Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-26T11:40:13.637Z Has data issue: false hasContentIssue false
  • English
  • Français

Dynamic associations between interpersonal needs and suicidal ideation in a sample of individuals with eating disorders

Published online by Cambridge University Press:  06 March 2020

Lindsay P. Bodell Open the ORCID record for Lindsay P. Bodell [Opens in a new window] ,
April R. Smith  and
Tracy K. Witte
Lindsay P. Bodell*
Affiliation:
Department of Psychology, Western University, London, Ontario, Canada
April R. Smith
Affiliation:
Department of Psychology, Miami University of Ohio, Oxford, Ohio, USA
Tracy K. Witte
Affiliation:
Department of Psychology, Auburn University, Auburn, Alabama, USA
*
Author for correspondence: Lindsay P. Bodell, E-mail: lbodell@uwo.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Over half of individuals with eating disorders experience suicidal ideation at some point in their lives, yet few longitudinal studies have examined predictors of ideation in this at-risk group. Moreover, prospective research has focused on relatively distal or trait-level factors that are informative for distinguishing who is most at risk but not when. Little is known about more proximal or state-level risk factors that fluctuate within an individual, which is critical for determining when a person is most likely to engage in suicidal behaviors.

Methods

Women (N = 97) receiving treatment for their eating disorder completed questionnaires weekly to assess suicidal ideation and interpersonal constructs (i.e. perceived burdensomeness, thwarted belongingness) theorized to be proximal predictors of suicidal desire. Longitudinal multilevel models were conducted to examine both within- and between-person predictors of suicidal ideation across 12 weeks of treatment.

Results

Statistically significant within-person effects for burdensomeness (β = 0.06; p < 0.001) indicate that when individuals have greater feelings of burdensomeness compared to their own average, they also experience higher suicidal ideation. We did not find any significant influence of thwarted belongingness or the interaction between burdensomeness and belongingness on suicidal ideation.

Conclusions

This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results are only partially consistent with the Interpersonal Theory of Suicide and suggest that short-term changes in burdensomeness may impact suicidal behavior in individuals with eating disorders.

Keywords

belongingnessburdensomenesseating disordersinterpersonal theory of suicidelongitudinalsuicidal ideation
Type
Original Articles
Information
Psychological Medicine , Volume 51 , Issue 9 , July 2021 , pp. 1516 - 1523
Check for updates
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, 78, 490–498.Google Scholar
Bodell, L. P., Cheng, Y., & Wildes, J. E. (2019). Psychological impairment as a predictor of suicide ideation in individuals with anorexia nervosa. Suicide and Life-threatening Behavior, 49, 520–528.CrossRefGoogle ScholarPubMed
Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: A meta-review. World Psychiatry, 13, 153–160.CrossRefGoogle ScholarPubMed
Chu, C., Buchman-schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., … Joiner, T. E. (2017). The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychological Bulletin, 143, 1313.CrossRefGoogle ScholarPubMed
Dodd, D. R., Smith, A. R., Forrest, L. N., Witte, T. K., Bodell, L., Bartlett, M., … Goodwin, N. (2018). Interoceptive deficits, nonsuicidal self-injury, and suicide attempts among women with eating disorders. Suicide and Life-threatening Behavior, 48, 438–448.CrossRefGoogle ScholarPubMed
Fairburn, C. G., & Belgin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363–370.Google ScholarPubMed
Fenton, W. S., McGlashan, T. H., Victor, B. J., & Blyler, C. R. (1997). Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders. American Journal of Psychiatry, 154, 199–204.Google ScholarPubMed
Forrest, L. N., Bodell, L. P., Witte, T. K., Goodwin, N., Bartlett, M. L., Siegfried, N., … Smith, A. R. (2016). Associations between eating disorder symptoms and suicidal ideation through thwarted belongingness and perceived burdensomeness among eating disorder patients. Journal of Affective Disorders, 195, 127–135.CrossRefGoogle ScholarPubMed
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., … Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143, 187.CrossRefGoogle ScholarPubMed
Franko, D. L., & Keel, P. K. (2006). Suicidality in eating disorders: Occurrence, correlates, and clinical implications. Clinical Psychology Review, 26, 769–782.CrossRefGoogle ScholarPubMed
Franko, D. L., Keel, P. K., Dorer, D. J., Blais, M. A., Delinsky, S. S., Eddy, K., … Herzog, D. (2004). What predicts suicide attempts in women with eating disorders? Psychological Medicine, 34, 843–853.CrossRefGoogle ScholarPubMed
Hoffman, L. (2015). Longitudinal analysis: Modeling within-person fluctuation and change. New York: Routledge.CrossRefGoogle Scholar
Joiner, T. E. (2005). Why people die by suicide. Cambridge, Massachusetts: Harvard University Press.Google Scholar
Joiner, T., Pfaff, J. J., & Acres, J. G. (2002). A brief screening tool for suicidal symptoms in adolescents and young adults in general health settings: Reliability and validity data from the Australian national general practice youth suicide prevention project. Behaviour Research and Therapy, 40, 471–481.CrossRefGoogle Scholar
Kleiman, E. M., Turner, B. J., Fedor, S., Beale, E. E., Huffman, J. C., & Nock, M. K. (2017). Examination of real-time fluctuations in suicidal ideation and its risk factors: Results from two ecological momentary assessment studies. Journal of Abnormal Psychology, 126, 726.CrossRefGoogle ScholarPubMed
Kyron, M. J., Hooke, G. R., & Page, A. C. (2018). Daily assessment of interpersonal factors to predict suicidal ideation and non-suicidal self-injury in psychiatric inpatients. Journal of Consulting and Clinical Psychology, 86(6), 556–567.CrossRefGoogle ScholarPubMed
Metalsky, G. I., & Joiner, T. E. (1997). The hopelessness depression symptom questionnaire. Cognitive Therapy and Research, 21, 359–384.CrossRefGoogle Scholar
Miller, A. B., Esposito-Smythers, C., & Leichtweis, R. N. (2016). A short-term, prospective test of the interpersonal-psychological theory of suicidal ideation in an adolescent clinical sample. Suicide and Life-threatening Behavior, 46(3), 337–351.CrossRefGoogle Scholar
Pisetsky, E. M., Thornton, L. M., Lichtenstein, P., Pedersen, N. L., & Bulik, C. M. (2013). Suicide attempts in women with eating disorders. Journal of Abnormal Psychology, 122, 1042.CrossRefGoogle ScholarPubMed
Preti, A., Rocchi, M. B. L., Sisti, D., Camboni, M. V., & Miotto, P. (2011). A comprehensive meta-analysis of the risk of suicide in eating disorders. Acta Psychiatrica Scandinavica, 124, 6–17.CrossRefGoogle ScholarPubMed
Ribeiro, J. D., Bodell, L. P., Hames, J. L., Hagan, C. R., & Joiner, T. E. (2013). An empirically based approach to the assessment and management of suicidal behavior. Journal of Psychotherapy Integration, 23, 207.CrossRefGoogle Scholar
Roeder, K. M., & Cole, D. A. (2019). Simultaneous longitudinal examination of hopelessness, thwarted belongingness, and perceived burdensomeness as predictors of suicidal ideation. Suicide and Life-Threatening Behaviors, 49(4), 1058–1071.CrossRefGoogle Scholar
Rogers, M. L., & Joiner, T. E. (2019). Exploring the temporal dynamics of the interpersonal theory of suicide constructs: A dynamic systems modeling approach. Journal of Consulting and Clinical Psychology, 87(1), 56–66.CrossRefGoogle ScholarPubMed
Smith, A. R., Dodd, D. R., Forrest, L. N., Witte, T. K., Bodell, L., Ribeiro, J. D., … Bartlett, M. (2016). Does the interpersonal–psychological theory of suicide provide a useful framework for understanding suicide risk among eating disorder patients? A test of the validity of the ipts. International Journal of Eating Disorders, 49, 1082–1086.CrossRefGoogle ScholarPubMed
Smith, A. R., Zuromski, K. L., & Dodd, D. R. (2018). Eating disorders and suicidality: What we know, what we don't know, and suggestions for future research. Current Opinion in Psychology, 22, 63–67.CrossRefGoogle ScholarPubMed
Teismann, T., Glaesmer, H., von Brachel, R., Siegmann, P., & Forkmann, T, . (2017). A prospective examination of perceived burdensomeness and thwarted belongingness as risk factors for suicide ideation in adult outpatients receiving cognitive-behavioral therapy. Journal of Clinical Psychology, 73, 1393–1402.CrossRefGoogle ScholarPubMed
Valtonen, H., Suominen, K., Mantere, O., Leppamaki, S., Arvilommi, P., & Isometsav, E. T. (2005). Suicidal ideation and attempts in bipolar I and II disorders. Journal of Clinical Psychiatry, 66, 1456–1462.CrossRefGoogle ScholarPubMed
Van Orden, K. A., Cukrowicz, K. C., Witte, T. K., & Joiner, T. E. (2012). Thwarted belongingness and perceived burdensomeness: Construct validity and psychometric properties of the interpersonal needs questionnaire. Psychological Assessment, 24, 197.CrossRefGoogle ScholarPubMed
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117, 575.CrossRefGoogle ScholarPubMed
Velkoff, E. A., & Smith, A. R. (2019). Examining patterns of change in the acquired capability for suicide among eating disorder patients. Suicide and Life-threatening Behavior, 49(4), 1032–1043.CrossRefGoogle ScholarPubMed
Witte, T. K., Zuromski, K. L., Gauthier, J. M., Smith, A. R., Bartlett, M., Siegfried, N., … Goodwin, N. (2016). Restrictive eating: Associated with suicide attempts, but not acquired capability in residential patients with eating disorders. Psychiatry Research, 235, 90–96.CrossRefGoogle Scholar
Wright, A. G., & Hopwood, C. J. (2016). Advancing the assessment of dynamic psychological processes. Assessment, 23, 399–403.CrossRefGoogle ScholarPubMed
Wright, A. G., & Simms, L. J. (2016). Stability and fluctuation of personality disorder features in daily life. Journal of Abnormal Psychology, 125, 641.CrossRefGoogle ScholarPubMed
Zuromski, K. L., Witte, T. K., Smith, A. R., Goodwin, N., Bodell, L. P., Bartlett, M., & Siegfried, N. (2015). Increased prevalence of vegetarianism among women with eating pathology. Eating Behaviors, 19, 24–27.CrossRefGoogle ScholarPubMed
Supplementary material: File

Bodell et al. supplementary material

Tables S1-S7

Download Bodell et al. supplementary material(File)
File 32.6 KB