The Role of Physical and Behavioral Self-Disgust in Relation to Insomnia and Suicidal Ideation

Self‐disgust and disgust sensitivity are increased in anorexia nervosa inpatients, but only self‐disgust mediates between comorbid and core psychopathology

“…Findings from previous studies have also evidenced the association of self‐disgust and anxiety‐based disorders (see, e.g., Brake et al., 2017). Interestingly, it has been suggested that anxiety and depressive symptoms may lead to the experience of self‐disgust and to negative self‐appraisal in individuals with insomnia (see Akram et al., 2019). The above‐mentioned evidence from previous research and our results from the mediation analysis thus suggest that self‐disgust may be implicated in the development and course of AN and, specifically, in the interplay between depressive symptoms and trait anxiety with EDs characteristics.…”

Self-disgust as a potential mechanism underlying the association between body image disturbance and suicidal thoughts and behaviours

“…In this context, cognitive and behavioural factors associated with body image disturbance may theoretically precipitate social isolation in this population. Negative self-appraisal may contribute to hopelessness, perceived burdensomeness (i.e., viewing oneself as a burden and valuing death over life) and thwarted belongingness (i.e., perceived alienation and deteriorated connection from social groups), reducing the threshold for suicidal thoughts and behaviours (Akram et al, 2019;Rudd, 2004). Negative self-appraisal may also prompt social withdrawal and sacrifice of social commitments (e.g., "I don't look good enough to go out") due to a fear of judgment from others (e.g., "Others may comment on my appearance"; Akram et al, 2019).…”

“…Negative self-appraisal may contribute to hopelessness, perceived burdensomeness (i.e., viewing oneself as a burden and valuing death over life) and thwarted belongingness (i.e., perceived alienation and deteriorated connection from social groups), reducing the threshold for suicidal thoughts and behaviours (Akram et al, 2019;Rudd, 2004). Negative self-appraisal may also prompt social withdrawal and sacrifice of social commitments (e.g., "I don't look good enough to go out") due to a fear of judgment from others (e.g., "Others may comment on my appearance"; Akram et al, 2019). Avoidance coping of this nature is likely to maintain physical and behavioural self-disgust and over time, the concurrence of additional psychological factors (e.g., loneliness, depression; Ypsilanti et al, 2019).…”

“…This suggests that selfdisgust can add unique incremental variance in models of BID and helps us better understand the emotional experiences of people with higher scores in body image concerns. Secondly, self-disgust can play a role is selfdestructive and suicidal behaviour (Akram, Ypsilanti, Drabble, & Lazuras, 2019;Brake et al, 2017), so, it is theoretically plausible that self-disgust can account for the association between body image disturbance and suicide risk. This is in accordance with cognitive-behavioural explanations of BID whereby body image concerns are assumed to lead to maladaptive self-appraisal and the experience of aversive, self-conscious, and self-directed emotional states (i.e., shame and guilt) which may subsequently trigger certain behavioural outcomes, such as experiential avoidance (Blakey, Reuman, Buchholz, & Abramowitz, 2017;O'Brien et al, 2013;Stasik O'Brien & Schmidt, 2018).…”

The interaction between suicidal ideation, insomnia symptoms, and student status

“…Although suicidal ideation may occur in the absence of other psychiatric disorders (Chiles & Strosahi, 2005), studies have typically shown that suicidal ideation co-occurs alongside underlying, yet treatable, mental health difficulties (Cracknell, 2015). Insomnia is a recognized public health concern, often related with and leading to long-term physical and mental exhaustion, disturbed mood, concentration and memory deficits, social isolation, body image disturbance, and suicidal ideation (Akram et al, 2019;2021a;2021b;Baglioni et al, 2011;Byrne, 2019;Choueiry et al, 2016;Ellis et al, 2014;Kyle et al, 2010;Perlis et al, 1997;Ypsilanti et al, 2018). Indeed, a recent review of sleep and suicidal ideation data in students (Russell et al, 2019) and the general population (Harris et al, 2020;Liu et al, 2020) found insomnia to be consistently associated with an increased risk of future suicidal thoughts and behaviors (Bernert et al, 2017;Hom et al, 2019;Littlewood et al, 2019;Shi et al, 2021).…”