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  1. Abstract Objective

    Previous work has outlined cognitive beliefs about exercise in general, but very little is known about momentary cognitions while engaging in pathological exercise. The primary aim of this study was to explore thought content during exercise and to test whether these thoughts predicted later engagement in eating disorder behaviors. We also tested associations between thoughts and specific exercise activity.

    Method

    We monitored 31 women with clinically significant eating psychopathology for 3 weeks via ecological momentary assessment as they reported on their exercise and eating disorder behaviors, and thoughts about shape, weight, or calories during exercise. Thoughts were self‐reported upon cessation of each exercise session.

    Results

    Thinking about weight loss during exercise predicted later engagement in body‐checking behaviors. Weight‐bearing exercise was associated with a decreased likelihood of thinking about calories but an increased likelihood of thinking about shape during exercise.

    Discussion

    These findings show that shape and weight thoughts are present during exercise and that their influence on eating disorder behaviors may exist on a much briefer time scale (i.e., within a day) than previous studies show. Clinically, future studies may seek to test interventions aimed at changing or restructuring cognitions during exercise to help shape adaptive exercise behavior during and after treatment.

    Public Significance

    This is the first study measuring thoughts during pathological exercise in real‐time among those with eating disorder psychopathology. The results show that thinking about weight loss during exercise might increase the likelihood of engaging in body‐checking behaviors. Findings will inform the development of treatment approaches to help those in recovery from eating disorders re‐engage with exercise.

     
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  2. Abstract Introduction

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

    Methods

    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.

    Results

    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.

    Conclusions

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

     
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  3. Abstract Objective

    Eating disordered (ED) behaviors (i.e., binge eating, compensatory behaviors, restrictive eating) and nonsuicidal self‐injury (NSSI; intentional and nonsuicidal self‐harm) are highly comorbid and share several similarities, including consequent pain and physical damage. However, whereas NSSI is considered direct self‐harm, ED behaviors are considered indirect self‐harm. These distinctions stem from theoretical understanding that NSSI is enacted to cause physical harm in the moment, whereas ED behaviors are enacted for other reasons, with consequent physical harm occurring downstream of the behaviors. We sought to build on these theoretically informed classifications by assessing a range of self‐harming intentions across NSSI and ED behaviors.

    Method

    Study recruitment was conducted via online forums. After screening for inclusion criteria, 151 adults reported on their intent to and knowledge of causing physical harm in the short‐ and long‐term and suicide and death related cognitions and intentions when engaging in NSSI and specific ED behaviors.

    Results

    Participants reported engaging in ED and NSSI behaviors with intent to hurt themselves physically in the moment and long‐term, alongside thoughts of suicide, and with some hope and knowledge of dying sooner due to these behaviors. Distinctions across behaviors also emerged. Participants reported greater intent to cause physical harm in the moment via NSSI and in the long‐run via restrictive eating. NSSI and restrictive eating were associated with stronger endorsement of most suicide and death‐related intentions than binge eating or compensatory behaviors.

    Conclusions

    Findings shed light on classification of self‐harming behaviors, casting doubt that firm boundaries differentiate direct and indirectly self‐harming behaviors.

     
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