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

Abstract

Objective: Suicidality is known to be elevated among people with an eating disorder.The aim of the current study was to examine whether any of three specific behavioral facets of eating disorders (i.e., purging, binge eating, restricting) would be the strongest predictors of suicidal ideation, controlling for one another, in longitudinal analyses from admission to discharge. We hypothesized that purging, above and beyond restricting or binge eating, would be the most important predictor of suicidal ideation.Method: In the present study, patients with an eating disorder (N = 936), the majority of whom met criteria for a current DSM-5 diagnosis of Anorexia Nervosa (n = 560), completed the Eating Pathology Symptoms Inventory (EPSI) and the Beck Depression Inventory II-Item 9 suicidal ideation index, at admission and again at discharge. The settings were eating disorder treatment facilities offering inpatient, residential, partial hospitalization program (PHP), and intensive outpatient (IOP) levels of care. We pitted EPSI purging, EPSI restriction, and EPSI binge eating against one another in a regression framework predicting discharge suicidal ideation controlling for suicidal ideation at admission.

“Terminal anorexia nervosa” may not be terminal: An empirical evaluation.

“…1It is important to acknowledge that participants who complete admission and discharge assessments may not be representative of those with only admission data. Past analyses on a related sample indicated attrition had no influence on outcomes (Joiner et al, 2022), and analyses on this sample further affirmed that view.…”

“…This single item was used as a proxy for Gaudiani et al’s (2022) fourth criterion for T-AN. The PHQ-9 is a well-validated measure (Kroenke & Spitzer, 2002; Kroenke et al, 2001; Spitzer et al, 2014), and regarding the one-item index of death ideation, there is evidence that such measures are defensibly reliable and valid (e.g., Joiner et al, 2022; Robison et al, 2022).…”

Treating individuals with suicidal ideation in primary care: Patient‐level characteristics associated with follow‐up in the Collaborative Care Model

“…For comparison, we also tracked patients who selected “no days” (0 points). This item has been shown to be predictive of the risk of repeat suicide attempts and of suicide death (Green et al., 2015; Joiner et al., 2022).…”

Effectiveness of Computer-Based Psychoeducational Self-Help Platforms for Eating Disorders (With or Without an Associated App): Protocol for a Systematic Review (Preprint)

“…Moreover, gender and sexual minorities are demonstrated to be particularly at risk for developing EDs, with anorexia nervosa and bulimia being the most prevalent [2][3][4]. Notably, compared to any other psychiatric conditions, anorexia nervosa and bulimia have the highest suicidality and mortality rates and lowest quality of life levels, highlighting the importance of urgency of care [5][6]. Research demonstrated that merely one-fourth of individuals with ED symptoms or developed EDs access care, which is explained by the lack of access to treatment and the individual's preference for treatment [7].…”