title: Binge/purge thoughts in nonsuicidal self-injurious adolescents: an ecological momentary analysis.
abstract: OBJECTIVE
  Adolescents who self-injure often engage in bingeing/purging (BP). Ecological momentary assessment (EMA) has potential to offer insight into the relationship between self-injury and BP. The aims of this study were to examine the frequency and context of BP using EMA in a sample of nonsuicidal self-injurious (NSSI) adolescents.
  
  
  METHODS
  Thirty adolescents with a history of NSSI responded to questions regarding self-destructive thoughts/behaviors using a palm-pilot device. Descriptive analyses compared thought/behavior contexts during reports of BP and NSSI thoughts/behaviors (occurring together vs. individually).
  
  
  RESULTS
  BP thoughts were present in 22 (73%) participants, occurring on 32% of the person-days recorded; 59% of these participants actually engaged in BP behavior. Seventy-nine percent of BP thoughts co-occurred with other self-destructive thoughts. Adolescents were more often with friends/peers than alone or with family when having BP thoughts. Worry and pressure precipitated both BP and NSSI thoughts, but perceived criticism and feelings of rejection/hurt were associated more often with BP thoughts than with NSSI thoughts.
  
  
  CONCLUSIONS
  BP thoughts and behaviors were common in this sample, often occurring with other self-destructive thoughts. Future EMA research is needed to address the function of BP symptoms, the contextual variables that increase risk for BP thoughts, and the factors that predict the transition of thoughts into behaviors in adolescents with and without self-injury.
authors.affiliation: Department of Psychology, Boston University, Boston, Massachusetts.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Shingleton
authors.forename: Kamryn T
authors.initials: KT
authors.lastname: Eddy
authors.forename: Aparna
authors.initials: A
authors.lastname: Keshaviah
authors.forename: Debra L
authors.initials: DL
authors.lastname: Franko
authors.forename: Sonja A
authors.initials: SA
authors.lastname: Swanson
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Yu
authors.forename: Meera
authors.initials: M
authors.lastname: Krishna
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Nock
authors.forename: David B
authors.initials: DB
authors.lastname: Herzog
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D000297:Psychology, Adolescent; D016728:Self-Injurious Behavior / Q000150:complications / Q000523:psychology*; D055815:Young Adult
keywords: adolescents; eating disorders; ecological momentary assessment; non-suicidal self-injury