Abstract
Anxiety sensitivity (AS) and disordered eating are significant risk factors for suicidality. Although the physical concerns subfactor of AS—specifically lower physical concerns—has been associated with suicide attempts, we sought to further clarify this relationship by exploring the association between AS physical concerns and the physical capability component (acquired capability) of Joiner’s (Why people die by suicide. Harvard University Press, Cambridge, MA, 2005) interpersonal theory of suicide. We predicted an inverse relationship between AS physical concerns and the acquired capability for suicide in a sample of 342 female outpatients. Additionally, we hypothesized that AS physical concerns would moderate the relationship between disordered eating—another risk factor for suicidality—and acquired capability, such that a significant relationship between disordered eating and acquired capability would exist only for those reporting low AS physical concerns. Both hypotheses were supported. The implications for understanding the joint influence of AS and disordered eating, as well as for determining suicide risk, are discussed.
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Anestis, M. D., Holm-Denoma, J. M., Gordon, K. H., Schmidt, N. B., & Joiner, T. E. (2008). The role of anxiety sensitivity in eating pathology. Cognitive Therapy and Research, 32, 370–385.
Asmundson, G. J. G., Norton, P. J., & Veloso, F. (1999). Anxiety sensitivity and fear of pain in patients with recurring headaches. Behaviour Research and Therapy, 37, 703–713.
Beck, A. T., & Steer, R. A. (1990). Manual for the beck anxiety inventory. San Antonio, TX: Psychological Corporation.
Beck, A. T., Steer, R., & Brown, G. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.
Bodell, L. P., Joiner, T. E., & Keel, P. K. Eating disorders increase risk for suicidality beyond risk associated with comorbid disorders. Journal of Psychiatric Research (under review).
Braun, D. L. (1999). More males seek treatment for eating disorders. International Journal of Eating Disorders, 25, 415–424.
Bulik, C. M., Sullivan, P. F., & Joyce, P. R. (1999). Temperament, character and suicide attempts in anorexia nervosa, bulimia nervosa and major depression. Acta Psychiatrica Scandinavica, 100, 27–32.
Capron, D. W., Cougle, J. R., Ribeiro, J. D., Joiner, T. E., & Schmidt, N. B. (2012a). An interactive model of anxiety sensitivity relevant to suicide attempt history and future suicidal ideation. Journal of Psychiatric Research, 46, 174–180.
Capron, D. W., Fitch, K., Medley, A., Blagg, C., Mallott, M., & Joiner, T. (2012b). Role of anxiety sensitivity subfactors in suicidal ideation and suicide attempt history. Depression & Anxiety, 29(3), 195–201.
Cavanagh, J. T. O., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33, 395–405.
Cougle, J. R., Keough, M. E., Riccardi, C. J., & Sachs-Ericsson, N. (2009). Anxiety disorders and suicidality in the national comorbidity survey-replication. Journal of Psychiatric Research, 43, 825–829.
Cox, B. J., Enns, M. W., Freeman, P., & Walker, J. R. (2001). Anxiety sensitivity and major depression: Examination of affective state dependence. Behaviour Research and Therapy, 39, 1349–1356.
Franko, D. L., & Keel, P. K. (2006). Suicidality in eating disorders: Occurrence, correlates, and clinical implications. Clinical Psychology Review, 26(6), 769–782.
Garner, D. M., Olmstead, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory of anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34.
Greenberg, J. J., & Burns, J. W. (2003). Pain anxiety among chronic pain patients: Specific phobia or manifestations of anxiety sensitivity? Behaviour Research and Therapy, 41, 223–240.
Grogan, S. (1999). Body image: Understanding body dissatisfaction in men, women, and children. London; New York: Routledge.
Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
Nepon, J., Belik, S. L., Bolton, J., & Sareen, J. (2010). The relationship between anxiety disorders and suicide attempts: Findings from the national epidemiologic survey on alcohol and related conditions. Depression and Anxiety, 27, 791–798.
Ocanez, K. L. S., McHugh, R. K., & Otto, M. W. (2010). A meta-analytic review of the association between anxiety sensitivity and pain. Depression and Anxiety, 27, 760–767.
Otto, M. W., Pollack, M. H., Fava, M., Uccello, R., & Rosenbaum, J. F. (1995). Elevated Anxiety Sensitivity Index scores in patients with major depression: Correlates and changes with antidepressant treatment. Journal of Anxiety Disorders, 9, 117–123.
Preti, A., Rochhi, M. B., Camboni, M. V., & Miotto, P. (2011). A comprehensive meta-analysis of the risk of suicidie in eating disorders. Acta Psychiatrica Scandinavia, 124, 6–17.
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.
Sareen, J., Cox, B. J., Afifi, T. O., de Graaf, R., Asmundson, G. J. C., ten Have, M., et al. (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: A population-based longitudinal study of adults. Archives of General Psychiatry, 62, 1249–1257.
Selby, E. A., Smith, A. R., Bulik, C. M., Olmsted, M. P., Thornton, L., McFarlane, T. L., et al. (2010). Habitual starvation and provocation behaviors: Two potential routes to extreme suicidal behavior in anorexia nervosa. Behavior Research and Therapy, 48, 634–645.
Simon, N. M., Pollack, M. H., Ostacher, M. J., Zalta, A. K., Chow, C. W., Fischmann, D., et al. (2007). Understanding the link between anxiety symptoms and suicidal ideation and behaviors in outpatients with bipolar disorder. Journal of Affective Disorders, 97, 91–99.
Smith, A. R., Fink, E. L., Anestis, M. D., Ribeiro, J., Gordon, K. H., Davis, H., Keel, P. K., Bardone-Cone, A. M., Peterson, C. M., Klein, M. H., Crow, S., Mitchell, J. E., Crosby, R. D., Wonderlich, S. A., le Grange, D., & Joiner, T. E. Exercise caution: over-exercise is associated with suicidality in bulimia nervosa. Psychiatry Research. (in press).
Swinbourne, J., Hunt, C., Abbott, M., Russell, J., St. Clare, T., & Touyz, S. (2012). The comorbidity between eating disorders and anxiety disorders: Prevalence in an eating disorder sample and anxiety disorder sample. The Australian and New Zealand Journal of Psychiatry, 46(2), 118–131.
Taylor, S. (1999). Anxiety sensitivity. Mahwah, NJ: Erlbaum.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600.
Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008). Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting Psychology, 76(1), 72–83.
Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669–689.
World Health Organization. (2009). Suicide prevention. Available at http://www.who.int/mental_health/prevention/suicide/suicide_prevent/en.
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Fink, E., Bodell, L., Smith, A. et al. The Joint Influence of Disordered Eating and Anxiety Sensitivity on the Acquired Capability for Suicide. Cogn Ther Res 37, 934–940 (2013). https://doi.org/10.1007/s10608-012-9502-3
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DOI: https://doi.org/10.1007/s10608-012-9502-3