Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students.

OBJECTIVE: Early COVID-19 eating disorders (EDs) research used regionally restricted samples with little sociodemographic diversity. The present study aimed to address these research gaps by examining whether pandemic-related changes in ED symptoms and mental healthcare prevalence differed for historically marginalized groups within a national sample of US college students. METHOD: Participants included 242,906 US college students (Mage  = 23.45, SD = 7.04; MBMI  = 25.28, SD = 5.91) who completed the repeated cross-sectional multi-institute Healthy Minds Study between January 2019 and May 2021. Moderated logistic regressions examined whether pandemic-related changes in individuals' likelihoods of exhibiting current probable ED, reporting lifetime ED diagnoses, and-among individuals with current probable ED-mental healthcare engagement differed for diverse gender, sexual, and racial/ethnic identity groups, and by body mass index (BMI) and financial stress. RESULTS: There were increases of 5% and 12% in individuals' likelihoods of exhibiting current probable ED and symptomatic individuals' mental healthcare engagement, respectively, pre- to post-COVID-19 onset, but no pandemic-related changes in lifetime ED diagnosis prevalence. There were also important variations in these time-trends for different marginalized groups. For example, individuals identifying as genderqueer/gender nonconforming and lesbian exhibited increasing ED symptoms pre- to post-COVID-19 onset, and individuals with current probable ED and higher BMIs were increasingly likely to receive mental healthcare. Associations between financial stress, and the ED and mental healthcare outcomes did not change over time. DISCUSSION: These findings provide insight into groups of US college students that experienced disproportionate ED burden during the pandemic at the population level, and directions for research and interventions that warrant consideration.

Changes in the prevalence and sociodemographic correlates of eating disorder symptoms from 2013 to 2020 among a large national sample of U.S. young adults: A repeated cross-sectional study.

OBJECTIVE: The present study aimed to: (1) identify recent temporal changes in the prevalence of different cognitive and behavioral eating disorder (ED) symptoms, current probable EDs, lifetime ED diagnoses, and mental healthcare use among college students across the United States; (2) determine whether established disparities in ED prevalence and receiving mental healthcare have widened or narrowed over time for marginalized groups within this population. METHOD: Participants included a large national sample of U.S. college students (N = 286,720) who completed the repeated cross-sectional Healthy Minds Study from 2013 to 2020. Descriptive statistics and polynomial regressions quantified time-trends in participants' ED symptoms and past 12-month mental healthcare. Moderated regressions examined temporal changes in ED symptoms and mental healthcare based on sociodemographic characteristics. RESULTS: Individuals' engagement in different cognitive and behavioral ED symptoms, and likelihoods of exhibiting current probable EDs, reporting lifetime ED diagnoses, and (for individuals with current probable EDs) receiving therapy or counseling in the past 12-months exhibited nonlinear increases from 2013 to 2020. Further, the prevalence of current and lifetime ED symptoms and (for symptomatic individuals) past 12-month mental healthcare differed over time for individuals with different BMIs and gender, sexual, and racial/ethnic identities (but not ages). In particular, individuals with higher BMIs and those who identified as male, bisexual, and gay, lesbian, or queer exhibited increasing ED pathology over time. DISCUSSION: These findings provide important information on groups of U.S. college students that have experienced increasing burden of ED symptoms and may help guide ED prevention, treatment, and research priorities. PUBLIC SIGNIFICANCE: Recent temporal changes in the prevalence of eating disorder (ED) symptoms and mental healthcare were examined in a national sample of U.S. young adults. Non-linear increases in ED symptoms and mental healthcare were identified among U.S. young adults overall from 2013 to 2020. U.S. young adults with higher BMIs, males, bisexual, and gay, lesbian, or queer individuals exhibited increasing ED burden over time.

Prevalence of child maltreatment in Ecuador using the ICAST-R.

OBJECTIVES: While the link between childhood experiences of physical, emotional, and sexual abuse and mental health problems has been largely studied, there is limited information regarding the prevalence of child maltreatment in developing countries, particularly in South America. The present study is an effort to investigate the prevalence of child maltreatment in Ecuador using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). METHOD: A student sample (males = 1579; females = 1554) from the seven largest universities in Quito, Ecuador, completed the ICAST-R. RESULTS: Our findings indicate that 69.6 % of participants experienced child maltreatment. Physical abuse was reported by 47.6 % of respondents; this commonly involved being beaten by parents. Emotional maltreatment was reported by 53 % of the participants; mostly through insults by same-sex peers and parents. Sexual abuse was reported by 15.5 % of the participants. The most prevalent forms of sexual abuse included being coerced into touching another person's genitals, having their genitals touched by others, or having someone expose their genitals to them. Sexual abuse was more prevalent amongst females (males = 12.9 %; females = 18.1 %, OR = 1.49; CI = 1.22-1.81), and physical abuse was more prevalent amongst males (males = 50.5 %; females = 44.6 %, OR = 0.79; CI = 0.69-0.91). CONCLUSIONS: Our study shows evidence of a high prevalence of child maltreatment in Ecuador. We also identify significant gender differences in the type of abuse experienced, and in the context in which this abuse takes place. These results are important given the negative consequences of child maltreatment. More research applying ICAST to different populations is recommended to further validate the present findings and facilitate international comparisons.