Evidence map›Paper›PMID 30770581›Full record

ArticleThe International journal of eating disorders2019

Comparing self-harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed.

Kathryn R Fox, Shirley B Wang, Chelsea Boccagno, Ann F Haynos, Evan Kleiman, Jill M Hooley

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Article in The International journal of eating disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Investigating Associations Between General and Disorder-Specific Reward and Suicidality in Anorexia Nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2025
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  12. Difficulties with positive emotion regulation in anorexia nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kathryn R FoxDepartment of Psychology, Harvard University, Cambridge, Massachusetts.ORCID 0000-0002-2697-7771
Shirley B WangDepartment of Psychology, Harvard University, Cambridge, Massachusetts.ORCID 0000-0002-8583-3014
Chelsea BoccagnoDepartment of Psychology, Harvard University, Cambridge, Massachusetts.
Ann F HaynosDepartment of Psychiatry, University of Minnesota, Minneapolis, Minnesota.ORCID 0000-0002-2548-1731
Evan KleimanDepartment of Psychology, Harvard University, Cambridge, Massachusetts.
Jill M HooleyDepartment of Psychology, Harvard University, Cambridge, Massachusetts.

Funding

Neural Correlates of Reward and Symptom Expression in Anorexia NervosaK23MH112867 · NIMH · UNIVERSITY OF MINNESOTA · PI HAYNOS, ANN FRANCES · 2017 to 2021
$878k
NIMH NIH HHS K23 MH112867
6 · The paper itself

Abstract

objectiveEating disordered (ED) behaviors (i.e., binge eating, compensatory behaviors, restrictive eating) and nonsuicidal self-injury (NSSI; intentional and nonsuicidal self-harm) are highly comorbid and share several similarities, including consequent pain and physical damage. However, whereas NSSI is considered direct self-harm, ED behaviors are considered indirect self-harm. These distinctions stem from theoretical understanding that NSSI is enacted to cause physical harm in the moment, whereas ED behaviors are enacted for other reasons, with consequent physical harm occurring downstream of the behaviors. We sought to build on these theoretically informed classifications by assessing a range of self-harming intentions across NSSI and ED behaviors.

methodStudy recruitment was conducted via online forums. After screening for inclusion criteria, 151 adults reported on their intent to and knowledge of causing physical harm in the short- and long-term and suicide and death related cognitions and intentions when engaging in NSSI and specific ED behaviors.

resultsParticipants reported engaging in ED and NSSI behaviors with intent to hurt themselves physically in the moment and long-term, alongside thoughts of suicide, and with some hope and knowledge of dying sooner due to these behaviors. Distinctions across behaviors also emerged. Participants reported greater intent to cause physical harm in the moment via NSSI and in the long-run via restrictive eating. NSSI and restrictive eating were associated with stronger endorsement of most suicide and death-related intentions than binge eating or compensatory behaviors.

conclusionsFindings shed light on classification of self-harming behaviors, casting doubt that firm boundaries differentiate direct and indirectly self-harming behaviors.

Indexed as

AdolescentAdultComorbidityEmotionsFeeding and Eating DisordersFemaleHumansIntentionMaleSelf-Injurious BehaviorSurveys and QuestionnairesYoung Adultbinge eatingdirect self-harmeating disorderindirect selfharmnonsuicidal self-injurypurgingrestrictive eatingsuicide

Identifiers

PMID30770581
PMCPMC6611160

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.