title: Exercise caution: over-exercise is associated with suicidality among individuals with disordered eating.
abstract: We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3-4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations.
authors.affiliation: Department of Psychology, Miami University, 90 N. Patterson Dr., Oxford, OH 45056, United States. aprilsmith@muohio.edu
authors.forename: April R
authors.initials: AR
authors.lastname: Smith
authors.forename: Erin L
authors.initials: EL
authors.lastname: Fink
authors.forename: Michael D
authors.initials: MD
authors.lastname: Anestis
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Ribeiro
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Gordon
authors.forename: Heather
authors.initials: H
authors.lastname: Davis
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Keel
authors.forename: Anna M
authors.initials: AM
authors.lastname: Bardone-Cone
authors.forename: Carol B
authors.initials: CB
authors.lastname: Peterson
authors.forename: Marjorie H
authors.initials: MH
authors.lastname: Klein
authors.forename: Scott
authors.initials: S
authors.lastname: Crow
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Wonderlich
authors.forename: Daniel
authors.initials: D
authors.lastname: le Grange
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Joiner
mesh_terms: D000293:Adolescent; D000328:Adult; D052018:Bulimia Nervosa / Q000523:psychology*; D003192:Compulsive Behavior / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058748:Pain Perception; D017288:Pain Threshold; D010468:Perceptual Disorders / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology; D055815:Young Adult