Behavioral functions underlying NSSI and eating disorder behaviors

Muehlenkamp, Jennifer J.; Suzuki, Takakuni; Brausch, Amy M.; Peyerl, Naomi L.

doi:10.1002/jclp.22745

Cited by 34 publications

(18 citation statements)

References 49 publications

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“…Factors potentially involved include body dissatisfaction and low self‐esteem (Perez et al, ). Growing evidence suggests that the risk of self‐harm is related to emotional dysregulation present in both EDs and patients who self‐harm or attempt suicide, where both self‐harm and altered eating behavior are used to self‐punish and avoid negative emotions (Muehlenkamp, Peat, Claes, & Smits, ; Muehlenkamp, Takakuni, Brausch, & Peyerl, ; Smithuis et al, ; Svirko & Hawton, ). Both groups of patients reported similar intent to hurt themselves both in the short and long term.…”

Section: Discussionmentioning

confidence: 99%

Suicide attempts requiring hospitalization in patients with eating disorders: A retrospective cohort study

Cliffe

Shetty

Himmerich

et al. 2020

Intl J Eating Disorders

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Objective: Suicide attempts requiring hospitalization are known to be common in patients who are diagnosed with eating disorders. Attempting suicide is a major indicator for those at risk of completed suicide. Both the specific eating disorder diagnosis and the influence of psychiatric comorbidities on suicide attempts requiring hospitalization were investigated, with demographic and socioeconomic variables as confounders, over a 10-year observation period from These data include all diagnoses for inpatient admissions. Hazard ratios, with 95% confidence intervals (CIs), were calculated from cox regression analyses and the effects of a number of confounders were estimated by performing multivariable analyses.Results: In total, 4,895 patients were diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder otherwise not specified (EDNOS). Of these, 331 (6.7%) had attempted suicide requiring hospitalization and 21 (0.04%) completed suicide. The eating disorder category associated with the highest risk of a suicide attempt was AN (HR: 1.43, 95%CI: 1.08-1.89, p = .01). The risk was significantly increased further if the patient had a comorbid diagnosis of personality disorder, depression, bipolar affective disorder, and substance misuse.Discussion: Suicide attempts requiring hospitalization have a high incidence rate among patients with eating disorders, and the risk is significantly increased in AN. Comorbid psychiatric illness and suicidal ideation should be carefully assessed in all eating disorder patients. K E Y W O R D Sanorexia nervosa, bulimia nervosa, eating disorder, self-harm, suicide, suicide attempt

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Section: Discussionmentioning

confidence: 99%

Suicide attempts requiring hospitalization in patients with eating disorders: A retrospective cohort study

Cliffe

Shetty

Himmerich

et al. 2020

Intl J Eating Disorders

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“…In sum, there is some evidence of functional equivalence between ED and NSSI. Findings revealed that similar intrapersonal such as affect regulation, and interpersonal functions such as interpersonal boundaries and autonomy, may be involved in the development and maintenance of both NSSI and ED behaviors (Muehlenkamp et al, 2019) and previous models of NSSI and ED behaviors highlight the role of similar emotion regulation de cits (e.g., Muehlenkamp et al, 2012).…”

Section: Emotion Regulation Nssi and Edmentioning

confidence: 67%

Eating Disorders and Non-suicidal Self-injury: Cluster Analysis Considering Eating Pathology, Emotion Dysregulation, and Negative Urgency

Gonçalves

Ramalho

Machado

et al. 2021

Preprint

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Purpose:Research on the interplay between eating pathology, difficulties in emotion regulation and negative urgency is needed to better inform and tailor the current intervention approaches for patients with eating disorders and non-suicidal self-injury. The current study aimed to investigate the phenotypic characterization of patients with eating disorders and history of lifetime non-suicidal self-injury when considering eating pathology, emotion dysregulation and negative urgency. Methods: This is a cross-sectional study evaluating 73 patients with eating disorders and history of lifetime non-suicidal self-injury (14-55 years; 68 Female). A cluster analysis (K-means) was performed using eating pathology, difficulties in emotion regulation and negative urgency. Differences between clusters were explored on sociodemographic/psychological variables, distribution of the DSM-5 eating disorder diagnostics and past/current non-suicidal self-injury engagement Results: Three clusters were identified. Cluster 1 (n = 29) (moderate severity) was characterized by high levels of eating pathology, but moderate emotion dysregulation and negative urgency. Cluster 2 (n = 29) (high severity) was characterized by the highest scores in eating pathology, emotion dysregulation and negative urgency. Within this cluster there was the highest prevalence of patients with current non-suicidal self-injury. Cluster 3 (n = 15) (low severity) was characterized by the lowest levels of eating pathology, emotion dysregulation and negative urgency and included more patients with past non-suicidal self-injury. Conclusion: The three distinctive profiles highlights the importance of emotion dysregulation and negative urgency as a personalized treatment target for eating disorders patients with current NSSI. Level III: Evidence obtained from well-designed cohort or case-control analytic studies

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“…These negative and positive reinforcement patterns are consistent with neurobiological models of shared mechanisms across eating and substance use, functional assessment of binge eating/purging, and recent work in samples with comorbid binge eating and non-suicidal selfinjury. 13,37,38,64,65 This study has several strengths, including its large sample size and the use of semi-structured interviews reliably administered by trained doctoral research clinicians to assess clinically-significant impulsive behaviors and psychopathology. Further, because the DIPD-IV investigates impulsivity across many domains (eg, substance use, risky sexual behavior, and antisocial behavior), our categorization of general impulsivity included clinically-significant impulsive behaviors across a wider scope than prior work in "multiimpulsive" BN that was primarily defined based on self-harm and/or comorbid substance use.…”

Section: Discussionmentioning

confidence: 99%

General impulsivity in binge-eating disorder

Boswell

Grilo

2020

CNS Spectr.

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Background. The nature and significance of impulse-control difficulties in binge-eating disorder (BED) are uncertain. Most emerging research has focused on food-specific rather than general impulsivity. The current study examines the clinical presentation of patients with BED categorized with and without clinical levels of general impulsivity. Method. A total of 343 consecutive treatment-seeking patients with BED were categorized as having BED with general impulsivity (GI+; N = 73) or BED without general impulsivity (GI−: N = 270) based on structured diagnostic and clinical interviews. The groups were compared on demographic, developmental, and psychological features, and on rates of psychiatric and personality comorbidity. Results. Individuals with BED and general impulsivity (GI+) reported greater severity of eating-disorder psychopathology, greater depressive symptoms, and greater rates of comorbidity than those without general impulsivity (GI−). Conclusions. A subtype of individuals with BED and general impulsivity may signal a more severe presentation of BED characterized by heightened and broader psychopathology. Future work should investigate whether these impulse-control difficulties relate to treatment outcomes.

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Behavioral functions underlying NSSI and eating disorder behaviors

Cited by 34 publications

References 49 publications

Suicide attempts requiring hospitalization in patients with eating disorders: A retrospective cohort study

Suicide attempts requiring hospitalization in patients with eating disorders: A retrospective cohort study

Eating Disorders and Non-suicidal Self-injury: Cluster Analysis Considering Eating Pathology, Emotion Dysregulation, and Negative Urgency

General impulsivity in binge-eating disorder

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