Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-19T08:21:29.310Z Has data issue: false hasContentIssue false
  • English
  • Français

Personality trait risk factors for attempted suicide among young women with eating disorders

Published online by Cambridge University Press:  16 April 2020

G. Youssef ,
B. Plancherel ,
J. Laget ,
M. Corcos ,
M.F. Flament  and
O. Halfon
G. Youssef*
Affiliation:
Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (Pr. O. Halfon), Lausanne, Switzerland
B. Plancherel
Affiliation:
Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (Pr. O. Halfon), Lausanne, Switzerland
J. Laget
Affiliation:
Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (Pr. O. Halfon), Lausanne, Switzerland
M. Corcos
Affiliation:
Département de Psychiatrie (Pr. Ph. Jeammet), Institut Mutualiste Montsouris, Paris, France
M.F. Flament
Affiliation:
University of Ottawa and Royal Ottawa Hospital, Canada
O. Halfon
Affiliation:
Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (Pr. O. Halfon), Lausanne, Switzerland
*
*Corresponding author. Unité d'Hospitalisation Psychiatrique pour Adolescents (UHPA), Centre Hospitalier UniversitaireVaudois (CHUV), 46 rue du Bugnon, BH-11, Lausanne 1011, Switzerland. E-mail address: georgesyoussef@bluemail.ch (G.Youssef).
Get access

Abstract

Objective

Clinical observations and a review of the literature led us to hypothesize that certain personality and character traits could provide improved understanding, and thus improved prevention, of suicidal behaviour among young women with eating disorders.

Method

The clinical group consisted of 152 women aged between 18 and 24 years, with DSM-IV anorexia nervosa/restrictive type (AN-R = 66), anorexia nervosa/purging type (AN-P = 37), bulimia nervosa/non-purging type (BN-NP = 9), or bulimia nervosa/purging type (BN-P = 40). The control group consisted of 140 subjects. The assessment measures were the Minnesota Multiphasic Personality Inventory—second version (MMPI-2) scales and subscales, the Beck Depression Inventory (BDI) used to control for current depressive symptoms, plus a specific questionnaire concerning suicide attempts.

Results

Suicide attempts were most frequent in subjects with purging behaviour (30.0% for BN-P and 29.7% for AN-P). Those attempting suicide among subjects with eating disorders were mostly students (67.8%). For women with AN-R the scales for ‘Depression’ and ‘Antisocial practices’ represented significant suicidal risk, for women with AN-P the scales for ‘Hysteria’, ‘Psychopathic deviate’, ‘Shyness/Self-consciousness’, ‘Antisocial Practices’, ‘Obsessiveness’ and ‘Low self-esteem’ were risk indicators and for women with BN-P the ‘Psychasthenia’, ‘Anger’ and ‘Fears’ scales were risk indicators.

Conclusion

This study provides interesting results concerning the personality traits of young women with both eating disorders and suicidal behaviour. Students and those with purging behaviour are most at risk. Young women should be given more attention with regard to the risk of suicide attempts if they: (a) have AN-R with a tendency to self-punishment and antisocial conduct, (b) have AN-P with multiple physical complaints, are not at ease in social situations and have antisocial behaviour, or (c) if they have BN-P and tend to be easily angered with obsessive behaviour and phobic worries. The MMPI-2 is an interesting assessment method for the study of traits indicating a risk of suicidal behaviour in young subjects, after controlling for current depressive pathology.

Keywords

Eating disorderSuicide attemptMMPI-2Personality traitYoung adultAdolescent
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 3 , May 2004 , pp. 131 - 139
Copyright
Copyright © 2004 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Apter, AGothelf, DOrbach, I et al. Correlation of suicidal and violent behavior in different diagnostic categories in hospitalized adolescent patients. Journal of the American Academy of Child and Adolescent Psychiatry 1995;34:912–8.CrossRefGoogle ScholarPubMed
Beautrais, ALJoyce, PRMulder, RTFergusson, DMDeavoll, BJNightingale, SK.Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study. American Journal of Psychiatry 1996;153(8):1009–14.Google ScholarPubMed
Beautrais, ALJoyce, PRMulder, RT.Psychiatric illness in a New Zealand sample of young people making serious suicide attempts. New Zealand Medical Journal 1998;111:44–8.Google Scholar
Beautrais, ALJoyce, PRMulder, RT.Personality traits and cognitive styles as risk factors for serious suicide attempts among young people. Suicide and Life-Threatening Behavior 1999;29(1):37–47.Google ScholarPubMed
Beautrais, AL.Risk factors for suicide and attempted suicide among young people. Australian and New Zealand Journal of Psychiatry 2000;34:420–36.CrossRefGoogle ScholarPubMed
Beck, ATWard, CHMendelson, MMock, JErbaugh, J.An inventory for measuring depression. Archives of General Psychiatry 1961;4:561–71.Google ScholarPubMed
Brent, DAJohnson, BBartle, SRather, CMatta, JConnolly, J et al. Personality disorder, tendency to impulsive violence, and suicidal behaviour in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 1993;32(1):69–75.CrossRefGoogle ScholarPubMed
Bulik, CMBeidel, DCDuchmann, EWeltzin, TE.Comparative psychopathology of women with bulimia nervosa and obsessive-compulsive disorder. Comprehensive Psychiatry 1992;33(4):262–8.CrossRefGoogle ScholarPubMed
Bulik, CMSullivan, PFWeltzin, TEKaye, WH.Temperament in eating disorders. International Journal of Eating Disorders 1995;17(3):251–61.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Bulik, CMSullivan, PFJoyce, PR.Temperament, character and suicide attempts in anorexia nervosa, bulimia nervosa and major depression. Acta Psychiatrica Scandinavia 1999;100(1):27–32.CrossRefGoogle ScholarPubMed
Bulik, CMSullivan, PFFear, JLPickering, A.Outcome of anorexia nervosa: eating attitudes, personality, and parental bonding. International Journal of Eating Disorders 2000;28(2):139–47.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Butcher, JNMegargee, EI In: Hathaway, SRMcKinley, J......Crs. Minnesota Multiple Personality Inventory-2™. University of Minnesota Press; 1989 [Revision of the original MMPI®]:4.Google Scholar
Corcos, MTaieb, OBenoit-Lamy, SJeammet, PFlament, MF.Suicide attempts in women with bulimia nervosa: frequency and characteristics. Acta Psychiatrica Scandinavia 2002;106:381–6.CrossRefGoogle ScholarPubMed
Cumella, EJWall, ADKerr-Almeida, N.MMPI-2 in the inpatient assessment of women with eating disorders. Journal of Personality Assessment 2000;75(3):387–403.CrossRefGoogle ScholarPubMed
Dancyger, IFSunday, SREckert, EDHalmi, KA.A comparative analysis of Minnesota Multiphasic Personality Inventory profiles of anorexia nervosa at hospital admission, discharge, and 10-year follow-up. Comprehensive Psychiatry 1997;38(3):185–91.CrossRefGoogle ScholarPubMed
Favaro, ASantonastaso, P.Purging behaviors, suicide attempts, and psychiatric symptoms in 398 eating disordered subjects. International Journal of Eating Disorders 1996;20(1):99–103.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Favaro, ASantonastaso, P.Suicidality in eating disorders: clinical and psychological correlates. Acta Psychiatrica Scandinavia 1997;95(6):508–14.CrossRefGoogle ScholarPubMed
Goldston, DBDaniel, SReboussin, DMKelley, AIevers, CBrunstetter, R.First-time suicide attempters, and previous attempters on an adolescent inpatient psychiatry unit. Journal of the American Academy of Child and Adolescent Psychiatry 1996;35(5):631–9.Google Scholar
Groholt, BEkeberg, OWichstrom, LHaldorsen, T.Young suicide attempters: a comparison between a clinical and an epidemiological sample. Journal of the American Academy of Child and Adolescent Psychiatry 2000;39(7):868–75.Google Scholar
Halfon, OLaget, JBarrie, M.An epidemiological approach to adolescent suicide. A comparison between suicidal and non-suicidal clinical groups in a health foundation center for French students. European Child and Adolescent Psychiatry 1995;4:32–8.CrossRefGoogle Scholar
Hollis, CDepression, family environment, and adolescent suicidal behavior. Journal of the American Academy of Child and Adolescent Psychiatry 1996;35(5):622–30.CrossRefGoogle ScholarPubMed
Horesh, NRolnick, TIancu, IDannon, PLepkifker, EApter, A et al. Coping styles and suicide risk. Acta Psychiatrica Scandinavia 1996;93(6):489–93.CrossRefGoogle ScholarPubMed
Houston, KHawton, KShepperd, R.Suicide in young people aged 15–24: a psychological autopsy study. Journal of Affective Disorders 2001;63:159–70.CrossRefGoogle ScholarPubMed
Kienhorst, ICWMde Wilde, EJDiekstra, RFWWolters, WHG.Adolescents’ image of their suicide attempt. Journal of the American Academy of Child and Adolescent Psychiatry 1995;34(5):623–8.CrossRefGoogle ScholarPubMed
Klump, KLBulik, CMPollice, C et al. Temperament and character in women with anorexia nervosa. Journal of Nervous and Mental Disease 2000;188(9):559–67.CrossRefGoogle ScholarPubMed
Kopper, BAOsman, AOsman, JRHoffman, J.Clinical utility of the MMPI-A and Harris-Lingoes subscales in the assessment of suicidal risk factors in psychiatric adolescents. Journal of Clinical Psychology 1998;54(2):191–200.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Lehoux, PMSteiger, HJabalpurlawa, S.State/trait distinction in bulimic syndromes. International Journal of Eating Disorders 2000;27(1):36–42.3.0.CO;2-U>CrossRefGoogle Scholar
Mann, JWaternaux, CHaas, GLMalone, KM.Toward a clinical model of suicidal behaviour in psychiatric patients. American Journal of Psychiatry 1999;156(2):181–9.Google Scholar
Pelkonen, MMarttunen, MPulkkinen, ELaippala, P.Characteristics of out-patient adolescents with suicidal tendencies. Acta Psychiatrica Scandinavia 1997;95(2):100–7.CrossRefGoogle ScholarPubMed
Pinto, AWhisman, MA.Negative affect and cognitive biases in suicidal and non suicidal hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 1996;35 (2):158–65.CrossRefGoogle Scholar
Pryor, TWiederman, MW.Use of the MMPI-2 in the outpatient assessment of women with Anorexia Nervosa or Bulimia Nervosa. Journal of Personality Assessment 1996;66(2):363–73.CrossRefGoogle ScholarPubMed
Schork, EJEckert, EDHalmi, KA.The relationship between psychopathology, eating disorder diagnosis, and clinical outcome at 10-year follow-up in anorexia nervosa. Comprehensive Psychiatry 1994;35(2):113–23.CrossRefGoogle ScholarPubMed
Sheehan, DVLecrubier, YSheehan, KHAmorin, PJanavs, JWeiller, E et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 1998;59(Suppl 20):22–33.Google ScholarPubMed
Sourander, AHelstela, LHaavisto, A et al. Suicidal thoughts and attempts among adolescents: a longitudinal 8-year follow-up study. Journal of Affective Disorders 2001;63(1–3):241–7.CrossRefGoogle ScholarPubMed
Stein, DApter, ARatzoni, GHar-Even, DAvidan, G.Association between multiple suicide attempts and negative affects in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 1998;37(5):488–94.CrossRefGoogle ScholarPubMed
Sullivan, PF.Mortality in anorexia nervosa. American Journal of Psychiatry 1995;152:1073–4.Google ScholarPubMed
Thompson, KMWonderlich, SACrosby, RDMitchell, JE.The neglected link between eating disturbances and aggressive behavior in girls. Journal of the American Academy of Child and Adolescent Psychiatry 1999;38(10):1277–84.CrossRefGoogle ScholarPubMed
Warshaw, MGMassion, AOPeterson, LGPratt, LAKeller, MB.Suicidal behavior in patients with panic disorder: retrospective and prospective data. Journal of Affective Disorders 1995;34(3):235–47.Google ScholarPubMed
Westen, DHarnden-Fischer, J.Personality profiles in eating disorders: rethinking the distinction between Axis I and Axis II. American Journal of Psychiatry 2001;158:547–62.CrossRefGoogle ScholarPubMed
Wichstrom, L.Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 2000;39(5):603–10.CrossRefGoogle ScholarPubMed
Wilson, KGStelzer, JBergman, JNKral, MJInayatullah, MElliott, CA.Problem solving, stress, and coping in adolescent suicide attempts. Suicide and Life Threatening Behavior 1995;25:241–52.Google ScholarPubMed
Yamaguchi, NKobayashi, JTachikawa, HSato, SHori, MSuzuki, T et al. Parental representation in eating disorder patients with suicide. Journal of Psychosomatic Research 2000;49(2):131–6.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.