Department of Psychology, Western University, London, Ontario, Canada.
Department of Psychology, Miami University of Ohio, Oxford, Ohio, USA.
Psychol Med. 2021 Jul;51(9):1516-1523. doi: 10.1017/S0033291720000276. Epub 2020 Mar 6.
Over half of individuals with eating disorders experience suicidal ideation at some point in their lives, yet few longitudinal studies have examined predictors of ideation in this at-risk group. Moreover, prospective research has focused on relatively distal or trait-level factors that are informative for distinguishing who is most at risk but not when. Little is known about more proximal or state-level risk factors that fluctuate within an individual, which is critical for determining when a person is most likely to engage in suicidal behaviors.
Women (N = 97) receiving treatment for their eating disorder completed questionnaires weekly to assess suicidal ideation and interpersonal constructs (i.e. perceived burdensomeness, thwarted belongingness) theorized to be proximal predictors of suicidal desire. Longitudinal multilevel models were conducted to examine both within- and between-person predictors of suicidal ideation across 12 weeks of treatment.
Statistically significant within-person effects for burdensomeness (β = 0.06; p < 0.001) indicate that when individuals have greater feelings of burdensomeness compared to their own average, they also experience higher suicidal ideation. We did not find any significant influence of thwarted belongingness or the interaction between burdensomeness and belongingness on suicidal ideation.
This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results are only partially consistent with the Interpersonal Theory of Suicide and suggest that short-term changes in burdensomeness may impact suicidal behavior in individuals with eating disorders.
超过一半的饮食障碍患者在其一生中的某个时刻会有自杀意念，但很少有纵向研究检查过该高危人群中意念的预测因素。此外，前瞻性研究集中在相对较远或特质水平的因素上，这些因素对于区分谁的风险最高是有帮助的，但无法确定时间。对于个体内部波动的更接近或状态水平的风险因素知之甚少，这对于确定一个人最有可能何时进行自杀行为至关重要。
接受饮食障碍治疗的女性（N=97）每周完成问卷，以评估自杀意念和人际关系结构（即感知负担、归属感受挫），这些结构被认为是自杀愿望的近端预测因素。进行了纵向多层模型分析，以研究在 12 周的治疗期间自杀意念的个体内和个体间预测因素。
负担感的个体内效应具有统计学意义（β=0.06；p<0.001），表明当个体与自身平均水平相比感到更大的负担感时，他们也会经历更高的自杀意念。我们没有发现归属感受挫或负担感和归属感之间的相互作用对自杀意念有任何显著影响。
这项研究首次检查了饮食障碍患者中人际关系结构和自杀意念之间的动态关联。结果仅部分符合自杀的人际理论，并表明负担感的短期变化可能会影响饮食障碍患者的自杀行为。
