The effectiveness of an online short-format Recovery College model: a co-learning model to support mental health

BACKGROUND

Our societies are facing mental health challenges, which have been compounded by the Covid-19. This event led people to isolate themselves and to stop seeking the help they needed. In response to this situation, the Health and Recovery Learning Center, applying the Recovery College (RC) model, modified its training program to a shorter online format. This study examines the effectiveness of a single RC training course delivered in a shortened online format to a diverse population at risk of mental health deterioration in the context of Covid-19.

METHODS

This quasi-experimental study used a one-group pretest-posttest design with repeated measures. Three hundred and fifteen (n = 315) learners agreed to take part in the study and completed questionnaires on wellbeing, anxiety, resilience, self-management, empowerment and stigmatizing attitudes and behaviors.

RESULTS

Analyses of variance using a linear mixed models revealed that attending a RC training course had, over time, a statistically significant effect on wellbeing (p = 0.004), anxiety (p < 0.001), self-esteem/self-efficacy (p = 0.005), disclosure/help-seeking (p < 0.001) and a slight effect on resilience (p = 0.019) and optimism/control over the future (p = 0.01).

CONCLUSIONS

This study is the first to measure participation in a single online short-format RC training course, with a diversity of learners and a large sample. These results support the hypothesis that an online short-format training course can reduce psychological distress and increase self-efficacy and help-seeking.

TRIAL REGISTRATION

This study was previously approved by two certified ethics committees: Comité d'éthique de la recherche du CIUSSS EMTL, which acted as the committee responsible for the multicenter study, reference number MP-12-2021-2421, and Comité d'éthique avec les êtres humains de l'UQTR, reference number CER-20-270-07.01.

When Eating Intuitively Is Not Always a Positive Response: Using Machine Learning to Better Unravel Eaters Profiles

BACKGROUND

The aim of the present study was to identify eaters profiles using the latest advantages of Machine Learning approach to cluster analysis.

METHODS

A total of 317 participants completed an online-based survey including self-reported measures of body image dissatisfaction, bulimia, restraint, and intuitive eating. Analyses were conducted in two steps: (a) identifying an optimal number of clusters, and (b) validating the clustering model of eaters profile using a procedure inspired by the Causal Reasoning approach.

RESULTS

This study reveals a 7-cluster model of eaters profiles. The characteristics, needs, and strengths of each eater profile are discussed along with the presentation of a continuum of eaters profiles.

CONCLUSIONS

This conceptualization of eaters profiles could guide the direction of health education and treatment interventions targeting perceptual and eating dimensions.

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.

Eating disorders: When food "Eats" time

The presence of a physical or mental health issue, such as an eating disorder (ED), impacts daily activities, also known as occupations. For example, an overinvestment in body shape and weight undoubtedly can lead to an underinvestment in other, more meaningful occupations. To address ED-related perceptual disturbances, a detailed log of daily time use can pinpoint food-related occupational imbalances. This study aims to characterize the daily occupations associated with EDs. The first specific objective (SO.1) is to categorize and quantify the temporal organization of a typical day's occupations as self-reported by individuals with an ED. The second specific objective (SO.2) is to compare daily occupational time use among people with different ED types. This retrospective study based on time-use research principles was conducted by analyzing data from an anonymized secondary dataset (Loricorps's Databank). Data were collected between 2016 and 2020, from 106 participants, with descriptive analysis completed to determine the average daily time use for each occupation. A series of one-way analyses of variance (ANOVAs) were performed to compare perceived time use in each occupation for participants with different types of EDs. The outcomes show a marked underinvestment in leisure categories compared to the general population. In addition, personal care and productivity can represent the blind dysfunctional occupations (SO.1). Moreover, compared to those with binge eating disorder (BED), individuals with anorexia nervosa (AN) are significantly more invested in occupations that focus explicitly on perceptual disturbances, such as personal care (SO.2). The highlight of this study is the distinction between marked versus blind dysfunctional occupation, which offers specific avenues for clinical intervention.

Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles

Introduction

COVID-19 pandemic negatively impacted people's mental and physical health. Three areas have been significantly impacted, among others: eating-related behaviors, occupational balance, and exposure to self-image due to videoconferencing. This study aims to explore and document eaters profiles that were reported during the pandemic in the general Canadian population using a holistic perspective, including body perceptions, attitudes, and eating behaviors (i.e., body image, behaviors, attitudes, and motivations regarding food), and occupations (i.e., physical activity and cooking).

Methods

This cross-sectional study was conducted from May to September 2020. Two hundred and seventy-three Canada's residents, French speaking of 18 years of age and older, participated in an online survey on behaviors, attitudes, and motivations regarding food and eating as well as body image and occupations during the COVID-19 pandemic. A hierarchical cluster analysis was used to determine the eaters profiles. One-way ANOVA and Chi-square test were conducted to differentiate occupational characteristics between eaters profiles.

Results

Three distinctive profiles were found during the COVID-19 pandemic and could be placed on a continuum: the Congruent-driven eater is at the functional pole of the continuum, whereas the Incongruent-driven eater is at the dysfunctional pole of the eaters continuum. In the middle of the continuum, the Incongruent-perceptual eater is at a critical crossing point. Significant differences were reported between eaters profiles.

Discussion

The empirical results based on an eaters continuum conceptualization highlight the importance of understanding how people perceive their body to assess and promote food well-being.

What my body looks like and what my body can do: A self-perception explanation of excessive exercise in young adults with anorexia and/or bulimia

The present study examined the relationships between quantitative and qualitative dimensions of excessive exercise (EE) with the physical self-perception’s dimensions and perceptual perspectives of body image (i.e., allocentric/3rd person and egocentric/1st person perspectives). The eLoriCorps Immersive Body Rating Scale 1.1, the very short form version of the Physical Self-Inventory and the Exercise and Eating Disorder test were used. The study includes 36 people with anorexia and/or bulimia seeking an external and specialized transdisciplinary program for eating disorders. Results show a different correlational profile of physical self-perceptions depending on the dimension (qualitative or quantitative) used to define EE. Differences in the perspectives used to assess body dissatisfaction (allocentric or egocentric) were also found. Perceived physical appearance was the key predictor of the qualitative dimension of excessive exercise. Findings suggest that EE in patients with an eating disorder could be explained by the feeling of competence not only related to physical appearance but also to physical abilities.

Assessing Changes in Anxiety, Empowerment, Stigma and Wellbeing in Participants Attending an Online-Based Recovery College in Quebec During the Covid-19 Pandemic: A Pre-Experimental Study

Objectives: The present study aims to evaluate the effect of an online Recovery College (RC) program implemented in Quebec (Canada) during the COVID-19 pandemic. From October 2020 to June 2021, 27 training groups were conducted with a total of 362 attendees.

Methods: Outcome was evaluated using a single group repeated measure design, assessing participants prior the training (T0), after the training (T1) and at follow up (T2). 107 learners of the Quebec RC program attended three two-hour sessions agreed to participate to the research.

Results: Overall findings show at T1 a small but statistically significant reduction of anxiety and increase in empowerment, and below threshold reduction of stigmatizing attitudes and increase of wellbeing. Conversely, the medium-term changes at follow up were non-significant for all the outcome dimension except for anxiety.

Conclusion: Findings suggest that the RC online program can be considered as a potential effective strategy to support self-regulation and empowerment of individuals and to reduce anxiety in the context of crisis for the general population.

The Relationship Between Women’s Negative Body Image and Disordered Eating Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study

Recent studies have shed light on how the COVID-19 pandemic changed our lives, and most of them have documented its detrimental effect on eating habits. Until now, the effects of this global crisis on negative body image and its association with disordered eating behaviors remain largely understudied. This study aimed to investigate changes in frequency of disordered eating behaviors (i.e., restrictive eating, emotional eating, and overeating) and negative body image (i.e., shape and weight concern, and body dissatisfaction) among a community sample of women during the COVID-19 pandemic (October 2020–May 2021). Furthermore, we explored the possible relation between body image-related variables and changes in the frequency of disordered eating behaviors in the context of the pandemic. A total of 161 self-identified female participants enrolled in an online-based survey. Descriptive statistics showed that women did not report clinically significant levels of weight and body shape concerns, but participants reported being dissatisfied with their body. One sample Wilcoxon Signed Rank tests revealed a tendency toward an increasing of the frequency of all disordered eating behaviors during the COVID-19 pandemic. Multinomial logistic regressions showed that weight concerns predicted an overall increase in the frequency of restrictive eating behaviors, whereas higher body dissatisfaction was associated with a moderate self-perceived increase in the frequency of emotional eating. These results shed light on a risk pattern of phenomena in a non-clinical sample of women, as they represent the key risk factors for the development of eating disorders. Findings could have implications for designing and implementing prevention programs.

Program esilence 1.0 - self-regulation program in food education via instagram-loricorps, study protocol

Introduction

Social medias are seen as a risk factor for mental health because they increase body dissatisfaction and decrease self-esteem. This program is based on alimentation and physical well-being by relying on integrated intuitive eating and physical self-esteem. This program, implemented in a community setting use social media (i.e. Instagram-Loricorps), is composed of 12 monthly 180-second video capsule that address themes related to the promotion of body sensations and intuitive movement.

Objectives

The main objective of this study is to evaluate the effects of the program into the physical environment targeting the physical self-perceptions (PSP). Specifically, this study evaluates whether the eSILENCE 1.0 Program improves the level of PSP related to nutrition and explores the changes in the level and variability of the PSP.

Methods

This project is a mixed sequential explanatory study. 300 participants (Experimental Group [EG; N=200], Control Group [CG; N=100]) are targeted. Online nomothetic questionnaires evaluate occupational changes and PSP in relation to alimentation and are completed by the EG and the CG at pre-test, mid-test and post-test. Online idiographic questionnaires assess PSP and are completed by the EG before and after each video capsule and by the CG once a month without viewing the capsules. Following a preliminary analysis, a focus group will be formed to explain and deepen these results. Participants (N=5) will be recruited voluntarily into the EG.

Results

to come.

Conclusions

Analysis of quantitative data will be used to assess the effectiveness of the program and analysis of qualitative data will provide an in-depth understanding of the linkages between the variables.

Disclosure

No significant relationships.

The use of yoga and mindfulness within an eating disorders population: Results of a scoping review

Introduction

Eating disorders (ED) are characterized by perturbed eating habits or behaviors (APA, 2013). Even if treatments are available, they need to be more adapted to ED (Monthuy-Blanc, 2018). A complementary approach as yoga or mindfulness demonstrated positive effects with ED, such as an augmentation of mindfulness while eating (Rachel, Ivanka, Amanda, & Carlene, 2013), a better body satisfaction (Beccia, Dunlap, Hanes, Courneene, & Zwickey, 2018; Neumark-Sztainer, MacLehose, Watts, Pacanowski, & Eisenberg, 2018) and less preoccupation with food (Carei, Fyfe-Johnson, Breuner, & Brown, 2010). As the effects of yoga and mindfulness vary between the different ED and different uses, it is difficult to generalize the results obtained about the efficacy of yoga or mindfulness with ED.

Objectives

A scoping review is actually done to map the evidence about the use (length, intensity, frequency) of yoga and mindfulness among ED and their effects.

Methods

The realization of the scoping review is based on the Joanna Briggs Institute Methodological Framework(Peters, Godfrey, McInerney, Baldini Soares, Khalil, & Parker, 2017). Research will be done in the following databases: CINAHL, PsycInfo, PubMed/MEDLINE, Web of Science, EBM Reviews/Cochrane. Different types of papers are going to be included and a content analysis is going to be done among the extracted data.

Results

Preliminary results of the scoping review are going to be presented.

Conclusions

Among the different treatments used with ED, yoga and mindfulness have demonstrated positive effects. These approaches as part of integrative health are helpful to improve physical and mental health of individuals suffering from ED.

The FitSpirit approach for increasing physical activity in canadian teenage girls: protocol of a longitudinal, quasi-experimental study

Background

Worldwide, most adolescent girls do not meet physical activity (PA) recommendations and very few PA programs are tailored specifically towards them. Even fewer information exists about the long-term effects of such programs. Some Canadian schools have implemented the FitSpirit PA intervention designed specifically for girls aged 12 to 17 years old. This paper describes the protocol of a quasi-experimental study evaluating long-term changes in health behaviours and outcomes following FitSpirit participation.

Methods

The study is conducted among schools that partner with FitSpirit every year. It started in 2018 and will be completed in 2022. The intervention comprises motivational talks, a turnkey running program, PA sessions and special events. Study participants fill out an online questionnaire twice a year. Follow-up questionnaires are sent at the end of each school year to the study participants who dropout from FitSpirit. The main outcome, changes in PA levels, is evaluated using questions validated for adolescents. Secondary outcomes are health (perceived health); lifestyle habits (sedentary activities, eating and sleeping habits); psychosocial outcomes (physical self-efficacy and body satisfaction); and FitSpirit appreciation (activity participation and satisfaction). Most questions originate from questionnaires validated for the adolescent population. Cross-sectional and longitudinal analyses will be performed.

Discussion

This study will provide one of the first longitudinal reports on the impact of a large extra-curricular PA intervention designed specifically for adolescent girls. The current study will uniquely contribute to PA research by assessing outcomes additional to PA levels, including markers of health, lifestyle habits and psychosocial determinants.

Trial registration

NCT, NCT03804151, Registered on January 22, 2019; retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10200-5.

Changes in Lifestyle Habits among Adolescent Girls after FitSpirit Participation

Adolescence is a crucial time in the development and maintenance of lifestyle habits. Interventions to improve health-related behaviors are important, including those that can contribute to an increase in physical activity (PA). During adolescence, PA typically decreases with age, particularly in girls. The FitSpirit program offers services that help Canadian schools from Quebec and Ontario implement PA interventions for adolescent girls. This study aimed to evaluate changes in participants' PA levels and lifestyle habits (sedentary time, sleep duration and eating habits) and to assess whether these changes depended on adherence to the Canadian 24-Hour Movement Guidelines and Canada's Food Guide recommendations at enrollment. At the time of FitSpirit registration (between December 2018 and March 2019) and in May/June 2019, 73 participants answered online questionnaires. The participants reported improvements, with an increase in the number of days with PA and a decrease in daily consumption of sweets. The greatest changes were observed in those who did not adhere to the Canadian recommendations before enrollment and who significantly increased their number of days with PA and their consumption of fruits and vegetables, and decreased their screen time. In conclusion, participation in FitSpirit improved several health behaviors among adolescent girls, particularly those who did not comply with the Canadian recommendations at enrollment.

Identification des pratiques prometteuses dans le traitement de l’anorexie mentale

L’anorexie mentale inquiète, d’une part, car elle est associée à de nombreuses complications médicales et, d’autre part, car elle est liée à un mauvais pronostic. Face à ces constats, il est impératif que les traitements les plus efficaces soient offerts aux personnes présentant une anorexie mentale. Cet article vise à présenter une revue systématique de la littérature portant sur les modalités thérapeutiques prometteuses dans le domaine de l’anorexie mentale. Parmi celles-ci, notons le traitement ambulatoire, l’importance d’une équipe multidisciplinaire ainsi que différentes approches psychothérapeutiques, dont l’approche familiale.

[Identification of promising practices in the treatment of anorexia nervosa]

Anorexia nervosa concerned, firstly, because this disorder is associated with many medical complications and secondly, because it is linked with a poor prognosis. Given these facts, it is imperative that effective treatments be available for anorexia nervosa. This article aims to present a systematic review of the literature on the best therapeutic modalities in the field of anorexia nervosa. Among these, we find outpatient treatment, importance of multidisciplinary team and various therapeutic approachs, like familial therapy.

Empathy toward virtual humans depicting a known or unknown person expressing pain

This study is about pain expressed by virtual humans and empathy in users immersed in virtual reality. It focuses on whether people feel more empathy toward the pain of a virtual human when the virtual human is a realistic representation of a known individual, as opposed to an unknown person, and if social presence is related to users' empathy toward a virtual human's pain. The 42 participants were immersed in virtual reality using a large immersive cube with images retro projected on all six faces (CAVE-Like system) where they can interact in real time with virtual characters. The first immersion (baseline/control) was with a virtual animal, followed by immersions involving discussions with a known virtual human (i.e., the avatar of a person they were familiar with) or an unknown virtual human. During the verbal exchanges in virtual reality, the virtual humans expressed acute and very strong pain. The pain reactions were identical in terms of facial expressions, and verbal and nonverbal behaviors. The Conditions by Time interactions in the repeated measures analyses of variance revealed that participants were empathic toward both virtual humans, yet more empathic toward the known virtual human. Multivariate regression analyses revealed that participants' feeling of social presence--impression that the known virtual character is really there, with them--was a significant predictor of empathy.

Factors influencing mental health providers' intention to use telepsychotherapy in First Nations communities

Telemental health is the use of information and communications technologies and broadband networks to deliver mental health services and support wellness. Although numerous studies have demonstrated the efficiency and utility of telemental health, certain barriers may impede its implementation, including the attitudes of mental health service providers. The current study draws on the technology acceptance model (TAM) to understand the role of mental health service providers' attitudes and perceptions of telemental health (psychotherapy delivered via videoconferencing) on their intention to use this technology with their patients. A sample of 205 broadly defined mental health service providers working on 32 First Nations reserves in the province of Quebec completed the questionnaire adapted to assess TAM for telepsychotherapy. Confirmatory factor analysis and structural equation modeling provided evidence for the factor validity and reliability of the TAM in this sample. The key predictor of the intention to use telepsychotherapy was not mental health providers' attitude toward telepsychotherapy, nor how much they expected this service to be complicated to use, but essentially how useful they expect it to be for their First Nations patients. If telemental health via videoconferencing is to be implemented in First Nations communities, it is essential to thoroughly demonstrate its utility to mental health providers. Perceived usefulness will have a positive impact on attitudes toward this technology, and perceived ease of use will positively influence perceived usefulness. Cultural issues specific to the populations receiving telemental health services may be more efficiently addressed from the angle of perceived usefulness.

The development of a haptic virtual reality environment to study body image and affect

We report the results of a preliminary study testing the effect of participants' mood rating on visual motor performance using a haptic device to manipulate a cartoonish human body. Our results suggest that moods involving high arousal (e.g. happiness) produce larger movements whereas mood involving low arousal (e.g. sadness) produce slower speed of performance. Our results are used for the development of a new haptic virtual reality application that we briefly present here. This application is intended to create a more interactive and motivational environment to treat body image issues and for emotional communication.

A very short visual analog form of the Center for Epidemiologic Studies Depression Scale (CES-D) for the idiographic measurement of depression

BACKGROUND

The experience sampling method, also referred to as ecological momentary assessment (ESM-EMA) has recently gained popularity in the study of depression. However, no psychometrically sound multidimensional depression questionnaires specifically designed for the ESM-EMA context are currently available.

AIMS

The main objective of the present study was to develop and validate a very short visual analog scale of the Center for Epidemiologic Studies Depression Scales (CES-D-VAS-VS) specifically designed for the ESM-EMA context. To this end, the full French version of the CES-D was adapted for the ESM-EMA context. From this full-length adapted version a very short version was then extracted from this longer instrument and validated.

STUDY DESIGN

A sample comprising 163 patients with a major depressive episode (MDE) and 306 participants without mental disorders was involved in this study.

RESULTS

The obtained results provided support for the factor validity, strong measurement invariance (invariance of the loadings and intercepts of the measurement model) across sex and clinical status groups, reliability and convergent validity of the CES-D-VAS-VS. This instrument comprises 4 items measuring positive affect, depressive affect, somatic complaints and disturbed interpersonal relationships.

CONCLUSION

The present results provide preliminary evidence regarding the construct validity of the CES-D-VAS-VS among patients and community adults sample but also underline the need to rely on latent variables methods in the use of this instrument to account for the differential levels of measurement errors (uniquenessess) that were observed across groups.

Construct Validity of the Fear of Negative Appearance Evaluation Scale in a Community Sample of French Adolescents

The main objective of the present series of studies was to test the construct validity (i.e., content, factorial, and convergent validities) of the Fear of Negative Appearance Evaluation Scale (FNAES) in a community sample of French adolescents. A total sample of 683 adolescents was involved in three studies. The factorial validity and the measurement invariance of the FNAES were verified through a series of confirmatory factor analyses. The convergent validity of the FNAES was then verified through correlational analyses. The first study showed that the content and formulation of the French FNAES items were adequate for children and adolescents. The following two studies (Studies 2 to 3) provided (a) support for the factor validity, reliability, and convergent validity of a five-item French version of the FNAES, and (b) partial support for the measurement invariance of the resulting FNAES across genders. However, the latent mean structure of the FNAES did not prove to be invariant across genders, revealing a significantly higher latent mean score of FNAES in girls relative to boys. The present results, thus, provide preliminary evidence regarding the construct validity of the FNAES in a community sample of French adolescents. Recommendations for future practice and research regarding this instrument are outlined.