lack of moderation and potential for harmful content can also prevent recovery.

CONCLUSIONS

These findings highlight the need for better recognition of diverse eating disorder presentations and improved accessibility to professional treatment in the wider community. Moderated use of the platform should be considered in order to minimize risks and increase benefits.