Identity problems and suicidal ideation severity among women with bulimic-spectrum pathology.

Abstract

Individuals with bulimia nervosa often experience suicidal ideation. Identity disturbance, or unstable sense of self, has been connected both to eating disorders and to suicidality. This study sought to test whether identity problems were related to severity of current suicidal ideation in a sample of women with bulimic-spectrum pathology, above and beyond history of suicidal behavior and several symptoms of borderline personality disorder. Women (N ϭ 204; 90.7% Caucasian; M age ϭ 25.7 years [SD ϭ 8.8]) with bulimic-spectrum pathology completed self-report personality assessments and items evaluating suicidality. A hierarchical linear regression was utilized to examine the association between identity problems and severity of current suicidal ideation, before and after inclusion of relevant clinical features (i.e., suicide attempt history [Step 2], affective lability, stimulus seeking, and rejection [Step 3]). Identity problems were directly associated with severity of current suicidal ideation (␤ ϭ .481, p Ͻ .001). This relationship retained significance after inclusion of suicide attempt history (␤ ϭ .335, p Ͻ .001) as well as borderline personality disorder symptoms (␤ ϭ .324, p Ͻ .001). Identity problems displayed a robust relationship with suicidal ideation severity in women with bulimic-spectrum pathology. Findings suggest that identity problems may be a specifically relevant personality feature regarding presence and severity of suicidal ideation in this high-risk group, even after considering the contributions of history of suicidal behavior and various symptoms of borderline personality disorder. There may be value in attending to identity problems when considering suicidal ideation in this population.