Eating disorders and suicide ideation: the mediating role of depression and aggressiveness

OBJECTIVE: Symptoms of depression and aggressiveness are important antecedents and correlates of suicide ideation and completion in adolescents and adults. Among adolescents, eating disorder symptoms were also found to associate with suicidal behavior. This study was aimed at investigating the role of depression and aggressiveness as mediators in the links between eating disorder symptoms and suicide ideation among adolescents, taking into account age and sex as covariates. METHOD: Data from the Conegliano Eating Disorders Survey were used to investigate the role of depression and aggressiveness in the links between eating disorder symptoms and suicide ideation, resorting to a bootstrapped sampling distribution model. RESULTS: In a mixed male-female sample of 930 adolescents, eating disorder symptoms were positively related to suicide ideation, taking age and sex into account. Depression and aggressiveness acted as full mediators in the links between eating disorder symptoms and suicidality, and virtually abolished any direct influence of eating disorders on suicide ideation. CONCLUSION: Because of the cross-sectional nature of this study and the resorting to self-report scales, no firm statement about causal association can be made. However, both suicidal behavior and eating disorder symptoms are a rather widespread occurrence among adolescents, hence the investigation on suicidal tendencies in young people might benefit from the inclusion of measures of eating disorders to prevent the worst outcomes of minor psychological distress.