Disordered eating linked to thoughts of suicide in teens.

BOSTON -- Disordered eating is an important risk factor for suicidal ideation in adolescents and appears to contribute an additional amount of variance above and beyond traditional risk factors, a study has shown.

The findings suggest that disordered eating should be included as a variable in risk models for adolescent suicidal ideation, Amy M. Brausch said at the annual conference of the American Association of Suicidology.

Using data collected from 392 adolescents as part of a mental health screening at an urban American high school during the 2005-2006 school year, Ms. Brausch and her colleagues at Northern Illinois University in DeKalb evaluated the impact of disordered eating and body image on a suicidal ideation model that also included the traditional risk factors of depression, hopelessness, and past suicidal behavior.

Previous studies have identified body dissatisfaction as a risk factor for depression and eating disorders--both of which have been associated with suicide. But few studies have considered body image and disordered eating as unique risk factors, Ms. Brausch said.

In the current study, all of the participants, mean age 15 years, completed the Reynolds Adolescent Depression Scale--2nd Edition, the Beck Hopelessness Scale, the Self-Harm Behavior Questionnaire, the Multidimensional Body-Self Relations Questionnaire, the Eating Attitudes Test, and the Suicidal Ideation Questionnaire to assess depression, hopelessness, past suicidal behavior, body image, disordered eating, and current suicidal ideation.

The investigators ran a hierarchical linear regression with suicidal ideation as the dependent variable and determined that depression, hopelessness, and past suicidal behavior all accounted for a significant amount of variance for current suicidal ideation, Ms. Brausch reported.

Disordered eating and body image, together, accounted for a small but significant amount of variance in the overall model, she said, noting that, when considered alone, disordered eating was a significant predictor of ideation, while body image was not.

"Overall, the level of disordered eating was low because of the community sample," Ms. Brausch said. "Generally, disordered eating and suicidal ideation were related, and higher levels of disordered eating were associated with higher levels of suicidal ideation."

The fact that disordered eating was a significant predictor of suicidal ideation, while body image was not, is an interesting finding, said Ms. Brausch, "especially since a study I presented [at the American Association of Suicidology meeting] in 2005 did find relationships between body image and suicidal ideation" (Body Image 2007;4:207-12).

One possible explanation is that the current study used a different measure of body image than was used in the 2005 study, Ms. Brausch suggested. "This study used the Multidimensional Body-Self Relations Questionnaire [MBSRQ], which focuses on assessing body satisfaction, appearance satisfaction, and so forth, while the 2005 study used the Body Investment Scale [BIS], which focuses on assessing comfort with touch, body care, body protection, and body attitudes/ feelings," she said.

"My hypothesis is that the factors of body image that are most influential in suicidal ideation are the body investment pieces, as measured by the BIS. The MB-SRQ subscales were predictive of depressive symptoms but not suicidal ideation, indicating to me the body satisfaction facets of body image may be more associated with depression."

BY DIANA MAHONEY

New England Bureau