How the COVID-19 Pandemic and its Consequences Affect the Presence of and Search for Meaning of Life: A Longitudinal Study.

The presence of meaning in life (PML) and the search for meaning in life (SML) are crucial when facing difficult times. Although several theoretical frameworks have tried to explain the dynamics of meaning in life during adversity, empirical evidence about interactions among both constructs using longitudinal designs is scarce. This study examined the trajectories of both PML and SML during the COVID-19 lockdown period in Spain. In total, 220 adults fulfilled an online survey during two periods: a strict and a relaxed lockdown period. Latent growth models showed that both PML and SML declined slightly during the strict lockdown, but they reached a plateau during the relaxed lockdown. Results also showed that age and having a partner predicted higher PML and lower SML at baseline, whereas being male predicted higher scores on PML. PML and SML were negatively associated at baseline, higher SML at baseline was related to a steeper decreasing PML slope during the strict lockdown, and the PML and SML slopes in the relaxed lockdown period were negatively related. This study contributes to better understanding longitudinal fluctuations of meaning in life in situations of adversity.

Too many lemons to make lemonade? Disentangling mental health during the third wave of COVID-19 infections in Spain.

The study aimed to analyze the longitudinal change in mental health during the third wave of COVID-19 infections in Spain. Negative (e.g., emotional distress) and positive (e.g., positive functioning variables) outcomes were analyzed. Protective factors (e.g., resilience) as predictors of psychological adjustment (i.e., positive mental health, openness to the future, and low burden due to COVID-19) after ten months of the pandemic were also examined. The sample consisted of 164 participants, and self-reported questionnaires were administered at the beginning of the lockdown (March 2020), at the end of the lockdown (June 2020), and during the third wave (January 2021). Linear mixed models showed that individuals' emotional distress increased, and positive functioning variables (i.e., meaning in life, gratitude, resilience, and life satisfaction) decreased over time, but an increase was observed in some dimensions of posttraumatic growth. Regression analyses showed that resilience scores at all three data collection time points were significant predictors of positive mental health, openness to the future, and burden during the third wave. Mediation analyses showed that positive mental health and openness to the future were mediators of the effect of resilience on burden. The prolonged situation of the COVID-19 crisis had an important impact on positive and negative mental health. However, resilience may help to build up resources that can act as a buffer against adverse psychological effects.

Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review.

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full-text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.

Los familiares de pacientes con trastorno límite de la personalidad (TLP) experimentan elevados niveles de estrés. Se han llevado a cabo varios estudios sobre intervenciones diseñadas para disminuir su carga. Sin embargo, los datos obtenidos de estos estudios no se han expuesto. El objetivo de este trabajo es explorar la utilidad clínica de las intervenciones desarrolladas para los familiares de los pacientes con TLP. Se realizó una revisión sistemática siguiendo las directrices de PRISMA (número de registro CRD42018107318), que incluyó intervenciones psicológicas centradas en los familiares de los pacientes con TLP. Se utilizaron las siguientes bases de datos: PsycINFO, PubMed, EBSCOhost, y Web of Science. Dos investigadores independientes revisaron los estudios para determinar si se cumplían los criterios de elegibilidad. Se identificaron un total de 2303 resúmenes. Después de extraer los duplicados, se evaluaron 1746 estudios. Finalmente, se revisaron 433 artículos de texto completo, lo que dio lugar a 11 estudios que cumplían los criterios de inclusión. Los resultados demuestran que estas intervenciones con diferentes formatos y orientaciones clínicas son eficaces. La calidad de los estudios incluidos varía, y el apoyo empírico para estos programas es todavía preliminar. Los resultados contribuyen a establecer un marco general para las intervenciones desarrolladas específicamente para los familiares de los pacientes con TLP, pero se deberían realizar esfuerzos adicionales para mejorar la calidad metodológica de este campo de investigación y determinar con mayor solidez la utilidad de estas intervenciones. Dada la escasez de datos hasta el momento, esta información puede abrir nuevas líneas de investigación para mejorar la eficacia de los futuros programas para los cuidadores de los pacientes con TLP y ayudar a reducir su carga.

How adolescents lose control over social networks: A process-based approach to problematic social network use.

Social networks (SNs) are immensely popular, especially among teenagers, yet our understanding of problematic SNs remains limited. Understanding motivations and patterns of use is crucial given the current prevalence of problematic SNs use. Perarles et al. (2020) distinguish two behavioral control modes: Model-Free Control, where actions are characterized by actions driven by immediate gratification without reflective consideration for long-term consequences, and Model-Based Control, enabling planned and goal-directed actions. Both control modes can lead to problematic social network use. This study aims to delve into problematic SNs use and the underlying motives behind adolescents' participation in SNs, drawing upon the theoretical proposal by Perales et al. (2020). We conducted four focus groups with adolescents aged 13-17 (50 % female; Mage = 14.5, SD = 1.75), comprising two public school and two Catholic private school groups. Thematic analysis using Atlas.ti software revealed three themes. The first uncovers characteristics of problematic SNs use, including withdrawal, increased usage time, impaired control, behavioral salience and attentional capture and cognitive hijacking. The second spotlights motives, emphasizing emotional regulation, finding out what is going on, and social interaction. The third theme explores consequences such as compromised academic performance and physical harm. In conclusion, addressing both motives and problematic behaviors present a more effective approach to confronting SNs use challenges and fostering healthier online experiences for adolescents.

"Validation of three scales for enhanced suicide prevention in Spanish-speaking populations: Suicidal ideation, stigma, and literacy".

BACKGROUND: Escalating suicide rates in Spain and Latin America underscore the critical need for accurate assessment and prevention tools tailored to these populations. This study aimed to culturally adapt and validate three essential scales: the Suicidal Ideation Attributes Scale (SIDAS), the Suicide Stigma Scale - Short Form (SOSS-SF), and the Suicide Literacy Scale - Short Form (LOSS-SF). METHOD: A total of 678 participants (including 150 with suicidal ideation) completed an online survey. The scales underwent rigorous back-translation and adaptation by native speakers from Spain and Latin America. SIDAS and SOSS-SF were validated using Confirmatory Factor Analysis (CFA), with criteria including fit indices (e.g., RMSEA, CFI). LOSS-SF underwent validation through Item Response Theory (IRT). Additionally, gender invariance was assessed across all scales. RESULTS: CFA confirmed the original factor structures of SIDAS and SOSS-SF, demonstrating good fit indices and internal consistency. The analysis of LOSS-SF required excluding two items, resulting in a final Spanish version with 10 items and an unifactorial structure. Gender invariance was established across all scales. CONCLUSIONS: The culturally adapted and validated scales in this study demonstrate robust reliability and validity for assessing suicidal ideation, suicide stigma, and suicide literacy among Spanish-speaking populations. These validated tools have the potential to enhance clinical assessment, inform personalized interventions, monitor public health initiatives, educate communities about suicide, and advance research in suicide prevention and treatment.

"Own doctor" presence in a web-based lifestyle intervention for adults with obesity and hypertension: A randomized controlled trial.

Introduction: Online interventions have long been shown to be an effective means to promote a healthy lifestyle, thereby helping to control body weight and blood pressure figures. Likewise, using video modeling is also considered an effective way to guide patients through behavioral interventions. Nonetheless, to the best of our knowledge, this study is the first to analyze how the presence of patients' "own doctor" in the audiovisual content of a web-based lifestyle program ("Living Better") aimed at promoting regular physical exercise and healthy eating behavior, compared with an "unknown doctor," influences the outcomes of adults with obesity and hypertension. Materials and methods: A total of 132 patients were randomly assigned either to the experimental (n = 70) or control (n = 62) group ("own doctor" or "unknown doctor", respectively). The body mass index, systolic and diastolic blood pressure, number of antihypertensive drugs used, physical activity level, and quality of life was assessed and compared at baseline and post-intervention (12 weeks). Results: The intention-to-treat analysis showed intragroup significant improvements in both groups in terms of the body mass index (control group: mean difference -0.3, 95% CI [-0.5, -0.1], p = 0.002; experimental group: -0.4 [-0.6, -0.2], p < 0.001) and systolic blood pressure (control group: -2.3 [-4.4, -0.2], p = 0.029; experimental group: -3.6 [-5.5, -1.6], p< 0.001). In addition, there were also significant improvements in the experimental group for the diastolic blood pressure (-2.5 [-3.7, -1.2], p < 0.001), physical activity (479 [9, 949], p = 0.046), and quality of life (5.2 [2.3, 8.2], p = 0.001). However, when comparing the experimental with the control group, no between-group significant differences were found in these variables. Conclusions: This study suggests that the presence of patients' "own doctor" in the audiovisual content of a web-based intervention, aimed at promoting a healthy lifestyle among adults with obesity and hypertension, do not show significant additional benefits over the efficacy of e-counseling. Trial registration: ClinicalTrials.gov NCT04426877. First Posted: 11/06/2020. https://clinicaltrials.gov/ct2/show/NCT04426877.

Food addiction and its relationship with other eating behaviours among Spanish university students.

BACKGROUND: Food addiction (FA) is characterised by symptoms such as loss of control over food consumption, inability to reduce consumption despite the desire to do so, and continued consumption despite negative consequences. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a widely used instrument to assess FA. OBJECTIVES: To validate the Spanish mYFAS 2.0; to analyse the relationships between FA with other eating behaviours, sociodemographic variables, and Body Mass Index (BMI); and to test the eating-related variables that account for the variance in FA. METHODS: The sample consisted of 400 university students (Mage = 24.16, SDage = 6.12; 51% female), who completed the mYFAS 2.0 and measures of eating-related constructs. RESULTS: A confirmatory factor analysis (CFA) supported the one-factor structure of the mYFAS 2.0. The scale showed good internal consistency (α = .78), and good convergent validity with the mYFAS. FA was related to eating styles, binge eating, and bulimia. No differences in FA were observed between males and females, and there was no association between FA and BMI. In addition, younger participants scored higher on FA than older participants. The eating-related variables explain 54.7% of the variance in FA. CONCLUSIONS: The mYFAS 2.0 is a valid and reliable scale to assess FA in the Spanish population. The positive and significant relationship of variables related to eating (eating styles, binge eating and bulimia) with FA was demonstrated. These variables were indicated by those at high risk of FA.

How the Presence of a Doctor Known to Patients Impacts a Web-Based Intervention to Promote Physical Activity and Healthy Eating Behaviour in Individuals with an Overweight/Obesity-Hypertension Phenotype: A Randomised Clinical Trial.

(1) Background: The 'Living Better' web-based programme has shown short- and long-term benefits for body composition and psychological variables in obese patients with hypertension by promoting a healthier lifestyle. To further explore the potential of this programme, in this work we aimed to explore the possible effect of the patient's 'own doctor' appearing in the video content of the Living Better intervention. (2) Methods: A total of 132 patients were randomly assigned either to the experimental (EG, n = 70) or control (CG, n = 62) group (with a doctor the patient knew as 'their own' or an 'unknown doctor', respectively). The body mass index (BMI), motivation towards physical activity (PA), PA levels, motivation to change one's eating habits, adherence to the Mediterranean diet, and eating behaviour were all assessed and compared at baseline and post-intervention (12 weeks). (3) Results: The results of this study confirmed the positive effects of the Living Better programme on BMI and external eating style, with significant improvements in these variables in both groups. In addition, in the EG there was higher intrinsic motivation to change eating behaviour (mean difference of 0.9, 95% CI [0.1, 1.6], p = 0.032) and lower amotivation (mean difference of -0.6, 95% CI [-1.2, -0.1], p = 0.027) compared to the CG. (4) Conclusions: This study suggests that the presence of the patients' own doctor in the audiovisual content of the Living Better intervention did not have significant additional benefits in terms of BMI or external eating style. However, their presence did improve intrinsic motivation and amotivation related to eating habits.

Eating behaviors, eating styles and body mass index during COVID-19 confinement in a college sample: a predictive model.

BACKGROUND: COVID-19 confinement affected lifestyles. There is inconclusive evidence about changes in eating patterns, and there are few studies on the impact on body mass index (BMI), the occurrence of dysfunctional behaviors (binge eating, fat intake), and the predictive role of maladaptive eating styles (emotional, external, and restrained eating). OBJECTIVES: (1) To analyze the differences in binge eating, fat intake, BMI, and maladaptive eating styles before and during COVID-19 confinement, and (2) to analyze whether maladaptive eating styles (before confinement) predicted binge eating, fat intake, and BMI during confinement. METHODS: The sample consisted of 146 Spanish college students, divided into 104 females (71.2%; age: M = 22.20, SD = 2.97) and 42 males (28.8%; age: M = 24.74; SD = 3.53). All completed several dietary measures and BMI twice: before COVID-19 confinement (T1, November 2019) and during COVID-19 confinement (T2, April 2020). RESULTS: BMI and maladaptive eating styles did not change in T2 (vs. T1). However, binge eating and fat intake decreased in T2. Emotional eating at T1 positively predicted BMI and binge eating at T2. External eating at T1 positively (and marginally) predicted fat intake at T2. Restrained eating at T1 positively predicted binge eating at T2, and negatively (and marginally) predicted BMI and fat intake at T2. The model explained 80.5% of the variance in BMI, 41.5% of the variance in binge eating, and 25.8% of the variance in fat intake during COVID-19 confinement. CONCLUSIONS: The COVID-19 confinement had a positive impact on some eating behaviors. Future policies should focus part of their prevention on maladaptive eating styles to curb dysfunctional eating behaviors and BMI problems in times of stress.

The COVID-19 confinement affected the lifestyles of the young population, especially eating behaviors. It is not yet known whether eating problems, such as binge eating and high fat intake, changed during this period in the young people. It is also not known whether the young population perceived changes in their BMI during COVID-19 confinement. In addition, eating styles (emotional eating, restrictive eating, and external eating) may be predictors of this change. The present study found that binge eating and fat intake decreased in COVID-19 confinement, and BMI and eating styles remained stable. Eating styles predicted change in these eating problems (binge eating and fat intake) and change in BMI during this period of elevated stress. Therefore, eating styles may help to understand dietary changes during times of high stress.

The Impact of a Web-Based Lifestyle Educational Program ('Living Better') Reintervention on Hypertensive Overweight or Obese Patients.

'Living Better', a self-administered web-based intervention, designed to facilitate lifestyle changes, has already shown positive short- and medium-term health benefits in patients with an obesity−hypertension phenotype. The objectives of this study were: (1) to examine the long-term (3-year) evolution of a group of hypertensive overweight or obese patients who had already followed the 'Living Better' program; (2) to analyze the effects of completing this program a second time (reintervention) during the COVID-19 pandemic. A quasi-experimental design was used. We recruited 29 individuals from the 105 who had participated in our first study. We assessed and compared their systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), eating behavior, and physical activity (PA) level (reported as METs-min/week), at Time 0 (first intervention follow-up), Time 1 (before the reintervention), and Time 2 (post-reintervention). Our results showed significant improvements between Time 1 and Time 2 in SBP (−4.7 (−8.7 to −0.7); p = 0.017), DBP (−3.5 (−6.2 to −0.8); p = 0.009), BMI (−0.7 (−1.0 to −0.4); p < 0.001), emotional eating (−2.8 (−5.1 to −0.5); p = 0.012), external eating (−1.1 (−2.1 to −0.1); p = 0.039), and PA (Time 1: 2308 ± 2266; Time 2: 3203 ± 3314; p = 0.030, Z = −2.17). Statistical analysis showed no significant differences in SPB, DBP, BMI, and eating behavior between Time 0 and Time 1 (p > 0.24). Implementation of the 'Living Better' program maintained positive long-term (3-year) health benefits in patients with an obesity−hypertension phenotype. Moreover, a reintervention with this program during the COVID-19 pandemic produced significant improvements in blood pressure, BMI, eating behavior, and PA.

mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial.

BACKGROUND: Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. OBJECTIVES: The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. METHOD: A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). CONCLUSIONS: It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04659746.

Understanding the Influence of Eating Patterns on Binge Drinking: A Mediation Model.

BACKGROUND: Binge drinking is an important health problem, and it has been related to binge eating and fat intake in animal models, but this relationship has not been tested in humans. The first objective of this study was to analyze whether binge eating and fat intake are related to binge drinking in a youth sample. The second objective was to analyze whether binge eating and fat intake mediate the relationship between individual factors associated with binge eating and fat intake (sex, body mass index (BMI), drive for thinness, body dissatisfaction, eating styles, impulsivity, and food addiction) and binge drinking. METHODS: A sample of 428 undergraduate students filled out several questionnaires on binge drinking, binge eating, fat intake, drive for thinness, body dissatisfaction, eating styles, food addiction, and impulsivity. RESULTS: Results showed an excellent model fit: χ2(25) = 30.342 (p = 0.212), comparative fit index (CFI) = 0.992, root mean squared error of approximation (RMSEA) = 0.022 [90% CI = 0.000, 0.047]. Binge eating and fat intake were positively related to binge drinking. Furthermore, emotional eating, external eating, and food addiction showed positive and statistically significant indirect relationships with binge drinking, whereas the relationship with restrained eating was negative. CONCLUSIONS: These findings point to the need to use a broader approach in understanding and preventing binge drinking in the youth population by showing the influence of the eating pattern on this problem. This information could be helpful in preventing future behaviors and improving interventions that address health risk behaviors.

Binge Eating and Binge Drinking: A Two-Way Road? An Integrative Review.

Unhealthy diet and alcohol are serious health problems, especially in adolescents and young adults. "Binge" is defined as the excessive and uncontrolled consumption of food (binge eating) and alcohol (binge drinking). Both behaviors are frequent among young people and have a highly negative impact on health and quality of life. Several studies have explored the causes and risk factors of both behaviors, and the evidence concludes that there is a relationship between the two behaviors. In addition, some research postulates that binge eating is a precipitating factor in the onset and escalation of excessive alcohol consumption, while other studies suggest that alcohol consumption leads to excessive and uncontrollable food consumption. Given that no review has yet been published regarding the directionality between the two behaviors, we have set out to provide an upto- date overview of binge eating and binge drinking problems, analyzing their commonalities and differences, and their uni- and bidirectional associations. In addition, we explore the reasons why young people tend to engage in both behaviors and consider directions for future research and clinical implications.

Efficacy of an Internet-Based Intervention to Promote a Healthy Lifestyle on the Reproductive Parameters of Overweight and Obese Women: Study Protocol for a Randomised Controlled Trial.

Background: Infertility is estimated to affect 15% of couples of reproductive age. Weight management problems (being obese or overweight) are among the problems that produce infertility, both in women seeking spontaneous pregnancy and in those undergoing assisted reproduction techniques. Over the last few decades, the prevalence of obesity has increased alarmingly in our society and is now considered one of the most important public health problems. The combination of diet and exercise to achieve weight loss are currently considered an effective intervention for the improvement of reproductive parameters in overweight or obese infertile women. In other population groups, it has been shown that Internet-based interventions are just as effective as traditional ones, and these cover a larger population with a good cost-benefit ratio. However, to the best of our knowledge, no studies so far have analysed any specific online interventions for this group of infertile women. Thus, the objective of this project will be to evaluate the effectiveness of an online program to promote a healthy lifestyle among women who are overweight or obese who also have a diagnosis of infertility and are on the waiting list for in vitro fertilisation treatment. Methods: This will be a randomised controlled clinical trial conducted in 94 women which will compare a self-administered Internet-based intervention promoting a healthy lifestyle in terms of diet and exercise (n = 47) to a control group that will receive standard medical care. The online program will comprise nine modules, will last for 3 months, and will be monitored every 3 months after the intervention until the final follow-up at 12 months. The main outcome will be the spontaneous pregnancy rate. Secondary outcomes will include changes in body composition, dietary and physical exercise habits, glycaemic profiles, lipid profiles, hormonal profiles, and patient quality of life related to their fertility problems. The data analysis will be done on an intention-to-treat basis. Discussion: The aim of this study is to increase our knowledge of the effectiveness of online interventions specifically adapted to infertile women who are overweight or obese in the promotion of healthy lifestyles.

The Binge Eating Scale: Structural Equation Competitive Models, Invariance Measurement Between Sexes, and Relationships With Food Addiction, Impulsivity, Binge Drinking, and Body Mass Index.

Introduction: The Binge Eating Scale (BES) is a widely used self-report questionnaire to identify compulsive eaters. However, research on the dimensions and psychometric properties of the BES is limited. Objective: The aim of this study was to examine the properties of the Spanish version of the BES. Methods: Confirmatory Factor Analyses (CFAs) were carried out to verify the BES factor structure in a sample of Spanish college students (N = 428, 75.7% women; age range = 18-30). An invariance measurement routine was carried out across sexes, the latent means were compared, and estimates of reliability and convergent and discriminant validity were presented. Results: A one-factor model fit the data best and was also equivalent between sexes. The scalar invariance model showed statistically significant differences across sexes, with a higher prevalence in women. Regarding reliability, the results were excellent. Finally, high statistically significant correlations were obtained with other measures of binge eating (BE), food addiction, impulsivity, binge drinking, and body mass index (BMI). Conclusion: The Spanish 16-item BES is a valid and reliable scale to evaluate BE in the youth population.

Correction: Indomethacin blocks the increased conditioned rewarding effects of cocaine induced by repeated social defeat.

[This corrects the article DOI: 10.1371/journal.pone.0209291.].