Potential support for a bidirectional relationship between eating disorders and suicidality has been found in a recent study published in the Journal of Abnormal Psychology. The authors include several Florida State affiliations – including Dr. April Smith (FSU alum), Mary Duffy (current clinical student), and Dr. Thomas Joiner – along with co-authors from Harvard University, Miami University, and University of Minnesota.

The study explores what clinical symptoms relate eating disorders and suicidality using network analysis — a method that commonly examines the relationship between co-occurring disorders. Authors analyzed networks of symptoms in three different groups of adults: those with a current eating disorder, those with history of a suicide attempt, and clinical outpatients (without suicide attempts or eating disorders).

Results revealed that "being out of touch with one's body…could facilitate both disordered eating and suicidality, and may contribute to their comorbidity" based on the analyses in the suicide attempt and the eating disorder groups. The authors continued, "…the more disconnected one is from one's body, the easier it is to harm." In the suicide attempt group, feeling alone was an important symptom that related suicidality and disordered eating symptoms. Further, feeling inadequate and thoughts of killing oneself were the strongest symptoms that related to the others in the networks for each group. "Taken together, being out of touch with one's body, feeling alone, and feeling inadequate connected suicidality and [eating disorder] symptoms," the researchers wrote.

A novel finding in the study provides the "first evidence that body dissatisfaction is a central symptom for individuals without [eating disorders], specifically, those who have attempted suicide.

"Clinical implications of these results might warrant examining "being out of touch with one's body" as a transdiagnostic risk factor that occurs across suicidality and eating disorders. Further, the central nature of suicidality in all three study groups emphasizes the continued need to monitor suicidality throughout treatment and could potentially be used as a treatment target to reduce disordered eating. Further studies examining these networks longitudinally and with objective measures of these clinical symptoms would support "the premise that [eating disorders] and suicidality may be bidirectionally related."

Citation: Smith, A. R., Forrest, L. N., Duffy, M. E., Jones, P. J., Joiner, T. E., & Pisetsky, E. M. (2020). Identifying bridge pathways between eating disorder symptoms and suicidal ideation across three samples. Journal of Abnormal Psychology. Advance online publication. https://doi-org.proxy.lib.fsu.edu/10.1037/abn0000553

By Lushna Mehra