title: Non-suicidal self-injury in patients with eating disorder: associations with identity formation above and beyond anxiety and depression.
abstract: In the present study, we investigated the association between non-suicidal self-injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self-report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI.
authors.affiliation: Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: Claes
authors.forename: Koen
authors.initials: K
authors.lastname: Luyckx
authors.forename: Patricia
authors.initials: P
authors.lastname: Bijttebier
authors.forename: Brianna
authors.initials: B
authors.lastname: Turner
authors.forename: Amarendra
authors.initials: A
authors.lastname: Ghandi
authors.forename: Jos
authors.initials: J
authors.lastname: Smets
authors.forename: Jan
authors.initials: J
authors.lastname: Norre
authors.forename: Leen
authors.initials: L
authors.lastname: Van Assche
authors.forename: Els
authors.initials: E
authors.lastname: Verheyen
authors.forename: Yvienne
authors.initials: Y
authors.lastname: Goris
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hoksbergen
authors.forename: Katrien
authors.initials: K
authors.lastname: Schoevaerts
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010551:Personality; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires
keywords: anxiety; depression; eating disorders; identity confusion; identity synthesis; non-suicidal self-injury