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Indirekte und direkte nichtsuizidale Selbstverletzungen bei Mädchen und jungen Frauen mit Essstörungen

Welche Bedeutung kommt dem borderlinespezifischen Denken als Mediator zu?

Published Online:September 03, 2019https://doi.org/10.1026/0942-5403/a000293

Abstract

Zusammenfassung. Nichtsuizidales selbstverletzendes Verhalten (NSSV) tritt häufig bei Essstörungen auf. Die Befundlage zum Zusammenhang zwischen einem restriktiv-asketischen beziehungsweise bulimischen Essverhalten und NSSV ist jedoch nicht konsistent. Es wird geprüft, ob borderlinespezifische Gedanken die Beziehung zwischen asketischen beziehungsweise bulimischen Essverhalten auf der einen Seite und NSSV auf der anderen Seite mediieren. Eine Stichprobe von 74 Mädchen und jungen Frauen im Alter von 14 bis 21 Jahren (M = 17.49; SD = 1.85), die eine Anorexie oder eine Bulimie aufweisen, bearbeiteten Fragebögen zu NSSV, borderlinespezifischen Gedanken sowie zu asketischen und bulimischen Verhaltensweisen. Borderline-Gedanken mediierten den Zusammenhang zwischen asketischem Verhalten auf der einen Seite und der Anzahl an bisher genutzten NSSV-Methoden und NSSI zur psychischen Regulation auf der anderen Seite. Bei Bulimie fand sich hingegen keine Mediation. Ein asketisches Verhalten ist bei Mädchen und jungen Frauen mit einer Essstörung über Borderline-Gedankenmuster mit der Anzahl an NSSV-Methoden und der Nutzung von NSSV zur psychischen Regulation verbunden. Ein primär durch Essattacken gekennzeichnetes Verhalten weist keinen Zusammenhang mit NSSV auf. Die verschiedenen Arten von gestörtem Essverhalten sollten separat auf einen Zusammenhang mit NSSV untersucht werden.


Indirect and Direct Nonsuicidal Self-Injury in Girls and Young Women With Eating Disorders: Do Borderline-Specific Cognitions Mediate the Relationship?

Abstract. Nonsuicidal self-injury (NSSI) is common in eating disorders. Nevertheless, findings on the relationship between restrictive-ascetic or bulimic eating behavior and NSSI are not consistent. The aim of our study was to clarify whether borderline-specific cognitions mediate the relationship between restrictive-ascetic or bulimic eating behavior and NSSI. A sample of 74 girls and young women aged 14 – 21 years (M = 17.49, SD = 1.85) who had anorexia (63.5 %) or bulimia (36.5 %) completed questionnaires on NSSI, borderline-specific cognitions, depressive symptoms, and ascetic and bulimic eating behavior. Results showed that borderline-specific cognitions mediate the relationship between ascetic behavior on one hand and the number of NSSI methods and NSSI for psychological regulation on the other. In the case of bulimic behavior, no such mediation was found. Ascetic behavior in girls and young women with an eating disorder was linked to the number of NSSI methods and to NSSI for psychological regulation via borderline cognitions. An eating behavior characterized primarily by binge eating was not related to NSSI methods or NSSI for psychological regulation. Depressive symptoms were associated with NSSI, but there was no such relationship when borderline cognitions were controlled for. This underlines that NSSI is more closely associated with emotional unstable thought patterns than with depression. In summary, ascetic but not bulimic behavior in girls and young women with anorexia or bulimia is linked via borderline cognitions to a high number of NSSI methods and a more frequent use of NSSI to regulate aversive mental states. Beyond emotion dysregulation and impulsivity, bulimia does not seem to account for NSSI. Further replication of these results is needed. A limitation of this study is the cross-sectional design. Accordingly, it should be clarified whether the conclusions of this study can withstand empirical testing with longitudinal data. In the future, types of dysfunctional eating behavior should be examined separately for a relationship with NSSI.

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