The Relationship between Body Dysmorphic Disorder Behaviors and the Acquired Capability for Suicide
ABSTRACT In a sample of 200 individuals diagnosed with body dysmorphic disorder (BDD), we utilized the interpersonal-psychological theory for suicide as a framework to examine BDD behaviors that might be associated with suicide risk, insofar as they might increase the acquired capability for suicide. We predicted that physically painful BDD behaviors (e.g., cosmetic surgery, restrictive eating) would be associated with suicide attempts but not suicide-related ideation because these behaviors increase capability for, but not thoughts about, suicide. Our hypothesis was partially confirmed, as BDD-related restrictive food intake was associated with suicide attempts (but not suicide-related ideation) even after controlling for numerous covariates.
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ABSTRACT: Objective: The relationship between obesity and suicidal ideation and behavior (suicidality) is not well understood, and conventional suicide risk factors do not adequately explain the associations observed. Thus, the current study aimed to further examine the relationship between body mass index (BMI; kg m(-2)) and suicidal ideation as well as potential mechanisms of this relationship. Methods: Two hundred seventy-one adults (n=151 undergraduates; n=120 obesity treatment participants) completed self-report questionnaires assessing relevant variables, including suicidal ideation, perceived burdensomeness, thwarted belongingness and current height/weight used to calculate BMI. Results: There was a significant, quadratic relationship between BMI and suicidal ideation (b=0.001, t=2.21, P=0.03, partial r=0.14) and between BMI and perceived burdensomeness (b=0.003, t=2.50, P=0.013, partial r=0.16), such that as BMI increased, these positive associations became more pronounced. Additionally, perceived burdensomeness partially mediated the relationship between BMI and suicidal ideation. Conclusions: Individuals with a higher BMI demonstrated increased suicidal ideation as well as greater feelings of perceived burdensomeness. These results provide novel information regarding potential mechanisms explaining the obesity-suicidal ideation association.International journal of obesity (2005) 01/2013; 37(9). DOI:10.1038/ijo.2012.224 · 5.00 Impact Factor
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ABSTRACT: This review will address pathological narcissism and narcissistic personality disorder (NPD)—the clinical presentation, the challenges involved in diagnosing NPD, and significant areas of co-occurring psychopathology (i.e., affective disorder, substance usage, and suicide). Major depressive disorder is the most common comorbid disorder in patients with pathological narcissism or NPD. Need for self-enhancement and chronic disillusionment with self make these individuals particularly susceptible to substance use. Suicidal preoccupation in these patients is characterized by the absence of depression, lack of communication, self-esteem dysregulation, and life events that decrease self-esteem. The diagnostic focus on patients' external characteristics and interpersonal behavior tends to dismiss the importance of their internal distress and painful experiences of self-esteem fluctuations, self-criticism, and emotional dysregulation. A collaborative and exploratory diagnostic approach to pathological narcissism and NPD is outlined that aims at engaging the patients and promoting their curiosity, narration, and self-reflection. Alliance building with a narcissistic patient is a slow and gradual process and mistakes are common. A central task is to balance these patients' avoidance and sudden urges to reject the therapist and drop out of treatment with the goal of encouraging and enabling them to face and reflect upon their experiences and behavior. Implications for treatment and possible areas or indications of change include: interpersonal and vocational functioning; sense of agency and self-direction; emotion regulation and ability to understand, tolerate, and modulate feelings; reflective ability; and ability to mourn the loss of wished for or unreachable internal self-states, relationships, and external ideals.03/2013; 11(2):167-177. DOI:10.1176/appi.focus.11.2.167
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ABSTRACT: Which factors distinguish suicide attempters from suicide ideators is a relatively neglected question in suicidology. Data from the 2001 Youth Risk Behavior Survey, encompassing 1,439 youth suicide ideators and 1,097 attempters, was used to explore which factors best differentiate suicide attempters from ideators, with a focus on violence involvement. Measures of violence include the contexts of fights, dating, and weapons carrying. Controls were incorporated for psychiatric disorders, risky sexual behavior, school integration, and demographics. Controlling for the other variables, violence differentiated attempts from ideation: fighting (OR = 2.18) and weapon carrying (OR = 1.13). Psychiatric factors that predicted attempts over ideation included major depression (OR = 1.86), use of cocaine (OR = 2.34), and having a suicide plan (OR = 2.69), while demographic factors included gender, age, residence in the Midwest, and Hispanic, African American, or Asian ethnicity. A supplementary analysis (N = 11,546) determined that violence also helped to differentiate suicide ideators from nonsuicidal youth. Four factors (including violence involvement, eating disorders, and gender consistently) differentiated both between suicide attempts and ideation, and also between suicide ideators and nonsuicidal youth. The link between violence involvement and suicidality is interpreted in terms of the capability for suicide from the interpersonal theory of suicide.Suicide and Life-Threatening Behavior 08/2013; 44(1). DOI:10.1111/sltb.12054 · 1.40 Impact Factor