Category: Suicide and Self-Injury
Objective: Non-suicidal self-injury and disordered eating have both been shown to associate with suicide ideation and behaviors in adolescents (Anestis et al., 2012). Previous research has implicated emotion dysregulation (ED) and interoceptive deficits (IDs) as possible reasons for the association between these behaviors (Muehlenkamp et al., 2012). Increased difficulty with emotion regulation has prospectively predicted engagement in NSSI and suicide (Muehlenkamp et al., 2009; Turner et al., 2013); however, little research has established a prospective path between emotion regulation and disordered eating (Monellet al., 2015). Furthermore, no prospective research has investigated the link between IDs and NSSI, disordered eating, and suicidality (Forrest et al., 2015; Ross, Heath, & Toste, 2009), though previous research has found IDs to be linked to both NSSI and disordered eating (Muehlenkamp et al., 2012). The goal of the present study was to examine the potential longitudinal pathways between ED and IDs to future engagement in NSSI, disordered eating, and suicide ideation. It was predicted that greater ED and IDs at baseline would prospectively predict engagement in NSSI, eating disorder behavior symptoms, and presence of suicide ideation at future time points.
Method: The sample included 436 high school and middle school students with mean age of 13.19 (1.09) and was largely female (52.5%) and white (85.4%). Participants were assessed at baseline, and at 6- and 12-month follow-ups, each time completing measures of NSSI, suicide ideation and behavior, depressive symptoms, disordered eating behaviors, ED, and ID.
Results: Multiple logistic regressions with ID and ED at Time 1 and were used to predict NSSI and suicide ideation at Times 2 and 3. Neither ED nor IDs were significant prospective predictors of NSSI when adjusting for depression. However, IDs and ED at Time 1 were significantly associated with suicide ideation at Time 3. Multiple linear regression found that interoceptive deficits, but not emotion dysregulation, at Time 1 prospectively predicted greater severity of eating disorder symptoms at both Time 2 and 3.
Conclusions: Despite existing evidence on the link between emotion dysregulation, interoceptive deficits, and self-harm behaviors, results only showed the emotion regulation dimensions to significantly predict suicide ideation. As expected, interoceptive deficits at Time 1 were significantly associated with disordered eating at all follow-up points. Future studies can explore the impact of changes in emotion regulation across time, particularly among those who continue to engage in NSSI.
Natalie Perkins– Student, Western Kentucky University, Bowling Green, Kentucky
Shelby Bandel– Graduate Student, Western Kentucky University, Bowling Green, Kentucky
Jordan Gregory– Western Kentucky University
Amy Brausch– Associate Professor of Psychological Sciences, Western Kentucky University, Bowling Green, Kentucky