Associations between emotion regulation difficulties, eating disorder symptoms, non-suicidal self-injury, and suicide attempts in a heterogeneous eating disorder sample
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Background This study examined the associations between specific dimensions of emotion dysregulation and eating disorder (ED) symptoms and behaviors, non-suicidal self-injury (NSSI), and suicide attempts in a heterogeneous ED sample.Methods Participants (N=110) completed the Difficulties in Emotion Regulation Scale (DERS), the Eating Disorder Examination Questionnaire (EDE-Q), and self-reported the presence of lifetime NSSI and a lifetime suicide attempt.Results The EDE-Q global score, a primarily cognitive measure of ED symptoms, was significantly positively correlated with DERS strategies, clarity, and awareness subscale scores and DERS total score (ps<0.01). Only the strategies subscale was uniquely positively associated with EDE-Q global score in a multivariate regression analysis. There was no association between the frequency of binge eating or frequency of driven exercise and any of the DERS subscale scores or total score (ps>0.01). Frequency of purging was significantly, positively associated with DERS impulse subscale score and total score (p<0.01). None of the DERS subscale scores were significantly different between those with and without NSSI or between those with and without a lifetime suicide attempt (ps>0.01).Conclusions Findings indicate that in a heterogeneous ED sample, emotion regulation deficits are more strongly associated with cognitively-oriented symptoms of EDs than behavioral symptoms such as a binge eating, purging, driven exercise, NSSI, or suicide attempts.
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Several studies did not find statistically significant associations or evidence of emotional dysregulation between patients with and without suicide attempts.
“Several studies did not find statistically significant associations [30,32,35,45] or evidence of emotional dysregulation between patients with and without suicide attempts [44,54,62,63,67].”
From The Role of Emotion Dysregulation in Understanding Suicide Risk: A Systematic Review of the Literature (2024) · cites this paper as [54]
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“…a history of suicide attempts, but there was no difference in DERS score between single and multiple attempters or between single and nonattempters; however, in the study by Pisetsky et al. [54], the authors did not detect any differences between individuals with or without suicide attempts.”
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Denning, D. M., Perry, T. R., Reilly, E. E., Berner, L. A., Velkoff, E. A., Kaye, W. H., Wierenga, C. E., & Brown, T. A. (2022) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12907 · Cited by 14 · see citing works
- Authors
- Pisetsky, E. M., Haynos, A. F., Lavender, J. M., Crow, S. J., & Peterson, C. B.
- Affiliations
- University of Minnesota (US)
- University of North Dakota (US)
- Corresponding author
- Pisetsky, Emily M.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 73
- Pages
- 143-150
- ISSN
- 0010-440X (ISSN-L)
- PMC
- PMC5263187
- OpenAlex
- W2558124220
- Cited by
- 69
- References
- 52
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 11 · 2021: 9 · 2020: 12 · 2019: 7 · 2018: 10 · 2017: 4
- FWCI
- 9.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000114)
- National Institute of Mental Health (T32MH082761)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK050456)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- emotional dysregulation, eating disorders, non-suicidal self-injury, suicide attempts, cognitive symptoms, binge eating, purging, impulsivity, emotion regulation strategies, Difficulties in Emotion Regulation Scale
- MeSH terms
- Adult, Feeding and Eating Disorders, Bulimia, Emotions, Female, Humans, Male, Suicide, Attempted, Exercise, Self-Injurious Behavior, Young Adult, Self Report
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