Authors suggest that deficits in distress tolerance might play a significant role in the etiology and maintenance of bulimic symptoms.

We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3–4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations.

Many theories exist regarding dysregulated eating behaviors such as bingeing and purging. Recent research has provided consistent and compelling evidence supportive of theories that favor an emotion regulatory model (Smyth et al. J Consult Clin Psychol 75:629-638, 2007). Specifically, these theories posit that individuals engage in dysregulated eating behaviors in a maladaptive attempt to alleviate negative affect. Along these lines, several studies have reported that negative urgency, the tendency to act rashly in an attempt to immediately reduce feelings of negative affect (Whiteside and Lynam Pers Individ Dif 30:669-689, 2001), is a particularly important variable in this process (Anestis et al. Behav Res Ther 45:3018-3029, 2007; Fischer et al. Int J Eat Disord 33:406-411, 2003). In this study, we sought to expand upon prior research by testing the relationship between negative urgency and EDI-Bulimia in a clinical sample (N = 130) when controlling for an extensive list of relevant covariates, including additional components of impulsivity. Results supported our hypotheses. These findings indicate that the previously reported relationship between negative urgency and dysregulated eating behaviors remains significant in a clinical setting, even when controlling a more extensive list of impulsivity related variables than has been utilized in prior research. As such, this study has potentially important clinical implications.

Our data replicated and extended the findings of Keel et al. and gave further support to the validity and distinctiveness of PD.

Background Although there has been a tremendous amount of research examining the risk conferred for suicide by depression in general, relatively little research examines the risk conferred by specific forms of depressive illness (e.g., dysthymic disorder, single episode versus recurrent major depressive disorder [MDD]). The purpose of the current study was to examine differences in suicidal ideation, clinician-rated suicide risk, suicide attempts, and family history of suicide in a sample of outpatients diagnosed with various forms of depressive illness. Methods To accomplish this aim, we conducted a cluster analysis using the aforementioned suicide-related variables in a sample of 494 outpatients seen between January 2001 and July 2007 at the Florida State University Psychology Clinic. Patients were diagnosed using DSM-IV criteria. Results Two distinct clusters emerged that were indicative of lower and higher risk for suicide. After controlling for the number of comorbid Axis I and Axis II diagnoses, the only depressive illness that significantly predicted cluster membership was recurrent MDD, which tripled an individual’s likelihood of being assigned to the higher risk cluster. Limitations The use of a cross-sectional design; the relatively low suicide risk in our sample; the relatively small number of individuals with double depression. Conclusions Our results demonstrate the importance of both chronicity and severity of depression in terms of predicting increased suicide risk. Among the various forms of depressive illness examined, only recurrent MDD appeared to confer greater risk for suicide.