More Like this

1. Presence and severity of suicidal thoughts and behaviors across the eating disorder diagnostic spectrum: A pilot study

   https://doi.org/10.1002/jclp.23095  

   Duffy, Mary E. ; Siegfried, Nicole ; Bass, Garrett ; Joiner, Thomas E. ( December 2020 , Journal of Clinical Psychology)

   There is a dearth of research on suicidal thoughts and behaviors among eating disorder patients diagnosed with binge eating disorder (BED) or other specified feeding or eating disorder (OSFED). This pilot study evaluated presence and severity of suicidal thoughts and behaviors by eating disorder diagnosis in a transdiagnostic clinical eating disorder sample.

   Participants were individuals (N = 257; 91.1% female; 94.6% Caucasian) currently receiving eating disorder treatment for anorexia nervosa (AN), bulimia nervosa (BN), BED, or OSFED. Participants completed online measures of variables.

   Lifetime and current presence and severity of suicidal ideation and suicide attempts were statistically similar among diagnostic groups.

   Though largely overlooked, treatment‐utilizing individuals with BED and OSFED may experience elevated rates and severity of suicidal thoughts and behaviors, like those with AN and BN. Attention to suicide‐related risk assessment and management is needed when treating individuals with eating disorders, regardless of diagnosis.

    

   more » « less
2. Correlates of suicidal thoughts and attempts in males engaging in muscle dysmorphia or eating disorder symptoms

   https://doi.org/10.1002/jclp.23102  

   Ortiz, Shelby N. ; Forrest, Lauren N. ; Smith, April R. ( December 2020 , Journal of Clinical Psychology)

   Despite the high rates of suicidality in body dysmorphic disorder and eating disorders (EDs), research on suicidality in a related disorder, muscle dysmorphia (MD), is essentially nonexistent. Thus, this study tested relations between suicidal thoughts and behaviors and MD and ED symptoms in an online male community sample.

   A total of 464 males (M_age = 40.3; 85% Caucasian) recruited from Amazon's Mechanical Turk completed measures that evaluated ED symptoms, MD symptoms, current suicidal ideation, and past suicide attempts.

   Most MD and ED symptoms were correlated with current suicidal ideation and previous suicide attempts. In multivariate regression models, vomiting and appearance intolerance remained significantly related to suicidal ideation, while hard exercise and lower functional impairment were significantly related to prior suicide attempts.

   Results indicate that appearance dissatisfaction, a core MD criterion, and hard exercise, a common behavioral symptom of MD, are associated with suicidality.

    

   more » « less
3. 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
4. Behavioral inhibition moderates the association between overvaluation of shape and weight and noncompensatory purging in eating disorders

   https://doi.org/10.1002/eat.23195  

   Liebman, Rachel E. ; Coniglio, Kathryn A. ; Becker, Kendra R. ; Tabri, Nassim ; Keshishian, Ani C. ; Wons, Olivia ; Keel, Pamela K. ; Eddy, Kamryn T. ; Thomas, Jennifer J. ( November 2019 , International Journal of Eating Disorders)

   The cognitive‐behavioral therapy (CBT) model of eating disorders suggests that compensatory purging behaviors (e.g., self‐induced vomiting, inappropriate laxative use) are primarily driven by binge eating. However, many individuals endorse purging in the absence of binge eating (i.e., noncompensatory purging [NCP]). Research is needed to understand why some individuals purge in the absence of objective or subjective binge‐eating episodes.

   Given the importance of overvaluation of shape/weight in the CBT model, and the existing evidence linking temperamental characteristics like behavioral inhibition (i.e., the tendency to withdraw in response to threat cues) with purging in general, we tested whether behavioral inhibition moderated the relationship between overvaluation of shape/weight and NCP in a sample of individuals in a residential eating disorder treatment center (N= 143).

   Overvaluation was more strongly related to NCP in individuals with high (relative to low) levels of behavioral inhibition. Among individuals low in behavioral inhibition, overvaluation predicted engagement in NCP to a much weaker extent.

   For those high (relative to low) in behavioral inhibition, both emotional avoidance and overvaluation may be important targets in the treatment of NCP, particularly in the absence of binge eating.

    

   more » « less
5. 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