Izquierdo Alyssa M, Nelson Jillian D, Daza Alyssa, Gasbarro Alexandra, Hardin Rebecca, Marino Joanna, Fischer Sarah
Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
Potomac Behavioral Solutions, Arlington, VA, USA.
J Eat Disord. 2023 Jun 8;11(1):94. doi: 10.1186/s40337-023-00789-w.
Individuals with eating disorders (EDs) have high rates of suicidal ideation (SI) and attempts (SA). Fasting, body dissatisfaction, binge eating and purging have been associated with SI in non-clinical samples, individuals with anorexia nervosa or low-weight EDs, and a multi-diagnostic sample. However, few studies have examined how ED symptoms contribute to risk for SI in conjunction with other well-established risk factors, such as nonsuicidal self-injury (NSSI) and past SA. The aim of this study was to examine which ED symptoms contribute unique risk for current SI in a multi-diagnostic, clinical sample when statistically adjusting for gender, NSSI, past SA, and past SI.
We conducted a chart review of 166 individuals who presented for ED treatment at an outpatient facility and signed informed consent. Initial intake interviews were coded for the presence versus absence of fasting, fear of weight gain, binge eating, purging, excessive exercise, restriction, body checking, self-weighing, and body dissatisfaction, as well as NSSI, past SA, past SI, and current SI.
A total of 26.5% of the sample endorsed current SI. In a logistic regression analysis, identifying as male (n = 17) or having a non-binary gender identity (n = 1), the presence of fasting, and past SI were all significantly associated with increased odds of current SI, whereas excessive exercise significantly decreased odds of current SI. Fasting was equally common across all diagnostic groups.
Future research should establish the temporal relationship between fasting and SI to better inform intervention.
饮食失调（ED）患者的自杀意念（SI）和自杀未遂（SA）发生率很高。在非临床样本、神经性厌食症患者或低体重饮食失调患者以及多诊断样本中，禁食、身体不满、暴饮暴食和催吐与自杀意念有关。然而，很少有研究探讨饮食失调症状如何与其他已确立的风险因素（如非自杀性自伤（NSSI）和既往自杀未遂）共同导致自杀意念风险。本研究的目的是在对性别、非自杀性自伤、既往自杀未遂和既往自杀意念进行统计调整的情况下，研究哪些饮食失调症状会给多诊断临床样本中的当前自杀意念带来独特风险。
我们对166名在门诊接受饮食失调治疗并签署知情同意书的个体进行了病历审查。对初次入院访谈进行编码，记录是否存在禁食、害怕体重增加、暴饮暴食、催吐、过度运动、限制饮食、身体检查、自我称重和身体不满，以及非自杀性自伤、既往自杀未遂、既往自杀意念和当前自杀意念。
共有26.5%的样本认可当前有自杀意念。在逻辑回归分析中，男性（n = 17）或具有非二元性别身份（n = 1）、存在禁食以及既往有自杀意念均与当前自杀意念的几率增加显著相关，而过度运动则显著降低当前自杀意念的几率。禁食在所有诊断组中同样常见。
未来的研究应确定禁食与自杀意念之间的时间关系，以便更好地为干预提供信息。
