A useful target for treatment intervention,
say the authors of 4 studies.
Reprinted from Eating Disorders Review
May/June Volume 24, Number 3
©2013 Gürze Books
Excessive exercise by women with bulimia nervosa (BN) has been linked to suicidal gestures and attempts, according to the results of four studies by April R. Smith, PhD, and researchers at Miami University, Oxford, OH (Psychiatry Res 2013; 206:246).
The first study evaluated whether over-exercising predicted suicidal behavior, after controlling for other eating disorder behaviors. This study included 204 women, 144 of whom had DSM-IV -defined BN. Dr. Smith and her colleagues found that the frequency of over-exercising, defined as “hard exercise used as a means of controlling weight or shape,” significantly predicted suicidal gestures and attempts, even after other bulimic behaviors, such as vomiting, purging, and fasting, were taken into consideration. Over-exercising was the only variable that maintained a significant relationship with suicidal behavior.
In the second study, the researchers tested the prospective association between over-exercise and acquired capability for suicide (ACS, defined as fearlessness about lethal self-injury) in a sample of 171 college students who were followed for 3 to 4 weeks. Over-exercise predicted ACS.
In the third study, involving 467 college students, pain insensitivity accounted for the relationship between over-exercise and ACS. A fourth study tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. ACS accounted for the relationship between over-exercise and suicidal behavior.
The researchers think that their results may help explain the increased rate of suicidal behavior displayed by persons with BN. It also is an important treatment target for individuals with BN who are currently over-exercising.