Thomas E. Joiner

Exercise caution: over-exercise is associated with suicidality among individuals with disordered eating.

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.

Status update: maladaptive Facebook usage predicts increases in body dissatisfaction and bulimic symptoms.

BACKGROUND The current study examined the effects of online social evaluations and comparisons on body dissatisfaction and bulimic symptoms. METHODS We tested the effects of maladaptive Facebook usage (defined as the tendency to seek negative social evaluations and/or engage in social comparisons via Facebook) on body dissatisfaction and bulimic symptoms in a sample of 232 college females followed for approximately 4 weeks. RESULTS Results provided evidence that maladaptive Facebook usage significantly predicted increases in bulimic symptoms and episodes of over-eating approximately four weeks later. Body dissatisfaction was found to fully mediate the relationship between maladaptive Facebook usage and increases in over-eating episodes, whereas body dissatisfaction partially mediated the relationship between maladaptive Facebook usage and increases in bulimic symptoms more broadly. LIMITATIONS Limitations include the use of a novel measure of maladaptive Facebook usage due to the absence of an existing measure and a non-clinical sample. CONCLUSIONS The results of this study suggest that reducing maladaptive Facebook usage may be a fruitful target for interventions aimed at reducing body dissatisfaction and symptoms of eating pathology.

Interpersonal-Psychological Precursors to Suicidal Behavior: A Theory of Attempted and Completed Suicide

Suicidal ideation is not uncommon in the general population and is even more prevalent in psychiatric samples; however, most individuals who experience ideation will not attempt suicide and even fewer will complete suicide. Despite these discrepancies, the number of studies investigating risk factors for serious suicidal behavior (i.e., attempts and completions) is relatively small. We first review studies in the literature which focus on the distinction between attempted and completed suicide and/or which predict completion status. We then highlight a program of research in our own laboratory which is grounded in Joiners interpersonal-psychological theory of attempted and completed suicide. The theory posits that serious suicidal behavior will not occur unless an individual has both the desire to commit suicide and the ability to do so. Two factors contribute to an individuals desire for suicide, a thwarted sense of belongingness and a sense of perceived burdensomeness on others, while the ability to commit suicide can be acquired over time through habituation to the physical and mental pain involved in self-injury. Finally, we discuss implications of the theory for assessment and treatment of suicidal behavior.

The Reinforcing Properties of Repeated Deliberate Self-Harm

The current study tested hypotheses derived from Joiners (2005) interpersonal theory of suicide, which proposes that deliberate self-harm (DSH) becomes increasingly more reinforcing with repetition. One hundred six participants with a history of DSH completed questionnaires about their emotions and experience of physical pain during their most recent DSH episode. Consistent with prediction, people with more numerous past DSH episodes felt more soothed, more relieved, and calmer following their most recent episode of DSH. Contrary to prediction, greater numbers of past DSH episodes were associated with more intense physical pain during the most recent episode. The findings suggest that the emotion regulation functions of DSH may become more reinforcing with repetition.

Cross-cultural examination of the tripartite model with children: data from the Barretstown studies.

The Positive and Negative Affect Scale for Children (PANAS-C; Laurent et al., 1999) and the Physiological Hyperarousal Scale for Children (PH-C; Laurent, Catanzaro, & Joiner, 1998) were administered to a group of 240 children from European countries to determine their utility in examining the tripartite model of anxiety and depression (L. A. Clark & Watson, 1991) in a cross-cultural sample. Most of the children (n = 196) had been diagnosed with a medical illness; the remainder were siblings of these youngsters (n = 44). Only slight variations were noted in items between this sample and samples from the United States. Despite these minor differences, 3 distinct scales measuring the positive affect, negative affect, and physiological hyperarousal constructs of the tripartite model were identified. These findings illustrate that the PH-PANAS-C provides a useful measure of the tripartite model in a cross-cultural sample of youth. The findings also demonstrate that the tripartite model is generalizable to a cross-cultural milieu.

Depression-Related Stress Generation: A Longitudinal Study of Black Adolescents.

The authors examined Hammens (1991) model of stress generation in depression in a Black adolescent population. The longitudinal sample of 1,766 participants entered the study at ages 13 to 18. Stressful events and depressive and other symptom occurrence over a 1-year period were analyzed. Results supported the stress generation model. Depressive symptoms were associated with an increase in negative stressful events. In addition, the study supported the symptom specificity of stress generation to depression versus anxious and conduct disorder symptoms.

Factor structure of a measure of anxiety sensitivity in children

Anxiety sensitivity (i.e., the disposition to react to autonomic arousal with fear) has taken a central role in recent conceptualizations of anxiety. However, questions regarding the dimensional nature of anxiety sensitivity remain. In particular, the factor structure of anxiety sensitivity is unexplored in nonadult populations. The factor structure of the Anxiety Sensitivity Index for Children (ASIC) was examined in three studies. Study 1 (N = 95) used a sample of school children in Grades 4-8 to investigate the reliability of items and factor structure. Items with weak psychometric properties were eliminated, and subsequent analyses revealed that the ASIC was best viewed as a hierarchical scale with a higher order factor (Anxiety Sensitivity) and two first-order factors (Fear of Physiological Arousal and Fear of Mental Catastrophe). Study 2 (N = 112) and Study 3 (N = 144) used more distressed samples of youngsters, and they also found the ASIC to be a hierarchical scale. These findings add a developmental perspective to the Anxiety Sensitivity Index factor analytic discussion and are highly consistent with emergent thinking in the adult anxiety sensitivity literature.

Understanding suicide among older adults: a review of psychological and sociological theories of suicide

Objectives: Older adults die by suicide at a higher rate than any other age group in nearly every country globally. Suicide among older adults has been an intractable clinical and epidemiological problem for decades, due in part to an incomplete understanding of the causes of suicide, as well as imprecision in the prediction and prevention of suicidal thoughts and behaviors in later life. Theory-driven investigations hold promise in addressing these gaps by systematically identifying testable, and thus falsifiable, mechanisms that may better explain this phenomenon and also point to specific interventions. Method: In this article, we comprehensively review key extant psychological and sociological theories of suicide and discuss each theorys applicability to the understanding and prevention of suicide among older adults. Results: Despite a modest number of theories of suicide, few have undergone extensive empirical investigation and scrutiny, and even fewer have been applied specifically to older adults. Conclusion: To advance the science and contribute findings with a measurable clinical and public health impact, future research in this area, from conceptual to applied, must draw from and integrate theory.

A Trait-Interpersonal Perspective on Suicide Risk in Criminal Offenders

Despite elevated rates of suicide among offenders, research has yet to adequately address theoretically driven risk models in this population. The present study addresses such a gap by investigating a synthesized framework using 2 well-developed theoretical models, the Five-Factor Model (FFM) of personality and the interpersonal-psychological theory of suicide (IPTS). Archival data from mitigation evaluations for pre-sentenced criminal offenders (n = 307) were analyzed using structural equation modeling (SEM). Results supported a hypothesized personality-IPTS-suicide framework in which neuroticism and extraversion predict IPTS components, namely perceived burdensomeness, thwarted belongingness, and acquired capability. IPTS constructs subsequently directly and indirectly (via suicidal ideation) predicted suicide potential. Findings have important implications for suicide theory, research, and risk assessment with offenders.

Reassurance seeking and negative feedback seeking.

Publisher Summary The risk factor research approach elaborated by Kraemer and colleagues provides a method for systematically evaluating the status of a proposed risk factor through increasingly stringent empirical studies. By examining research on excessive reassurance seeking (ERS) and negative feedback seeking (NFS) within this context, the quality of the causal claims made about these proposed risk factors are tested, and areas in need of further research are identified. The study of ERS as a risk factor for depression grew from Coynes initial presentation of an interpersonal description of depression, which described a process in which depressed individuals behave in a way that elicits negative information from the environment that then strengthens their depression. NFS—the opposite of reassurance seeking—has also been associated with depression. Depressive individuals actively seek negative feedback. Self-verification theory proposes that individuals are motivated to maintain consistent self-views, and that they will actively solicit, attend to, and recall feedback that confirms their self views. Additionally, individuals are more likely to believe feedback that they find to be self-verifying. The description of causal models with specific terminology clearly specifies the proposed pathways from the risk factor to the disorder, which can help to clarify the role of ERS and NFS in depression.