Abstract
BackgroundMany patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are thus used as coping mechanisms for these patients. We aimed to determine the prevalence of self-injurious behaviour, its characteristics and its emotion-regulation function in patients with anorexia nervosa or an eating disorder not otherwise specified (n = 136).MethodsA cross-sectional design using a self-report questionnaire. Mann–Whitney U-tests were conducted to compare the background and clinical variables between patients with self-injurious behaviour and patients without this type of behaviour. Changes in emotional state before and after self-injurious behaviour were tested by Wilcoxon signed rank tests.ResultsOur results showed a 41% prevalence of self-injurious behaviour in the previous month. Patients who performed self-injurious behaviour had a statistically significant longer treatment history for their eating disorder than those who did not. Whereas 55% of self-injuring patients had a secondary psychiatric diagnosis, only 21% of participants without self-injurious behaviour did. Regarding the impact of self-injurious behaviour, our results showed a significant increase in “feeling relieved” and a significant decrease in “feeling angry at myself”, “feeling anxious” and “feeling angry at others”. This indicates that self-injurious behaviour can be regarded as an emotion-regulation behaviour. Participants were usually aware of the causes of their self-injurious behaviour acts.ConclusionsProfessionals should systematically assess the occurrence of self-injurious behaviour in eating disorder patients, pay special attention to patients with more severe and comorbid psychopathology, and those with a long treatment history. This assessment should be followed by a functional analysis of the self-injurious behaviour and by effective therapeutic interventions alongside the eating disorder treatment.
Highlights
Many patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour
We investigated the prevalence and the emotion-regulation function of this behaviour in patients with anorexia nervosa or an eating disorder not otherwise specified
The present study describes the prevalence of self-injurious behaviour (SIB) and the SIB characteristics in a sample of 136 Dutch patients with Anorexia Nervosa (AN) or eating disorder not otherwise specified (EDNOS) who received treatment in a specialized treatment setting for eating disorders
Summary
Many patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are used as coping mechanisms for these patients. Whitney U-tests were conducted to compare the background and clinical variables of participants who had performed SIB in the previous month (n = 56) with those who never performed SIB (n = 53). The chi-square tests between these groups on having a comorbid psychiatric diagnosis was found to be statistically significant (χ2(1) = 13.77, p < .001): over half of the participants (55%) who had performed SIB in the previous month had a comorbid diagnosis, compared to 21% of patients who never performed SIB.
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