Body Image Disturbance in Female Adolescents Using Online Learning Platforms: A Concept Analysis

Aim To analyze the concept of body image disturbance in female adolescents using online learning platforms as a phenomenon of interest to nurse practitioners and other health care practitioners. Background With the declaration of the COVID-19 pandemic, the use of online learning platforms as a primary mode of learning has increased exponentially among adolescents. While research is still lacking in this field, the literature on traditional social media suggests that these online learning platforms may negatively influence body image and emotional outcomes. Particularly vulnerable to these outcomes are female adolescents, whose construction of own body image is highly influenced by their self-perceived evaluation from their peers. While the concept of body image disturbance is well defined in adolescent eating disorders, it has not been characterized in the context of online learning platforms. Defining the concept of body image disturbance in this context is crucial for recognizing its occurrence and providing early intervention. Methods The Walker and Avant method of concept analysis was used to analyze the concept. Findings The defining attributes of body image disturbance among female adolescents using online learning platforms are: (1) Viewing a digitally distorted image of oneself and feeling displeasure with the perceived appearance; (2) Self-surveillance of one’s appearance; and (3) Upward comparison of one’s appearance with others and experiencing feelings of inadequacy. Conclusion As COVID-19 continues to disrupt the traditional school experience, nurse practitioners can use the presented scenarios, along with examples of questionnaires noted in this study, to recognize and delineate the occurrence of body image disturbance in female adolescents using online learning platforms. A standardized definition of the concept will enable nurse practitioners to recognize its occurrence and to provide interventions in a timely manner.

A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders

Background Eating disorders have serious psychological and physical consequences. Current evidence-based treatments for adolescents with eating disorders have modest effects, underscoring the need to improve current treatment approaches. Cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) have been proposed as alternative treatment options, with burgeoning research in this area. This review aims to summarize and critically analyze the current literature on the feasibility, acceptability, effectiveness, and efficacy of CBT and DBT for adolescent eating disorders, and then proposes areas of future research. Methods PsycINFO and PubMed were searched using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify studies examining the feasibility, acceptability, effectiveness and/or efficacy of CBT or DBT for adolescent eating disorders. Results Eligible studies (N = 50; CBT: n = 40, DBT: n = 10) indicated that both treatments are reasonably feasible, acceptable, and possibly effective for adolescent eating disorders across diagnoses and levels of care, though efficacy trials are lacking. Conclusions CBT and DBT demonstrate promise as alternatives to family-based approaches for adolescent eating disorders. Adequately powered trials to establish the effectiveness and efficacy of CBT and DBT are needed, particularly ones that compare these treatments against other leading approaches. Plain English summary Despite high rates of relapse and likelihood for severe and enduring illness, there is a dearth of evidence-based treatment options for adolescents with eating disorders. Potentially viable but less well-studied treatments for adolescents with eating disorders include cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). This systematic review of CBT and DBT for adolescent eating disorders focuses on feasibility (i.e., how easy it was to implement the treatment), acceptability (i.e., how well the intervention was received by patients and therapists), effectiveness (i.e., how well the intervention performed under routine, real-world circumstances), and efficacy (i.e., how well the intervention performed in highly-controlled research settings). This review concludes that research supports the feasibility and acceptability of these approaches, as well as preliminary evidence of their effectiveness. However, the field is lacking studies that systematically compare CBT and DBT to other evidence-based approaches. Recommendations to advance research on CBT and DBT for adolescent eating disorders are provided, including a call for efficacy studies that clarify their performance compared to other leading approaches.

Formulation in eating disorder focused family therapy: why, when and how?

In the broadest sense, formulation, or case conceptualisation, is the process of collaborative sense-making. It is something all clinicians are doing constantly, whether formally and consciously or not. Most clinicians are familiar with the general principals and need to formulate as it is a core part of clinical training across most disciplines. Treatment manuals often discuss formulation, but the practical steps involved and the process of developing, building upon and revising formulations are not always provided. In clinical practice, the active use and continued development of formulation during treatment is not always prioritised, especially beyond the initial assessment. This could be due to a number of reasons, such as a potential lack of clarity, understanding or confidence in the use of formulation across treatment, a lack of dedicated time and reflective space for formulation in the context of increasingly busy clinical settings, or a perception that it may be less necessary in the context of treatment approaches that are more structured and prescriptive. This article outlines the use of formulation in family therapy for child and adolescent eating disorders, provides guidance on how to actively include formulation more throughout treatment and discusses why this might be useful.