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39. Similar functions, different behaviors: New insights into the co-occurrence of eating disorders and nonsuicidal self-injury
Eating disorder (ED) behaviors, including restrictive eating, binge eating, and purging, frequently co-occur with nonsuicidal self-injury (NSSI). Theoretical evidence suggests this co-occurrence may be driven by shared functions underlying multiple behaviors. We aimed to provide the first empirical examination of the within-person organization of functions of ED and NSSI behaviors. Participants (N=524) were adolescents endorsing 2+ of the following behaviors: restrictive eating, binge eating, purging, NSSI. Participants completed the Functional Assessment of Maladaptive Behaviors (Wedig & Nock, 2010) for each behavior endorsed. Exploratory factor analyses indicated that a four-factor model was a good fit for each behavior, with factors reflecting automatic negative, automatic positive, social negative, and social positive reinforcement. Hierarchical clustering analyses revealed that social positive functions and social negative functions of each behavior clustered together. Automatic negative and automatic positive functions of restrictive eating and purging also clustered together, but these clusters did not include automatic negative or automatic positive functions of binge eating or NSSI, which also clustered separately from each other. Results demonstrated similarity in social functions of ED and NSSI behaviors, such that individuals who engage in one behavior for social negative (e.g., to avoid interactions with others) or social positive (e.g., to communicate distress to others) are also likely to engage in other behaviors for the same reason. Automatic negative and positive functions (e.g., to escape negative emotions or increase positive emotions) were less strongly correlated across behaviors. Social functional similarities underlying engagement in EDs and NSSI may contribute to their high rates of co-occurrence.