Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating

Abstract

We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3–4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations.

Physical activity in European adolescents and associations with anxiety, depression and well-being

“…This is in keeping with previous findings on an adult population [35]. It may be the case that the sub-group reporting very frequent or daily physical activity includes some adolescents who over-exercise and suffer from eating disorders or other psychopathology [36,37].…”

Psychometric properties of the Compulsive Exercise Test in an adolescent eating disorder population

“…Compulsive exercise has been linked to longer hospital admissions, relapse, suicidal behavior, and treatment drop-out (Carter, Blackmore, Sutandar-Pinnock, & Woodside, 2004;El Ghoch et al, 2013;Smith et al, 2013;Solenberger, 2001). The Compulsive Exercise Test (CET) (Taranis, Touyz, & Meyer, 2011) is based on a cognitive-behavioral model and assesses the cognitive, behavioral, and affective features of compulsive exercise.…”

Etiological Models of Non-suicidal Self-Injury and Eating Disorders

“…Similarly, there is evidence from laboratory pain assessment tasks that individuals with eating disorders have decreased pain sensitivity compared to healthy controls (e.g., de Zwaan, Biener, Schneider, & Stacher, 1996;Raymond et al, 1995Raymond et al, , 1999. In addition to these findings on altered physical pain perception, there is also some initial evidence of a reduced sense of fear about physical pain among individuals who engage in NSSI (Selby, Connell et al, 2010) and disordered eating behaviors (e.g., particularly among those who engage in overly vigorous exercising; Smith et al, 2013).…”