Department of Psychology, Harvard University, Cambridge, Massachusetts.
Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
Int J Eat Disord. 2020 Mar;53(3):472-477. doi: 10.1002/eat.23210. Epub 2019 Dec 30.
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.
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.
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 (ΔR = .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).
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.
本研究探讨了饮食障碍行为（包括限制进食、暴食和催吐）与自杀意念之间的关系。我们假设，限制进食会显著预测自杀意念，超过暴食/催吐的影响。
参与者为 82 名患有低体重饮食障碍的青少年和年轻人。我们进行了分层逻辑回归，在步骤 1 中纳入暴食和催吐，在步骤 2 中纳入限制进食，以预测自杀意念。
步骤 1 具有统计学意义（p =.01），解释了自杀意念 20%的方差；暴食和催吐均不能显著预测自杀意念。在步骤 2 中加入限制进食显著改善了模型（ΔR =.07，p =.009）。最终模型解释了 27%的方差，限制进食（而非暴食/催吐）显著预测自杀意念（p =.02）。
限制进食与患有低体重饮食障碍的青少年的自杀意念有关，超过了其他饮食障碍行为的影响。尽管医疗保健提供者可能更倾向于对暴食和催吐的患者进行自杀风险筛查，但我们的研究结果表明，临床医生应定期评估限制进食患者的自杀和自残情况。未来研究探讨个体如何从自杀意念进展到自杀企图，可以进一步增强我们对饮食障碍中自杀的理解。
