Department of Psychology, Miami University, Oxford, Ohio, USA.
Department of Psychology, Auburn University, Auburn, Alabama, USA.
Psychol Med. 2023 Mar;53(4):1518-1526. doi: 10.1017/S003329172100310X. Epub 2021 Aug 5.
Suicide is one of the most commonly reported causes of death in individuals with eating disorders. However, the mechanisms underlying the suicide and disordered eating link are largely unknown, and current assessments are still unable to accurately predict future suicidal thoughts and behaviors. The purpose of this study is to test the utility of two promising proximal risk factors, sleep quality and agitation, in predicting suicidal ideation in a sample of individuals with elevated suicidal thoughts and behaviors, namely those with eating disorders.
Women ( = 97) receiving treatment at an eating disorder treatment center completed weekly questionnaires assessing suicidal ideation, agitation, and sleep. General linear mixed models examined whether agitation and/or sleep quality were concurrently or prospectively associated with suicidal ideation across 12 weeks of treatment.
There was a significant interaction between within-person agitation and sleep quality on suicidal ideation [(s.e.) = -0.02(0.01), < 0.05], such that on weeks when an individual experienced both higher than their average agitation and lower than their average sleep quality, they also experienced their highest levels of suicidal ideation. However, neither agitation nor sleep quality prospectively predicted suicidal ideation.
This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results suggest that ongoing assessment for overarousal symptoms, such as agitation and poor sleep quality, in individuals with eating disorders may be warranted in order to manage suicidal ideation among this vulnerable population.
自杀是饮食障碍患者中最常见的死因之一。然而，自杀与饮食障碍之间的潜在机制尚不清楚，目前的评估方法仍然无法准确预测未来的自杀想法和行为。本研究旨在检验两个有前途的近端风险因素，即睡眠质量和激越，在预测有自杀想法和行为的饮食障碍患者中自杀意念的有效性。
在饮食障碍治疗中心接受治疗的女性（n = 97）每周完成评估自杀意念、激越和睡眠质量的问卷。采用广义线性混合模型，考察在 12 周的治疗过程中，激越和/或睡眠质量是否与自杀意念同时或前瞻性相关。
个体内激越和睡眠质量对自杀意念存在显著交互作用[(s.e.) = -0.02(0.01)， < 0.05]，即当个体经历高于平均水平的激越和低于平均水平的睡眠质量时，他们也会经历最高水平的自杀意念。然而，激越和睡眠质量都不能前瞻性地预测自杀意念。
本研究首次在饮食障碍患者中检验了人际间结构与自杀意念之间的动态关联。结果表明，在饮食障碍患者中，持续评估过度兴奋症状，如激越和睡眠质量差，可能有助于管理这一脆弱人群的自杀意念。
