Transdiagnostic Prevalence and Characteristics of Suicidality Across the Spectrum of Restrictive Eating Pathology

Limited research has evaluated variability in the prevalence and characteristics of suicidality across the spectrum of restrictive eating disorders, including Anorexia Nervosa (AN) and atypical AN (AAN). It is also unclear the extent to which diagnostic subtypes (i.e., Restricting, Binge-Eating/Purging) and remission status (i.e., active diagnosis, partial remission) are associated with suicide risk in this population. Leveraging two unique samples, the present study substantially advances our transdiagnostic understanding of suicide risk in restrictive eating disorders. In Study 1 (n = 184), we compared the frequency and intensity of suicidal thoughts and behaviors across diagnostic subtypes of AN/AAN, as well as across remission status. In Study 2 (n = 83), using intensive longitudinal data, we examined average levels of suicidality and profiles of suicidal ideation over 21 days. The prevalence of suicidal ideation was comparable across AN/AAN diagnoses, though the BP subtype was associated with more lifetime suicide attempts. Individuals in partial remission were more likely to report past-month ideation than those with an active diagnosis. AN and AAN demonstrated similarities in the average intensity and variability of suicide-related cognitions and suicidality profiles. These findings suggest that a symptom-level or behavioral approach may provide the greatest insight into an individual's likelihood of suicidal thoughts and behaviors.