Objective We aimed first to identificate psychopathological variables differentiating between suicide ideators, suicide attempters and patients without suicide ideation or attempts, and second to identificate better predictors of suicide attempts longitudinally. Method We compared suicide ideation, hopelessness, borderline symptoms, frequency, types, number of different non‐suicidal self‐injury (NSSI) methods, intrapersonal and interpersonal functionality of NSSI in a sample of 238 patients with Eating Disorders (1) with no history of suicide ideation or suicide attempts (n = 150); (2) with recent suicide ideation (n = 65); and (3) with suicide attempts in the previous year (n = 23). In addition, we analyzed the predictive power of the mentioned variables over the number of suicide attempts 7 months after the first assessment. Results The group of suicide attempters showed a major number of different methods of NSSI, higher frequency of NSSI, cutting, and more NSSI intra and interpersonal functions than the group of ideators. Unlike in previous studies, hopelessness did not differentiate between patients with ideation and suicide attempts. In addition, the best predictor of suicide attempts 7 months later was frequency of NSSI at T1 (N = 123). Conclusions Cutting, frequency and different methods of NSSI, intra and interpersonal functions were risk factors that differentiated ideators from attempters, being frequency of NSSI the best predictor of suicide attempts longitudinally. Thus, patients with ED with NSSI should be the focus of preventive interventions for suicidal behavior.

IntroductionSuicide is a preventable death in young people. It is well known that suicide behavior is a multicausal phenomenon. However, suicidal ideation (SI) commonly underlies suicide, and Ecological Momentary Assessment (EMA) can help us to better characterize it and its risk and protective factors in the short term. We aimed, first, to investigate the estimated prevalence and trajectories of SI in a community sample of Spanish college students using an EMA methodology and, second, explore the associations between risk and protective factors and SI categorized as moderate or low.Materials and MethodsA total of 737 participants followed the EMA during a period of 6 months. We estimated the prevalence and trajectories of SI and the associations between depressive symptoms, positive and negative affect, thwarted belongingness, perceived burdensomeness, cognitive reappraisal, emotional suppression, and purpose in life with the MEmind smartphone App. SI was assessed 14 times during this period.ResultsTwenty-eight participants referred to SI at least once in longitudinal assessments. We found a lack of curvature and, thus, a relatively stable trajectory of SI. Two groups of latent dimensions were observed related to risk and protective factors of SI. One latent dimension of the risk factors (higher levels of thwarted belongingness, perceived burdensomeness, depressive symptoms, negative affect, and emotional suppression) best represented the group with moderate levels of SI, and a second latent dimension of protective variables (positive affect, cognitive reappraisal, and purpose in life) best represented the group with lower levels of SI.DiscussionThese findings may indicate that students with a sense of having a life worth living, in addition to having the ability to reevaluate their negative beliefs, are less likely to experience high levels of SI. Therefore, purpose in life would be a protective factor against the presence of SI.