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Little is known about how female adolescent ballet dancers—a group at high‐risk for the development of body dissatisfaction and eating disorders—construct body ideals, and how their social identities interact with body ideals to confer risk for disordered eating. Using a novel body figure behavioral task, this study investigated (1) whether degree of body dissatisfaction corresponded to severity of disordered eating thoughts and behaviors, and (2) how ballet identity corresponded with ideal body figure size among adolescent ballet dancers.

Participants were 188 female ballet dancers ages 13‐18 years who completed self‐report measures of study constructs and the behavioral task.

Linear regression models indicated that more severe body dissatisfaction was positively associated with increased disordered eating thoughts and behaviors (p < .19), except for muscle building (p = .32). We also found that identifying more strongly as a ballet dancer was correlated with having a smaller ideal body size (p = .017).

Findings from this study suggest desire to achieve smaller body sizes is correlated with more severe disordered eating endorsement and stronger ballet identity. Instructors and clinicians may consider assessing the extent to which individuals identify as a ballet dancer as a risk factor for disordered eating and encourage adolescent dancers to build and nurture other identities beyond ballet.

Eating disorders are debilitating conditions that can lead to malnutrition, social isolation, and even premature death. Though disordered eating thoughts and behaviors can affect anyone, adolescents in physically demanding and body image‐driven activities including ballet dance are particularly vulnerable. Investigating how factors like body dissatisfaction and strength of identity are associated with disordered eating among high‐risk groups is crucial for developing effective prevention and intervention methods that minimize harm.

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.

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.

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.

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.

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

Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are restrictive eating disorders. There is a proposal before the American Psychiatric Association to broaden the currentDSM‐5criteria for ARFID, which currently require dietary intake that is inadequate to support energy or nutritional needs. We compared the clinical presentations of ARFID and AN in an outpatient sample to determine how a more inclusive definition of ARFID, heterogeneous for age and weight status, is distinct from AN.

As part of standard care, 138 individuals with AN or ARFID completed an online assessment battery and agreed to include their responses in research.

Individuals with ARFID were younger, reported earlier age of onset, and had higher percent median BMI (%mBMI) than those with AN (allps < .001). Individuals with ARFID scored lower on measures of eating pathology, depression, anxiety, and clinical impairment (allps < .05), butdid notdiffer from those with AN on restrictive eating (p = .52), and scored higher on food neophobia (p < .001).

Allowing psychosocial impairment to be sufficient for an ARFID diagnosis resulted in a clinical picture of ARFID such that %mBMI was higher (and in the normal range) compared with AN. Differences in gender distribution, age, and age of onset remained consistent with previous research. Both groups reported similar levels of dietary restriction, although ARFID can be distinguished by relatively higher levels of food neophobia. Currently available measures of eating pathology may capture certain ARFID symptoms, but highlight the need for measures of impairment relative to ARFID.

We examined whether eating disorder (ED) outcome trajectories during residential treatment differed for patients screening positive for comorbid borderline personality disorder (BPD) and/or substance use disorders (SUDs) than those who do not.

We examined data from patients in a residential ED treatment program. Patients completed validated self‐report surveys to screen for SUDs and BPD on admission, and the ED Examination‐Questionnaire (EDE‐Q) on admission and every 2 weeks until discharge (N= 479 females).

Fifty‐four percent screened positive for at least one co‐occurring condition. At admission, patients screening positive for SUD and/or BPD had significantly greater eating pathology than patients screening negative for both (t[477] = 8.23,p< .001). Patients screening positive for SUD (independent of BPD screening status) had a significantly faster rate of symptom improvement during the initial 4 weeks than patients screening positive for BPD only and those with no comorbidities.

Screening positive for SUD and/or BPD was common in residential ED treatment, and associated with more severe ED symptoms. Screening positive for SUD was associated with faster ED symptom improvement than screening positive for BPD. These findings suggest that intensive ED treatment, even in the absence of intensive SUD treatment, may enhance patient outcomes for those with SUDs.

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.

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.