Purpose
To examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN).
Method
In total 79 females with ...first-onset AN (aged 12–22 years) were included and were followed up across a period of 1 year. We assessed AN participants recruited pre-pandemic (
n
= 49) to those recruited peri-pandemic (
n
= 30). Pre- (
n
= 37) and peri-pandemic (
n
= 38) age-, and education-matched typically developing (TD) girls (
n
= 75) were used as a reference cohort. ED features and psychopathology were assessed at baseline. After 1 year of follow-up the association between pandemic timing and clinical course was assessed. Analyses of covariance were used to examine differences in ED features and psychopathology.
Results
Peri-pandemic AN participants experienced less ED symptoms at baseline compared to pre-pandemic AN participants. In particular, they were less dissatisfied with their body shape, and experienced less interpersonal insecurity. In addition, the peri-pandemic AN group met fewer DSM-IV criteria for comorbid disorders, especially anxiety disorders. In contrast, peri-pandemic AN participants had a smaller BMI increase over time. In TD girls, there were no differences at baseline in ED features and psychopathology between the pre- and peri-pandemic group.
Conclusion
Overall, peri-pandemic AN participants were less severely ill, compared to pre-pandemic AN participants, which may be explained by less social pressure and peer contact, and a more protective parenting style during the pandemic. Conversely, peri-pandemic AN participants had a less favorable clinical course, which may be explained by reduced access to health care facilities during the pandemic.
Level of evidence
Level III: Evidence obtained from well-designed cohort or case–control analytic studies.
Abstract Background Exposure to community violence and trauma, stress, and childhood abuse and neglect have been identified as risk factors for the development of posttraumatic stress disorder (PTSD) ...symptoms among adolescents. Although evidence suggests that resilience may moderate the relationship between some of these risk factors and PTSD symptoms, no studies to date have examined these risk factors collectively. Aims Our first aim was to examine the relationship between exposure to community violence, childhood abuse and neglect, perceived stress, and PTSD symptoms. Our second aim was to examine the extent to which resilience moderated the relationship between risk factors and PTSD symptoms. Method A convenience sample of 787 participants was drawn from 5 public secondary schools in the Cape Town metropole of South Africa. The participants were invited to complete a battery of questionnaires on a single occasion. Results Of the participants, 48.3% were Black, 58.6% were female, and 31.6% were in grade 8. After controlling for covariates, we found that exposure to community violence, perceived stress, and childhood abuse and neglect together accounted for 33.4% of the variance in PTSD symptoms ( F8,778 = 71.06, P < .001). Nevertheless, resilience moderated the relationship between childhood abuse and symptoms of PTSD ( β = .09, t786 = 2.88, P < .001), where the independent effect of childhood abuse and neglect on PTSD symptoms was significantly reduced with increasing resilience. Resilience did not, however, interact with exposure to community violence or perceived levels of stress to influence PTSD symptoms. Conclusion High levels of exposure to community violence, perceived stress, and childhood abuse and neglect may contribute to the development of PTSD symptoms in South African adolescents. However, high levels of resilience may buffer the negative effects of childhood abuse and neglect.
Full text
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
