Eating disorders and suicidality: what we know, what we don’t know, and suggestions for future research

Smith, April R.; Zuromski, Kelly L.; Dodd, Dorian R.

doi:10.1016/j.copsyc.2017.08.023

Cited by 150 publications

(121 citation statements)

References 43 publications

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“…Research to date has provided mixed support for the IPTS as an explanatory framework for suicide risk in EDs (e.g., see Smith et al., ; Smith, Zuromski, & Dodd, ; Witte et al., ). However, the majority of this research has been cross‐sectional and therefore unable to test the theory's longitudinal predictions (e.g., that eating disorder symptoms would increase theory constructs over time).…”

Section: Cross‐sectional Literature On the Association Between Eatingmentioning

confidence: 99%

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta‐analysis

Smith

Velkoff

Ribeiro

et al. 2018

Suicide & Life Threat Behav

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This meta-analysis addressed whether eating disorders (EDs) are risk factors (i.e., longitudinal predictors) for suicidal thoughts and behaviors. We identified 2,611 longitudinal studies published through August 1, 2017. Inclusion required studies include at least one longitudinal analysis predicting suicide ideation, attempt, or death using an ED diagnosis and/or symptom. Fourteen studies (42 prediction cases) met criteria. Results indicated that clinically diagnosed EDs and disordered eating symptoms were significant but weak predictors of suicide attempts but not death. Effects remained weak when moderators were considered. By reviewing the methodological limitations of previous research, these results highlight avenues for future research.

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Section: Cross‐sectional Literature On the Association Between Eatingmentioning

confidence: 99%

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta‐analysis

Smith

Velkoff

Ribeiro

et al. 2018

Suicide & Life Threat Behav

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show abstract

“…Despite the strong cross-sectional link between disordered eating and suicidal behavior, few studies have looked at this link prospectively to determine if disordered eating is a true risk factor for suicide (Smith, Zuromski, & Dodd, 2018). As previously mentioned, Smith et al (2019) found that eating disorders were weak predictors of future suicidal behavior; however, these results did not take into account the differences in findings for various eating behaviors.…”

mentioning

confidence: 94%

Body dissatisfaction and symptoms of bulimia nervosa prospectively predict suicide ideation in adolescents

Perkins

Brausch

2019

Intl J Eating Disorders

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Objective: Symptoms of eating disorders have been established as significant concurrent correlates with suicide ideation and behaviors in adolescent samples, but very few studies have examined eating disorder symptoms as prospective risk factors for suicide. The current study examined eating disorder symptoms as prospective risk factors for suicide ideation in an unselected community sample of adolescents.Method: Data were collected from 436 adolescents in middle and high school at baseline and 6-and 12-month follow-ups. Adolescents completed self-report measures assessing eating disorder symptoms and suicide ideation and behaviors at each time point during school hours.Results: Regression analyses found that body dissatisfaction was a significant prospective predictor of suicide ideation severity at the 6-and 12-month follow-ups, symptoms of bulimia nervosa (binge-eating disorder and purging) predicted suicide ideation severity at the 12-month follow-up only, and symptoms of anorexia nervosa (drive for thinness and restricting) were not significant predictors of suicide ideation at either follow-up. Exploratory analyses found the same pattern of results for the sample of girls only, while no significant predictors were found for boys only.Discussion: This is the first longitudinal study of disordered eating and suicide ideation in American adolescents. Symptoms of bulimia nervosa and body dissatisfaction seem to be true risk factors for suicidal ideation. The current study demonstrates the importance of disordered eating behaviors in the development of suicidal ideation in adolescents, particularly for adolescent girls. K E Y W O R D S adolescents, body dissatisfaction, bulimia nervosa, eating disorders, longitudinal, suicide ideation

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“…Second, both ED behaviors (Hudson et al, 2008) and NSSI (Nock, ) have a typical age of onset in adolescence, suggesting a potentially shared etiology. Third, ED behaviors (Smith, Zuromski, & Dodd, ) and NSSI (Andover, Morris, Wren, & Bruzzese, ; Hamza, Stewart, & Willoughby, ) often co‐occur with suicidal thoughts and behaviors. Fourth, similar cognitive and affective mechanisms are involved in the risk and maintenance of ED and NSSI behaviors (Buckholdt et al, ; Wang, Pisetsky, Skutch, Fruzzetti, & Haynos, ).…”

Section: Introductionmentioning

confidence: 99%

Comparing self‐harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed

Fox

Wang

Boccagno

et al. 2019

Intl J Eating Disorders

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Objective Eating disordered (ED) behaviors (i.e., binge eating, compensatory behaviors, restrictive eating) and nonsuicidal self‐injury (NSSI; intentional and nonsuicidal self‐harm) are highly comorbid and share several similarities, including consequent pain and physical damage. However, whereas NSSI is considered direct self‐harm, ED behaviors are considered indirect self‐harm. These distinctions stem from theoretical understanding that NSSI is enacted to cause physical harm in the moment, whereas ED behaviors are enacted for other reasons, with consequent physical harm occurring downstream of the behaviors. We sought to build on these theoretically informed classifications by assessing a range of self‐harming intentions across NSSI and ED behaviors. Method Study recruitment was conducted via online forums. After screening for inclusion criteria, 151 adults reported on their intent to and knowledge of causing physical harm in the short‐ and long‐term and suicide and death related cognitions and intentions when engaging in NSSI and specific ED behaviors. Results Participants reported engaging in ED and NSSI behaviors with intent to hurt themselves physically in the moment and long‐term, alongside thoughts of suicide, and with some hope and knowledge of dying sooner due to these behaviors. Distinctions across behaviors also emerged. Participants reported greater intent to cause physical harm in the moment via NSSI and in the long‐run via restrictive eating. NSSI and restrictive eating were associated with stronger endorsement of most suicide and death‐related intentions than binge eating or compensatory behaviors. Conclusions Findings shed light on classification of self‐harming behaviors, casting doubt that firm boundaries differentiate direct and indirectly self‐harming behaviors.

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Eating disorders and suicidality: what we know, what we don’t know, and suggestions for future research

Cited by 150 publications

References 43 publications

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta‐analysis

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta‐analysis

Body dissatisfaction and symptoms of bulimia nervosa prospectively predict suicide ideation in adolescents

Comparing self‐harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed

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