Assessing Longitudinal Relationships among Thwarted Belongingness, Perceived Burdensomeness, and Eating Disorder Symptoms

Abstract

Objective Past work has documented a cross‐sectional relationship between eating disorders (ED) and suicidality, but few studies have examined the directionality of this relationship. Informed by the interpersonal–psychological theory of suicide (IPTS), this study examines the bidirectional, longitudinal relationship between ED symptoms and two determinants of suicide ideation—thwarted belongingness (TB) and perceived burdensomeness (PB). Method Ninety‐two treatment‐seeking individuals with ED (94.5% White, 95.6% female) completed baseline (T1) measures of ED symptoms along with TB and PB. Of those, 75 (81.5%) completed a follow‐up assessment eight weeks later (T2). Results Separate linear regression models revealed that T1 ED symptoms did not predict T2 TB (b = .03, p = .42) or T2 PB (b = −.01, p = .68). Similarly, T1 TB did not predict T2 ED symptoms (b = .25, p = .37). T1 PB did significantly predict T2 ED symptoms (b = 0.52, p = .04). Further, among participants with AN/sub‐AN, T1 TB and PB predicted T2 ED symptoms (p's ≤ .03). Conclusion Our results reveal the need for a nuanced understanding of the relationship between ED and suicidality. This study found that PB predicts greater ED symptoms and, among the AN/sub‐AN sample, TB does as well.

Longitudinal relationships between muscle dysmorphia symptoms and suicidal ideation

“…Contrary to hypotheses, suicidal ideation predicted increases in specific MD symptoms, rather than viceversa. Results support affect regulation models of psychopathology, such that suicidality or related constructs temporally predict engagement in ED behaviors, potentially to manage negative emotions or escape from thoughts about suicide (Forrest et al, 2016;Ortiz et al, 2019;Trujillo et al, 2019). This may suggest that individuals experiencing suicidal ideation engage in specific MD symptoms to manage negative emotions or discomfort inherit to suicidality.…”

The Interpersonal-Psychological Theory of Suicide to Explain Suicidal Risk in Eating Disorders: A Mini-Review

“…Study design was cross-sectional in 6 (60%) out of 10 studies (28,(30)(31)(32)(33)36); it was longitudinal in 3 (30%) studies only (29,34,35). The remaining study was a case series (27).…”

“…All the studies included ED patients only (27)(28)(29)(30)(31)(33)(34)(35)(36), except for the one by Smith et al (32) which included a control group of psychiatric patients and a control group of college students.…”

“…Most studies included at least one measure for EDs, usually one of the Eating Disorders Inventory (EDI) versions or the Eating Disorders Examination Questionnaire (EDE-Q); this datum was not specified in some studies (32,35). Regarding measures for the IPTS, the INQ was used in the following studies: (29,33,34) while the ACSS was used in these ones: (30,31,35). Some studies used both the INQ and the ACSS (32,36).…”

“…Selby et al found two possible pathways to suicidal behavior, especially SA, in AN ( 28): one through repetitive experience with provocative behaviors (vomiting, laxative use, NSSI) in the binge/purging subtype of AN, and one through the painful experience of starvation in the restricting subtype. Trujillo et al studied the associations between ED symptoms and TB and PB (34). ED symptoms at baseline did not predict either TB or PB at follow-up.…”