Dissociation and Suicidality in Eating Disorders: The Mediating Function of Body Image Disturbances, and the Moderating Role of Depression and Anxiety

In patients with eating disorders (EDs), elevated dissociation may increase the risk of suicide. Bodily related disturbances, depression, and anxiety may intervene in the association between dissociation and suicidality. In this study we aimed to examine the influence of bodily related disturbances,...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-09, Vol.10 (17), p.4027
Main Authors: Lewis, Yael Doreen, Kapon, Shirley, Enoch-Levy, Adi, Yaroslavsky, Amit, Witztum, Eliezer, Stein, Daniel
Format: Article
Language:English
Subjects:
Anorexia
Anxiety
Attitudes
Behavior
Body image
Bulimia
Clinical medicine
Eating disorders
Hebrew language
Human remains
Influence
Pain
Self image
Suicides & suicide attempts
Teenagers
Trauma
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Summary:In patients with eating disorders (EDs), elevated dissociation may increase the risk of suicide. Bodily related disturbances, depression, and anxiety may intervene in the association between dissociation and suicidality. In this study we aimed to examine the influence of bodily related disturbances, depression, anxiety, severity of ED symptoms, body mass index (BMI), and type and duration of the ED on the relationship between elevated dissociation and elevated suicidality. The study included 172 inpatients: 65 with anorexia nervosa restricting type, 60 with anorexia nervosa binge/purge type, and 37 with bulimia nervosa. Participants were assessed using self-rating questionnaires for dissociation, suicidality, bodily related parameters, and severity of ED symptomatology, depression, and anxiety. We found that dissociation and suicidality were directly associated. In addition, depression and anxiety moderated the mediating role of body image parameters in the association between increased dissociation and increased suicidality. Thus, only in inpatients with high depression and anxiety, i.e., above the median range, body image disturbances were found to mediate the association between dissociation and suicidality. ED-related parameters did not moderate these relationships. Our study demonstrates that in inpatients with EDs, increased dissociation may be significantly associated with increased suicidality, both directly and via the intervening influence of body image, depression, and anxiety.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10174027