Body Trust, agitation, and suicidal ideation in a clinical eating disorder sample

OBJECTIVE Research has established pairwise relationships between suicidal ideation (SI), low Body Trust, elevated agitation, and eating disorders, but knowledge of how these aspects relate in a single model is lacking. This study tested an indirect pathway with low Body Trust relating to severity of SI via agitation in a clinical eating disorder sample. METHOD Participants (N = 319; 92.8% female; 93.4% Caucasian; mean age 21.8 years) were adults currently receiving specialized eating disorder treatment (44.3% intensive outpatient or higher level-of-care) who completed online self-report measures of study variables. The PROCESS macro was utilized to test proposed pathways. RESULTS Low Body Trust was significantly directly associated with increased severity of current SI, both before (B = -.89, p < .001) and after (B = -.51, p = .001) accounting for the indirect effect through agitation, also significant (B = -.37, SE = .06, CI -.52 to -.26). DISCUSSION Perception of the body as unsafe may be related to agitation, and this intolerable sensation of trapped arousal could contribute to a desire to die. Future work should investigate these relationships prospectively to determine the relevance of Body Trust for assessment and treatment of suicide-related factors among individuals with eating disorders.