Clarifying the association of eating disorder features to suicide ideation and attempts

Abstract

Objective We examine the relationships of eight eating disorder (ED) features to histories of suicide ideation and suicide attempts. Method Participants were 387 adults (62% female, mean age = 36 years) recruited via an online platform, and oversampled for the presence of ED features, who completed standardized self‐report measures of study variables. Results Different ED features predicted suicide ideation versus attempts. Specifically, Restrictive Eating (d = 0.44), Purging (d = 0.30), and Body Dissatisfaction (d = 0.27) were higher among ideators compared to nonsuicidal participants. In contrast, Muscle Building (d = 0.31), Excessive Exercise (d = 0.26), Cognitive Restraint (d = 0.23), and Restrictive Eating (d = 0.20) were higher among attempters compared to ideators—however, we note that the p‐values for these effects range between 0.02 and 0.04 and it is unclear if they would replicate. Independent replication is important. Conclusion Findings have implications for the conceptualization of suicide risk in individuals with EDs.

Eating disorder behaviors as predictors of suicidal ideation among people with an eating disorder

“…Regarding specific ED symptoms, Hunt and Levinson (2021) found that fasting and purging exhibited direct associations with suicidal ideation. Shahnaz and Klonsky (2021) reported similar findings. Overall in the work conducted to date, purging and restricting appear to be more strongly associated with suicidality as compared to other ED behaviors such as binge eating.…”

Association of hospitalization for suicide attempts in adolescent girls with subsequent hospitalization for eating disorders

“…An analysis of 36,171 adults found that a lifetime history of suicide attempt was associated with earlier onset of bulimia nervosa and longer duration of anorexia nervosa (Udo et al, 2019). A study of 387 adults found that excessive exercise, muscle building, and restrictive eating were common among individuals with a history of suicide attempt (Shahnaz & Klonsky, 2021). These studies were however cross‐sectional and did not address adolescents (Shahnaz & Klonsky, 2021; Udo et al, 2019).…”

“…A study of 387 adults found that excessive exercise, muscle building, and restrictive eating were common among individuals with a history of suicide attempt (Shahnaz & Klonsky, 2021). These studies were however cross‐sectional and did not address adolescents (Shahnaz & Klonsky, 2021; Udo et al, 2019). The objective of this hypothesis‐testing study was to determine the association between adolescent suicide attempts and the subsequent risk of eating disorder hospitalization.…”