More Like this

1. Binge‐eating disorder with and without lifetime anorexia nervosa: A comparison of sociodemographic and clinical features

   https://doi.org/10.1002/eat.23858  

   Pawar, Pratiksha S. ; Thornton, Laura M. ; Flatt, Rachael E. ; Sanzari, Christina M. ; Carrino, Emily A. ; Tregarthen, Jenna P. ; Argue, Stuart ; Bulik, Cynthia M. ; Watson, Hunna J. ( November 2022 , International Journal of Eating Disorders)

   To compare individuals who have experienced binge‐eating disorder (BED) and anorexia nervosa (AN) (BED AN+) to those who have experienced BED and not AN (BED AN–).

   Participants (N = 898) met criteria for lifetime BED and reported current binge eating. Approximately 14% had a lifetime diagnosis of AN. Analyses compared BED AN+ and BED AN– on sociodemographic variables and clinical history.

   The presence of lifetimeANwas associated with more severe eating disorder symptoms, including earlier onset, more frequent, more chronic, and more types of eating disorder behaviors over the lifetime, as well as a higher lifetime prevalence of bulimia nervosa (BN). Participants with lifetimeANreported being more likely to have received treatments forBEDorBN, had significantly lower minimum, current, and maximumBMIs, had more severe general anxiety, and were significantly more likely to be younger and female. In the full sample, the lifetime prevalence of unhealthy weight control behaviors was high and treatment utilization was low, despite an average 15‐year history since symptom onset. Gastrointestinal disorders and comorbid anxiety, depression, and attention‐deficit/hyperactivity disorder symptoms were prevalent.

   Individuals fared poorly on a wide array of domains, yet those with lifetimeANfared considerably more poorly. All patients withBEDshould be screened for mental health and gastrointestinal comorbidities and offered referral and treatment options.

   Individuals experiencing binge‐eating disorder have severe symptomology, but those who have experienced binge‐eating disorder and anorexia nervosa fare even more poorly. Our study emphasizes that patients with binge‐eating disorder would benefit from being screened for mental health and gastrointestinal comorbidities, and clinicians should consider history of unhealthy weight control behaviors to inform treatment and relapse prevention.

    

   more » « less
2. Comparing self‐harming intentions underlying eating disordered behaviors and nonsuicidal self‐injury : Replication and extension in adolescents

   https://doi.org/10.1002/eat.24043  

   Kline, Kiki M. ; Jorgensen, Saskia L. ; Lawson, W. Cole ; Ohashi, Yuri‐Grace B. ; Wang, Shirley B. ; Fox, Kathryn R. ( August 2023 , International Journal of Eating Disorders)

   Eating disorder (ED) behaviors are often characterized as indirect forms of self‐harm. However, recent research has found less clear demarcations between direct self‐harming behaviors (e.g., nonsuicidal self‐injury [NSSI], suicidal behaviors) than previously assumed. The aim of this study was to replicate findings of this prior research on adult populations in adolescents with a history of restrictive eating.

   A total of 117 adolescents between ages 12–14 were included in the study. Participants reported the presence and frequency of binge eating, compensatory, restrictive eating, and NSSI. Participants also reported thoughts of and intentions to hurt and kill themselves when engaging in each behavior on average. Thet‐tests and linear effects models were conducted to compare self‐harming thoughts and intentions across behaviors.

   Participants reported at least some intent to hurt themselves physically in the moment and in the long‐term when engaging in all ED behaviors and NSSI, and reported engaging in these behaviors while thinking about suicide. Direct self‐harming knowledge and intentions were most frequently reported with NSSI and longer‐term knowledge and intentions via NSSI and restrictive eating. Additionally, participants reported some suicidal thoughts and intentions across behaviors.

   This study replicates prior research, suggesting that adolescents engage in ED behaviors and NSSI with non‐zero self‐harming and suicidal thoughts and intentions. ED behaviors and NSSI may better be explained on a continuum. Implications include the recommendation of safety planning during ED treatment.

   This study highlights the overlap between eating disorder (ED) behaviors, nonsuicidal self‐injury (NSSI), and suicide. Though clear distinctions typically exist for motives of self‐harming behavior between ED behaviors (i.e., indirect, in the long run) and NSSI (i.e., direct, in the moment), this research suggests that intentions for self‐harming and suicide may exist on a continuum. Clinical ED treatment should consider safety planning as part of routine interventions.

    

   more » « less
3. Gender differences in eating disorder psychopathology across DSM‐5 severity categories of anorexia nervosa and bulimia nervosa

   https://doi.org/10.1002/eat.22941  

   Zayas, Lazaro V. ; Wang, Shirley B. ; Coniglio, Kathryn ; Becker, Kendra ; Murray, Helen B. ; Klosterman, Eric ; Kay, Brian ; Bean, Pamela ; Weltzin, Theodore ; Franko, Debra L. ; et al ( September 2018 , International Journal of Eating Disorders)

   This study examined whether patterns of eating‐disorder (ED) psychopathology differed by gender acrossDSM‐5severity specifiers in anorexia nervosa (AN) and bulimia nervosa (BN).

   We tested whether ED psychopathology differed acrossDSM‐5 severity specifiers among 532 adults (76% female) in a residential treatment center with AN or BN. We hypothesized that severity of ED psychopathology would increase in tandem with increasing severity classifications for both males and females with AN and BN.

   Among females with BN,DSM‐5severity categories were significantly associated with increasing ED psychopathology, including Eating Disorder Examination‐Questionnaire dietary restraint, eating concern, shape concern, and weight concern; and Eating Disorder Inventory drive for thinness and bulimia. ED psychopathology did not differ acrossDSM‐5severity levels for males with BN. For both males and females with AN, there were no differences in ED psychopathology across severity levels.

   Results demonstrate thatDSM‐5severity specifiers may function differently for males versus females with BN. Taken together, data suggestDSM‐5severity specifiers may not adequately capture severity, as intended, for males with BN and all with AN. Future research should evaluate additional clinical validators ofDSM‐5severity categories (e.g., chronicity, treatment non‐response), and consider alternate classification schemes.

    

   more » « less
4. Restrictive eating, but not binge eating or purging, predicts suicidal ideation in adolescents and young adults with low‐weight eating disorders

   https://doi.org/10.1002/eat.23210  

   Wang, Shirley B. ; Mancuso, Christopher J. ; Jo, Jenny ; Keshishian, Ani C. ; Becker, Kendra R. ; Plessow, Franziska ; Izquierdo, Alyssa M. ; Slattery, Meghan ; Franko, Debra L. ; Misra, Madhusmita ; et al ( December 2019 , International Journal of Eating Disorders)

   This study examined the relationship between eating‐disorder behaviors—including restrictive eating, binge eating, and purging—and suicidal ideation. We hypothesized that restrictive eating would significantly predict suicidal ideation, beyond the effects of binge eating/purging.

   Participants were 82 adolescents and young adults with low‐weight eating disorders. We conducted a hierarchical logistic regression, with binge eating and purging in Step 1 and restrictive eating in Step 2, to predict suicidal ideation.

   Step 1 was significant (p= .01) and explained 20% variance in suicidal ideation; neither binge eating nor purging significantly predicted suicidal ideation. Adding restrictive eating in Step 2 significantly improved the model (ΔR²= .07,p= .009). This final model explained 27% of the variance, and restrictive eating (but not binge eating/purging) significantly predicted suicidal ideation (p= .02).

   Restrictive eating is associated with suicidal ideation in youth with low‐weight eating disorders, beyond the effects of other eating‐disorder behaviors. Although healthcare providers may be more likely to screen for suicidality in patients with binge eating and purging, our findings indicate clinicians should regularly assess suicide and self‐injury in patients with restrictive eating. Future research examining how individuals progress from suicidal ideation to suicidal attempts can further enhance our understanding of suicide in eating disorders.

    

   more » « less
5. Do people know how suicidal they will be? Understanding suicidal prospection

   https://doi.org/10.1111/sltb.13087  

   Coppersmith, Daniel D. L. ; Jaroszewski, Adam C. ; Gershman, Samuel J. ; Cha, Christine B. ; Millner, Alexander J. ; Fortgang, Rebecca G. ; Kleiman, Evan M. ; Nock, Matthew K. ( May 2024 , Suicide and Life-Threatening Behavior)

   Little research has been done on how people mentally simulate future suicidal thoughts and urges, a process we termsuicidal prospection.

   Participants were 94 adults with recent suicidal thoughts. Participants completed a 42‐day real‐time monitoring study and then a follow‐up survey 28 days later. Each night, participants provided predictions for the severity of their suicidal thoughts the next day and ratings of the severity of suicidal thoughts over the past day. We measured three aspects of suicidal prospection: predicted levels of desire to kill self, urge to kill self, and intent to kill self. We generated prediction errors by subtracting participants' predictions of the severity of their suicidal thoughts from their experienced severity.

   Participants tended to overestimate (although the average magnitude was small and the modal error was zero) the severity of their future suicidal thoughts. The best fitting models suggested that participants used both their current suicidal thinking and previous predictions of their suicidal thinking to generate predictions of their future suicidal thinking. Finally, the average severity of predicted future suicidal thoughts predicted the number of days participants thought about suicide during the follow‐up period.

   This study highlights prospection as a psychological process to better understand suicidal thoughts and behaviors.

    

   more » « less