Suicidal Ideation in Adult Women: The Unique Roles of Binging, Purging, and Restricting

Suicidal ideation represents a serious experience common in individuals with eating disorders. To inform screening and clinical assessment and advance theoretical work, the current study compared clinical characteristics between adult women with and without current suicidal ideation and examined whether binging, fasting, and purging behaviors are uniquely associated with suicidal ideation above and beyond existing psychiatric diagnoses.

Data come from four studies conducted between 2000 and 2023 (N = 732) that evaluated current suicidal ideation in all participants. Participants completed diagnostic interviews assessing lifetime psychiatric diagnoses and current eating disorder diagnoses and behavioral symptom frequencies. Five hundred and fifty-three participants had DSM-5 eating disorders (54.6% bulimia nervosa, 15.0% purging disorder [PD], 28.2% other specified [excluding PD], 1.4% anorexia nervosa, and 0.7% binge-eating disorder).

Individuals with current suicidal ideation had a greater prevalence of most psychiatric diagnoses and greater frequency of binging, fasting, and purging. Additionally, purging frequency was associated with current suicidal ideation independent of binging, fasting, and lifetime psychiatric comorbidities.

Results support prior work suggesting that purging may fall on the self-harm continuum with nonsuicidal self-injury. Further, findings support screening for purging and suicide risk assessment in individuals with eating disorders.