Wang SB, Mancuso CJ, Jo J, Keshishian AC, Becker KR, Plessow F, Izquierdo AM, Slattery M, Franko DL, Misra M, Lawson EA, Thomas JJ, Eddy KT. Int. J. Eat. Disord. 2019; ePub(ePub): ePub.
Affiliation
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
OBJECTIVE: This study examined the relationship between eating-disorder behaviors-including restrictive eating, binge eating, and purging-and suicidal ideation. We hypothesized that restrictive eating would significantly predict suicidal ideation, beyond the effects of binge eating/purging.
METHODS: Participants were 82 adolescents and young adults with low-weight eating disorders. We conducted a hierarchical logistic regression, with binge eating and purging in Step 1 and restrictive eating in Step 2, to predict suicidal ideation.
RESULTS: Step 1 was significant (p =.01) and explained 20% variance in suicidal ideation; neither binge eating nor purging significantly predicted suicidal ideation. Adding restrictive eating in Step 2 significantly improved the model (ΔR2 =.07, p =.009). This final model explained 27% of the variance, and restrictive eating (but not binge eating/purging) significantly predicted suicidal ideation (p =.02).
DISCUSSION: Restrictive eating is associated with suicidal ideation in youth with low-weight eating disorders, beyond the effects of other eating-disorder behaviors. Although healthcare providers may be more likely to screen for suicidality in patients with binge eating and purging, our findings indicate clinicians should regularly assess suicide and self-injury in patients with restrictive eating. Future research examining how individuals progress from suicidal ideation to suicidal attempts can further enhance our understanding of suicide in eating disorders.