Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders.
OBJECTIVE
The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD) and suicide attempts (SA), BSD patients with non-suicidal self-injury (NSSI), and BSD patients without these behaviors.


METHODS
One hundred and twenty-two female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD), BSD with lifetime NSSI (BSD + NSSI) or BSD with lifetime SA (BSD + SA).


RESULTS
The BSD + NSSI and BSD + SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD + SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD + NSSI groups. No differences in impulsivity between the BSD and BSD + NSSI groups were found.


CONCLUSIONS
The results show that BSD + NSSI and BSD + SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e., BSD + NSSI), may have a regulatory role rather than being due to impulsivity.
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain.
Alexandra
A
Gómez-Expósito
Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain.
Ines
I
Wolz
Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain.
Ana B
AB
Fagundo
Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain; Departament de Psicobiologia i Metodologia. Universitat Autònoma de BarcelonaBarcelona, Spain.
Roser
R
Granero
Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain.
Trevor
T
Steward
Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain; Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain.
Susana
S
Jiménez-Murcia
Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain.
Zaida
Z
Agüera
Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos IIIBarcelona, Spain; Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain.
Fernando
F
Fernández-Aranda
bulimic spectrum disorder (BSD); emotion regulation; impulsivity; non-suicidal self-injury (NSSI); personality; suicide attempts