This study investigated whether attitudes about life and death are associated with suicidal behavior in eating disorders (EDs). We examined 43 nonsuicidal inpatients with EDs, 32 inpatients with EDs who attempted suicide, and 21 control participants with scales assessing attitudes to life and death, body-related attitudes, core ED symptoms, depression, and anxiety. Both ED groups showed less attraction to life and more repulsion from life than did the control participants. The suicide attempters showed greater attraction to death, less repulsion from death, and more negative attitudes toward their body than did the nonsuicidal ED and control participants. Fear of life was associated with elevated depression, body-related problems, and childhood sexual abuse. Pathological attitudes toward death were associated with greater depression and body-related problems. Suicide attempts were found in the inpatients with EDs showing binge/purge ED pathology and maladaptive attitudes toward death. This study suggests that whereas fear of life is a core feature of an ED, maladaptive attitudes toward death appear only in ED patients who have attempted suicide.

In EDs, diverse factors may predict different outcome variables.