Dissociation and suicidality in eating disorders: The mediating function of body image disturbances, and the moderating role of depression and anxiety

Yael Doreen Lewis, Shirley Kapon, Adi Enoch‐levy, Amit Yaroslavsky, Eliezer Witztum, Daniel Stein

    Research output: Contribution to journalArticlepeer-review

    6 Scopus citations

    Abstract

    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.

    Original languageEnglish
    Article number4027
    JournalJournal of Clinical Medicine
    Volume10
    Issue number17
    DOIs
    StatePublished - 1 Sep 2021

    Keywords

    • Anorexia nervosa
    • Anxiety
    • Body image
    • Bulimia nervosa
    • Depression
    • Dissociation
    • Mediation
    • Moderation
    • Suicidality

    ASJC Scopus subject areas

    • General Medicine

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