Restricted food intake a predictor of increased suicide attempts in Body Dysmorphic Disorder patients

Rhode Island Hospital and Auburn University researchers found a link between restrictive food intake, or excessive dieting, and an increase in suicide attempts in people with Body Dysmorphic Disorder (BDD). The study focused on the acquired capability of suicide, which is one component of Joiner's (2005) interpersonal-psychological theory of suicide and is comprised of physical pain tolerance and lowered fear of death. The paper is published in the journal Suicide and Life-Threatening Behavior, and is now available online in advance of print.

BDD is a common, often severe, and under-recognized body image disorder. People with BDD experience distressing or impairing preoccupations with perceived flaws in their appearance and are obsessed with the belief that something is wrong with how they look, when in reality they look normal. More than 75 percent of people with BDD feel life is not worth living or think about suicide in their lifetime, and approximately 25 percent have a history of a suicide attempt.

Authors Tracy K. Witte, Ph.D., of Auburn University, Elizabeth R. Didie, Ph.D., a psychologist in the department of psychiatry at Rhode Island Hospital, and Katharine A. Phillips, M.D., director of the Body Dysmorphic Disorder Program at Rhode Island Hospital examined the association of suicide attempts with physically painful BDD-related behaviors, including restrictive food intake, excessive exercise, BDD-related cosmetic surgery, compulsive skin picking, and physical self-mutilation.

The study found that BDD-related restrictive food intake was associated with more than double the number of suicide attempts, but was not associated with suicide ideation; and that those with a history of BDD-related excessive exercise had less than half the number of suicide attempts as those without such a history. The study also found that none of the other variables indicating exposure to painful and provocative experiences, such as BDD-related cosmetic surgery and compulsive skin picking, were significant predictors of suicide attempts.

Because restriction of food intake can be physically painful, the researchers theorize that a person who is capable of enduring the physical discomfort of caloric restriction may be more capable of enduring the physical discomfort required in order to inflict self-harm. They theorize that severe restriction of food intake that results in long-standing physical discomfort would predict capability for suicide, whereas more moderate dieting behaviors would have less of a relationship (if any).

"Significantly limiting food intake can be physically painful," Phillips said. "It goes against our natural instincts to feed our bodies and respond to the physical pain that comes with extreme hunger. The results of this study suggest the importance of assessing individuals with BDD for restrictive eating behaviors to identify suicide risk, even if they have not previously been diagnosed with an eating disorder."

The study included interviews with 200 individuals (68.5 percent women) between the ages of 14 and 64 who had a lifetime diagnosis of BDD. The main criterion variable was the participants' number of past suicide attempts, which ranged from 0 to 25 in the study group. Additionally, 78 percent of the study group had a history of suicide-related ideation. The study only included examination of suicide attempts, not deaths by suicide.

"While some of the other BDD-related behaviors may seem outwardly more painful – such as undergoing repeated cosmetic procedures, or compulsive skin picking, the level of pain associated with excessive dieting could significantly increase a person's pain tolerance," Didie said. "This study suggests that those who are capable of enduring such physical discomfort and pain from restrictive eating also may be capable of enduring the physical discomfort required to inflict self harm."

Provided by Lifespan

"Restricted food intake a predictor of increased suicide attempts in Body Dysmorphic Disorder patients." June 5th, 2012.http://medicalxpress.com/news/2012-06-restricted-food-intake-predictor-suicide.html

Posted by
Robert Karl Stonjek

Anxious girls' brains work harder

This electrode cap was worn by participants in a Michigan State University psychology study that suggests anxious girls' brains work harder than boys'. Credit: Michigan State University

In a discovery that could help in the identification and treatment of anxiety disorders, Michigan State University scientists say the brains of anxious girls work much harder than those of boys.

The finding stems from an experiment in which college students performed a relatively simple task while their brain activity was measured by an electrode cap. Only girls who identified themselves as particularly anxious or big worriers recorded high brain activity when they made mistakes during the task.

Jason Moser, lead investigator on the project, said the findings may ultimately help mental health professionals determine which girls may be prone to anxiety problems such as obsessive compulsive disorder or generalized anxiety disorder.

"This may help predict the development of anxiety issues later in life for girls," said Moser, assistant professor of psychology. "It's one more piece of the puzzle for us to figure out why women in general have more anxiety disorders."

The study, reported in the International Journal of Psychophysiology, is the first to measure the correlation between worrying and error-related brain responses in the sexes using a scientifically viable sample (79 female students, 70 males).

Participants were asked to identify the middle letter in a series of five-letter groups on a computer screen. Sometimes the middle letter was the same as the other four ("FFFFF") while sometimes it was different ("EEFEE"). Afterward they filled out questionnaires about how much they worry.

Although the worrisome female subjects performed about the same as the males on simple portions of the task, their brains had to work harder at it. Then, as the test became more difficult, the anxious females performed worse, suggesting worrying got in the way of completing the task, Moser said.

"Anxious girls' brains have to work harder to perform tasks because they have distracting thoughts and worries," Moser said. "As a result their brains are being kind of burned out by thinking so much, which might set them up for difficulties in school. We already know that anxious kids – and especially anxious girls – have a harder time in some academic subjects such as math."

Currently Moser and other MSU researchers are investigating whether estrogen, a hormone more common in women, may be to blame for the increased brain response. Estrogen is known to affect the release of dopamine, a neurotransmitter that plays a key role in learning and processing mistakes in the front part of the brain.

"This may end up reflecting hormone differences between men and women," Moser said.

In addition to traditional therapies for anxiety, Moser said other ways to potentially reduce worry and improve focus include journaling – or "writing your worries down in a journal rather than letting them stick in your head" – and doing "brain games" designed to improve memory and concentration.

Provided by Michigan State University

"Anxious girls' brains work harder." June 5th, 2012. http://medicalxpress.com/news/2012-06-anxious-girls-brains-harder.html

Posted by
Robert Karl Stonjek

‎#### BABASAHEB DR. AMBEDKAR on Gandhi and Jinnah ####

‎#### BABASAHEB DR. AMBEDKAR on Gandhi and Jinnah #### I can give only my impressions of them, for what they are worth. The first thing that strikes me is that it would be difficult to find two persons who would rival them for their colossal egotism, to whom personal ascendancy is everything and the cause of the country a mere counter on the table. They have made Indian politics a matter of personal feud. Consequences have no terror for them ; indeed they do not occur to them until they happen. When they do happen they either forget the cause, or if they remember it, they overlook it with a complacency which saves them from any remorse. They choose to stand on a pedestal of splendid isolation. They wall themselves off from their equals. They prefer to open themselves to their inferiors. They are very unhappy at and impatient of criticism, but are very happy to be fawned upon by flunkeys. Both have developed a wonderful stagecraft and arrange things in such a way that they are always in the limelight wherever they go. Each of course claims to be supreme. If supremacy was their only claim, it would be a small wonder. In addition to supremacy each claims infallibility for himself. Pius IX during whose sacred regime as Pope the issue of infallibility was raging said— ” Before I was Pope I believed in Papal infallibility, now I feel it.” This is exactly the attitude of the two leaders whom Providence—may I say in his unguarded moments—has appointed to lead us. source: SECTION VIII, Ranade, Gandhi and Jinnah. Vol-I, Dr. Babasaheb Ambedkar Writing and Speeches