Body uneasiness and suicide risk in a non-clinical sample of university students

Predictive Factors of Suicidal Ideation in Spanish University Students: A Health, Preventive, Social, and Cultural Approach

Suicide, as the ultimate expression of suicidal ideation, has accompanied human beings throughout history within specific social and cultural contexts. However, in recent decades the increase in suicides, especially in developed countries after the Second Demographic Transition and the rise of postmaterialist values, has been increasing in the youth population. This study is created from a quantitative perspective and aims to determine the predictors of suicidal ideation in university students in Spain. The fieldwork was carried out in a large sample of Spanish universities over several weeks in 2022, with the participation of hundreds of university students (n = 1472). The predictors of suicidal ideation were gender, types of social relationships, history of bullying, health status, taking antidepressant medication, increased anxiety after COVID-19, economic difficulties in continuing studies, and perspective on their future. The results highlight the need for the greater involvement of universities by establishing programs for preventing, detecting, and treating suicidal ideation, always in coordination with health systems to prevent further suicides in their university community.

Self-disgust as a potential mechanism underlying the association between body image disturbance and suicidal thoughts and behaviours

This study examined whether self-disgust added incremental variance to and mediated the multivariate association between measures of body image disturbance and suicidal thoughts and behaviours. We hypothesized that self-disgust would be associated with suicidal ideation above the effects of body image disturbance, and that self-disgust would mediate the relationship between body image disturbance and suicidal ideation. A total of N=728 participants completed The Body Image Disturbance Questionnaire, The Self-Disgust Scale, and the Suicidal Behaviours Questionnaire-Revised. Suicidality was significantly related to increased levels of self-disgust and body image disturbance, whereas self-disgust was associated with greater body image disturbance. Linear regression analysis showed that self-disgust was associated with suicidal thoughts and behaviours, over and above the effects of body image disturbance. Multiple mediation modelling further showed that self-disgust mediated the relationship between body image disturbance and suicidal thoughts and behaviours. Our findings highlight the role of self-disgust in the context of body image disturbance and support the notion that body image disturbance is associated with aversive self-conscious emotions. Interventions aiming to reduce the risk of suicidality in people with body image disturbance may address self-disgust and negative self-conscious emotions.

Insatisfação com a imagem corporal em estudantes universitários – Uma revisão integrativa

RESUMO Objetivo Caracterizar a insatisfação corporal entre estudantes universitários. Métodos Revisão integrativa da literatura nas bases de dados PubMed, Lilacs, Bireme, portal SciELO e banco de teses com descritores indexados com os critérios de inclusão: população exclusivamente universitária, apresentação de dados referentes à frequência/prevalência da insatisfação corporal e/ou a caracterização de fatores relacionados. Resultados Foram selecionados 76 estudos (40 nacionais e 36 internacionais). A amplitude de insatisfação de imagem corporal em ambos os sexos foi de 8,3% a 87% nos estudos nacionais, e de 5,2% a 85,5% nos internacionais, avaliados, principalmente, por meio de escalas de silhuetas e/ou questionários (como o Body Shape Questionnaire, o Eating Disorder Inventory, e o Body-Self Relations Questionnaire Appearance Scales). Os fatores como exposição à mídia e redes sociais, o período menstrual e a baixa autoestima foram relacionados à insatisfação corporal. Conclusão A insatisfação corporal é um fenômeno comum entre os universitários, mas apresentando grande amplitude dependendo do sexo, instrumento, método e objetivo do estudo. Padronização na avaliação do construto é necessária para melhor compressão e discussão do problema.

Mediating effects of stress, weight-related issues, and depression on suicidality in college students

OBJECTIVE

Through a holistic health lens, the current study examines the effects of weight-related issues and stress on suicidality while controlling for depressive symptoms in college students.

PARTICIPANTS

In total, 872 undergraduate and graduate students at DePaul University completed the American College Health Association-National College Health Assessment II Web-based survey in Spring 2010.

METHODS

Measures of suicidality, depression, weight-related issues, and life stressors were assessed, along with gender differences.

RESULTS

Females reported experiencing more weight loss attempts and total stressors than males. Weight-related issues and stress both significantly predicted depressive symptoms in a path analysis; depressive symptoms, in turn, significantly predicted suicidality. Gender differences were found; depressive symptoms mediate the relation between stress and suicidal behavior for females but not for males.

IMPLICATIONS

This investigation furthers previous research on suicidality in college students and suggests that all-inclusive interventions that address weight-related issues and stress may help reduce depressive symptoms, which then may reduce suicidal behavior.

Cutaneous body image dissatisfaction and suicidal ideation: mediation by interpersonal sensitivity

OBJECTIVE

Cutaneous body image (CBI) dissatisfaction, feelings of social exclusion and stigmatization have been associated with increased suicidality in dermatology patients. We examined the relation between CBI dissatisfaction and suicidal ideation in a non-clinical sample, and examined the possible mediating effect of interpersonal sensitivity (IS), a symptom dimension related to self-consciousness, feelings of inferiority and social exclusion.

METHODS

As part of a larger study, 312 community-based participants from London, Ontario, Canada (241 women, 71 men; mean±SD age: 38.4±14.9years) rated their CBI satisfaction, measured with the Cutaneous Body Image Scale (Gupta MA et al., 2004). The Brief Symptom Inventory (BSI) (Derogatis L et al.,1982) was used to measure the constructs of suicidal ideation (4 suicide-related items from the BSI) and IS (Interpersonal Sensitivity subscale of BSI).

RESULTS

Assessing mediation using the Baron & Kenny (1986) model, CBI satisfaction had a significant negative effect on suicidal ideation [c=-0.316, t(296)=-5.73, p<0.001] and IS [a=-0.365, t(297)=-6.76, p<0.001]; when CBI satisfaction and IS were considered together, IS had a significant positive effect on suicidal ideation (b=.690, t(295)=15.80, p<.001) while the effect of CBI satisfaction on suicidal ideation was no longer significant [c*=-.063, t(295)=-1.44, ns].

CONCLUSION

Our findings suggest an inverse relationship between CBI satisfaction and suicidal ideation, which is mediated by IS. This relationship likely falls in a continuum between non-clinical and clinical situations, with suicide risk being greater when individuals experience greater CBI dissatisfaction and social alienation.

Suicidality and unhealthy weight control behaviors among female underaged psychiatric inpatients

OBJECTIVE

The aim of this study was to investigate whether unhealthy weight control behaviors, fear of becoming obese, binge eating, impulsivity, and body mass index are associated with suicide ideation, repetitive self-mutilative behavior (SMB), suicide attempts, or both suicide attempts and SMB among female adolescent psychiatric inpatients.

METHODS

Data were drawn from a clinical inpatient cohort of female adolescents (N = 300, aged 12-17 years) consecutively admitted for psychiatric hospitalization between April 2001 and March 2006. Information on adolescents' suicidal behavior, psychiatric Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnoses and weight control behaviors was obtained using the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL).

RESULTS

Even after adjustment with DSM-IV, affective, anxiety and eating disorders self-induced vomiting was significantly associated with SMB and suicide attempts with SMB. Impulsivity was related to suicide attempts with SMB. Excessive exercising was a significant finding only in those girls who had attempted suicide. Girls who had attempted suicide were more often overweight compared with girls without suicidal behavior.

CONCLUSION

Unhealthy weight control behaviors among adolescent girls were found to be strongly associated with suicidal behavior. Girls with a history of both suicide attempts and SMB seem to be the most disturbed group, with multiple weight loss methods and impulsivity. Girls who are overweight or exercise excessively may represent risk groups for attempted suicide.

Body attitudes and objectification in non-suicidal self-injury: comparing males and females

The authors evaluated the theoretical suggestion that self-objectification, negative body attitudes, and body-image avoidant behaviors are associated with non-suicidal self-injury among both males and females. A sample of 365 male and female (82.4% reporting female) undergraduate students (26.5% reporting NSSI) from a variety of academic disciplines completed a secure on-line survey assessing objectification, body image related variables, and history of NSSI. Participants reporting a history of NSSI endorsed significantly more body-related disturbances than participants reporting no history of NSSI. Males reporting a history of NSSI scored similarly to females both with and without a history of NSSI, and only differed from males without a history of NSSI on self-objectification. Theoretical models proposing body objectification and attitudes are important to understanding etiological risks for NSSI have merit. Additional research on these potential risk factors is needed.

Body mass index and attempted suicide: Cohort study of 1,133,019 Swedish men

Associations between body mass index (BMI) and attempted (nonfatal) suicide have recently been reported. However, the few existing studies are relatively small in scale, the majority cross-sectional, and results contradictory. The authors have explored BMI-attempted suicide associations in a large cohort of 1,133,019 Swedish men born between 1950 and 1976, with BMI measured in early adulthood. During a mean follow-up of 23.9 years, a total of 18,277 (1.6%) men had at least 1 hospital admission for attempted suicide. After adjustment for confounding factors, there was a stepwise, linear decrease in attempted suicide with increasing BMI across the full BMI range (per standard deviation increase in BMI, hazard ratio = 0.93, 95% confidence interval: 0.91, 0.94). Analyses excluding men with depression at baseline were essentially identical to those based on the complete cohort. In men free from depression at baseline, controlling for subsequent depression slightly attenuated the raised risk of attempted suicide, particularly in lower weight men. This study suggests that lower weight men have an increased risk of attempted suicide and that associations may extend into the "normal" BMI range.

Body image dissatisfaction as an important contributor to suicidal ideation in Korean adolescents: gender difference and mediation of parent and peer relationships

OBJECTIVES

This study was to examine not only the contribution of body image dissatisfaction to suicidal ideation, according to gender, but the mediating role of parent and peer relationships on the association between body image dissatisfaction and suicidal ideation.

METHODS

Data from the 2004 Korean Education and Employment Panel, a school-based survey administered to a nationally representative sample of Korean adolescents, are used in the study. With the exception of participants with missing data on important questions (suicidal ideation, self-evaluated body image, self-reported weight/height, risk factors related to suicide), information from 5426 students (2896 males and 2530 females) in grades 9 and 12 was separately analyzed along gender lines using multivariate logistic regression.

RESULTS

In both genders, body image dissatisfaction contributed to suicidal ideation, after controlling for covariates (i.e., school type, perceived family economic hardship, parent-related negative life events, delinquent behaviors, unhealthy behaviors, and self-efficacy). Such association existed throughout all body mass index ranges, and underweight males and normal females were most vulnerable to suicidal ideation if they are dissatisfied with their bodies. Parent and peer relationships partially mediated the association between body image dissatisfaction and suicidal ideation in both genders, but these effects were very small.

CONCLUSIONS

How adolescents evaluate their body image may be an important indicator of suicidal ideation. Future research should further test the link between body dissatisfaction and suicidal ideation, even after controlling for other important forms of psychopathology known to be associated with these issues.

Body checking in the eating disorders: association with narcissistic characteristics

There is substantial evidence that body image is a clinically important element of eating pathology, and that patients' body checking cognitions and behaviours are key elements in the maintenance of that body image. However, there is little understanding of individual differences in body checking. This study considered the potential role of narcissism and narcissistic defences in driving body checking cognitions and behaviours. 68 eating-disordered and 70 non-clinical women completed well-validated measures of body checking and narcissism. There were specific patterns of association between different elements of narcissism and different aspects of body checking. These patterns are compatible with a model where body checking serves the defensive function of maintaining self-esteem, rather than promoting positive levels of narcissistic self-esteem.

Suicide and attempted suicide in eating disorders, obesity and weight-image concern

Suicide in anorexia nervosa and bulimia nervosa is a major cause of death. Meta-analyses have shown that individuals suffering from anorexia nervosa and bulimia nervosa commit suicide more often than their counterparts in the general population; also a few studies have suggested that suicide is the major cause of death among patients with anorexia nervosa, refuting the assumption that inanition generally threatens the life of these patients. Data concerning suicide in bulimia nervosa, on the other hand, are still scarce but suicide attempts are easily found among cohorts of patients with bulimia nervosa, which constitutes a risk factor for completed suicide. Suicidality in obesity and individuals with disturbed weight status has been reported. Both in the case of bulimia nervosa and obesity more long-term follow-up studies need to be completed before the risk of suicide for such disorders may be compared with that for anorexia nervosa.