Objective The Covid-19 pandemic has wrought disruption to everyday life and services, and emerging evidence suggests that those with eating disorders (EDs) are likely to experience marked distress and exacerbation of their symptoms. However, little is known around the most relevant factors to symptom change; whether certain emotion regulation and coping strategies are linked to better outcomes; and how people with EDs are adjusting to psychological interventions moving online. Method In a mixed-method design, we collected qualitative and quantitative data from 207 (76 males) self-selected UK residents with self-reported ED, who described and ranked impacts of the pandemic on their symptoms. Regression analysis examined whether emotion regulation strategies were associated with self-reported symptom change, ED symptomatology, and negative emotional states. Thematic analysis explored participants’ experiences of the pandemic, particularly factors affecting their ED, coping strategies used, and experiences of psychological intervention. Results Most participants (83.1%) reported worsening of ED symptomatology, though factors affecting symptom change differed between specific EDs. Emotion regulation, such as having fewer strategies, poorer emotional clarity, and non-acceptance of emotions, explained nearly half of the variance in emotional distress during the pandemic. Qualitative findings indicated that difficult emotions (such as fear and uncertainty), changes to routine, and unhelpful social messages were triggering for participants during the pandemic. While some participants described employing positive coping strategies (such as limiting social media exposure), many reported using ED behaviours (among other maladaptive strategies, like alcohol use) to cope with the pandemic. Finally, loss of treatment support, feeling underserving of support and experiencing a ‘detached connection’ online were further exacerbating factors for these participants. Discussion While our sample was self-selected and may not represent all people with EDs, our results suggest that people with EDs have been strongly affected by the pandemic. Some aspects of online treatment were found to be beneficial but our findings suggest it also needs some improvement. Our paper discusses implications for online treatment such as taking into account personal circumstances and, in a time where people have limited control over the antecedents of negative emotion, the need to develop skills to manage emotions when they arise.

中文翻译：

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COVID-19 大流行对饮食失调患者的影响：情绪调节的作用和在线治疗体验的探索


目标 Covid-19 大流行对日常生活和服务造成了干扰，新的证据表明，饮食失调 (ED) 患者可能会经历明显的痛苦和症状恶化。然而，人们对与症状变化最相关的因素知之甚少。某些情绪调节和应对策略是否与更好的结果相关；以及 ED 患者如何适应在线心理干预。方法 在混合方法设计中，我们收集了 207 名（76 名男性）自选的患有自我报告 ED 的英国居民的定性和定量数据，他们描述了大流行对其症状的影响并对其进行了排名。回归分析检查情绪调节策略是否与自我报告的症状变化、ED 症状和消极情绪状态相关。主题分析探讨了参与者的大流行经历，特别是影响其急诊室的因素、所使用的应对策略以及心理干预的经历。结果 大多数参与者 (83.1%) 报告 ED 症状恶化，但影响症状变化的因素在特定 ED 之间有所不同。情绪调节，例如策略较少、情绪清晰度较差和不接受情绪，解释了大流行期间情绪困扰差异的近一半。定性研究结果表明，在大流行期间，参与者会引发困难的情绪（例如恐惧和不确定性）、日常生活的改变和无益的社交信息。 虽然一些参与者描述了采用积极的应对策略（例如限制社交媒体曝光），但许多参与者报告使用 ED 行为（以及其他适应不良策略，例如饮酒）来应对这一流行病。最后，失去治疗支持、感觉得不到支持以及在网上经历“孤立的联系”是这些参与者进一步恶化的因素。讨论 虽然我们的样本是自行选择的，可能无法代表所有 ED 患者，但我们的结果表明 ED 患者受到了这一流行病的严重影响。在线治疗的某些方面被发现是有益的，但我们的研究结果表明它还需要一些改进。我们的论文讨论了在线治疗的影响，例如考虑个人情况，以及在人们对负面情绪的前因控制有限的时代，需要培养在情绪出现时管理情绪的技能。