EDs and the IPTS
Previous research regarding the IPTS and eating behaviors has typically
focused on populations with clinically diagnosed EDs. Perceived
burdensomeness has been associated with body dissatisfaction, binge
eating, restricting, and laxative misuse in inpatient samples (Forrest
et al., 2016). Furthermore, body dissatisfaction and restricting are
related to suicidal ideation through higher perceived burdensomeness
(Forrest et al., 2016). Thwarted belongingness has been positively
associated with body dissatisfaction and restricting behaviors (Forrest
et al., 2016). When looking specifically at a population of women
diagnosed with bulimia, Lieberman and colleagues (2021) found perceived
burdensomeness had a stronger effect on suicidal ideation than thwarted
belongingness did, and that the interaction between perceived
burdensomeness and thwarted belongingness was significantly associated
with suicidal ideation. Similar results were found among a heterogenous
ED sample, where the combination of thwarted belongingness and perceived
burdensomeness was associated with lifetime suicidal ideation (Pisetsky
et al., 2017).
Studies on capability for suicide have not provided entirely consistent
results. For instance, Pisetsky and colleagues (2017) found that the
pain tolerance facet of acquired capability was significantly associated
with suicide attempts among those diagnosed with EDs, but it was not
associated with fearlessness about death. A study among a college
student sample examined pain tolerance and fearlessness about death
among individuals who restricted calories and did not find an
association (Zuromski & Witte, 2015). Similar results were demonstrated
in a clinical sample which indicated that restricting was not associated
with capability after controlling for other maladaptive eating behaviors
(Witte et al., 2016). This finding is interesting considering research
does indicate that restricting is associated with suicide attempts
(Zuromski & Witte, 2015; Witte et al., 2016). Other maladaptive eating
behaviors, such as vomiting and laxative misuse, have demonstrated
strong associations with capability even when controlling for
restricting behaviors (Witte et al., 2016). Additionally, vomiting was
significantly associated with both facets of capability (i.e., pain
tolerance and fearlessness about death; Witte et al., 2016).
Individuals diagnosed with EDs and individuals in psychiatric care have
been found to demonstrate higher levels of thwarted belongingness,
perceived burdensomeness, and suicidal ideation than a general college
student population (Smith et al., 2016). However, college student
populations in themselves constitute an important group for maladaptive
eating behaviors and suicide risk research (Lipson & Sonneville, 2020).
Studies examining the IPTS in college student samples have found that
greater numbers of maladaptive eating symptoms as measured by the Eating
Disorder Examination- Questionnaire were associated with greater
thwarted belongingness and perceived burdensomeness, both of which were
associated with a greater suicide risk (Kwan et al., 2017). Overall,
research indicates that suicide risk is higher among those who engage in
maladaptive eating behaviors and is influenced by severity and specific
symptom presentations (Lipson & Sonneville, 2020).