Perceived burdensomeness, thwarted belongingness, and hopelessness as predictors of future suicidal ideation in Spanish university students.

The Interpersonal Theory of Suicide (IPTS) has received support for its role in understanding suicidal thoughts and behaviors. However, few longitudinal studies have focused on testing this theory in university students. The present study aimed to confirm the theoretical model of the IPTS in a sample of 225 Spanish university students, using path analysis in a longitudinal study. We assessed thwarted belongingness and perceived burdensomeness at T1 and hopelessness and suicidal ideation at T2, 12-14 weeks later. Moreover, we assessed suicidal ideation weekly for 14 weeks. Path analyses confirmed the Interpersonal Theory of Suicide model, with thwarted belongingness and perceived burdensomeness as direct and indirect predictors of suicidal ideation through hopelessness. Providers of guidance and clinical services in university settings should be trained to identify perceived burdensomeness, social belongingness, hopelessness, and suicidal ideation when screening for suicide prevention.

A systematic review of the effectiveness of meaning-centred psychotherapies in depressed participants.

Depression is a mental disorder that is associated with low quality of life, increased risk of suicide and a high economic cost for society. Meta-analyses indicate that Meaning Centred Psychotherapies (MCP) are an efficacious psychotherapy to reduce depression in participants with chronic illness and cancer. However, to date, no systematic review has analysed the effectiveness of MCP in depressed participants who do not have a physical illness or cancer. The objective of this study was to carry out a systematic review to analyse the effectiveness of MCP in participants with depression and no physical illness. The search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Six studies (two randomised controlled trials and four quasi-experimental studies) were included in the systematic review. The results indicate that MCP is more effective than a control group as waitlist (four studies), psychoeducation group (one study), and cognitive behavioural therapy (CBT, one study), in reducing depressive symptoms, improving meaning in life and reducing anxiety in participants without physical illness. MCP would be considered a probably efficacious treatment for depression. However, further research with better experimental designs will be necessary to confirm the effectiveness of MCP for depression.

Longitudinal evolution of meaning in life and its relationship with coping strategies in Spanish patients with a breast cancer diagnosis.

BACKGROUND: Changes in Meaning in life (MIL) have been shown to be particularly important when people face very stressful events such as receiving a cancer diagnosis and treatment. Active coping strategies have been related to higher levels of MIL in people with a diagnosis of cancer. OBJECTIVE: To explore the evolution of MIL in a sample of cancer patients at the time of their diagnosis and three, six, and nine months after surgery, and identify the association between coping strategies three months after diagnosis (T2) and levels of MIL at the different moments in the cancer process (T1-T4). METHODS: We assessed MIL at diagnosis and three, six, and nine months after surgery, and coping strategies (fighting spirit, anxious preoccupation, hopelessness, fatalism, and cognitive avoidance) three months after surgery, in 115 women with a diagnosis of Stage I-III breast cancer. RESULTS: We found higher levels of MIL nine months after surgery, compared to previous stages. MIL correlated significantly and positively with a fighting spirit and cognitive avoidance, and negatively with hopelessness and anxious preoccupation. CONCLUSIONS: Results highlight the importance of coping in relation to meaning-making processes in cancer. Meaning-centred interventions could help patients who are in the process of coping with cancer to make sense of their lives and the experience.

Spanish adaptation of the Burden Assessment Scale in family caregivers of people diagnosed with borderline personality disorder.

BACKGROUND: Caregiving is a strong source of stress and leads the family caregiver to experience the burden of being responsible for the care of a severely mentally ill family member. The Burden Assessment Scale (BAS) assesses burden in family caregivers. This study aimed to analyze the psychometric properties of the BAS in a sample of family caregivers of people diagnosed with Borderline Personality Disorder (BPD). METHODS: Participants were 233 Spanish family caregivers (157 women and 76 men aged between 16-76 years old, M = 54.44, SD = 10.09) of people diagnosed with BPD. The BAS, the Multicultural Quality of Life Index, and the Depression Anxiety Stress Scale-21 were used. RESULTS: An exploratory analysis resulted in a three-factor 16-item model (Disrupted Activities; Personal and Social Dysfunction; Worry, Guilt, and Being Overwhelmed) with an excellent fit (χ2(101) = 56.873, p = 1.000, CFI = 1.000, TLI = 1.000, RMSEA = .000, SRMR = .060), good internal consistency (ω = .93), a negative correlation with quality of life, and a positive correlation with anxiety, depression, and stress. CONCLUSION: The model obtained for the BAS is a valid, reliable, and useful tool for assessing burden in family caregivers of relatives diagnosed with BPD.

Family connections vs treatment at usual optimized in the treatment of relatives of people with suicidal behavior disorder: study protocol of a randomized control trial.

BACKGROUND: Relatives of people diagnosed with suicidal behavior disorder (SBD) feel guilty, afraid, hopeless, depression and anxiety. It is necessary to help the relatives of people with SBD to reduce their discomfort and burden. Family Connections (FC) is a program that has been shown to be effective in reducing burden, depression, and anxiety, and increasing dominance and validating behaviors in relatives of people with borderline personality disorder. However, there are no RCTs that demonstrate the efficacy of the FC program in patients with SBD. Our research team adapted FC for relatives of people with SBD for delivery in the Spanish population (FC-SBD). The FC-SBD program contains 12 two-hour sessions held once a week. The first aim is to verify the efficacy of the FC-SBD intervention for relatives of people diagnosed with SBD in a randomized control trial with a Spanish sample. The second objective is to analyze the feasibility and acceptance of FC-SBD in relatives. The third aim is to analyze whether the changes produced in the psychological variables in the relatives after the intervention are related to changes in the psychological variables of the patients. This paper presents the study protocol. METHODS: The study design consists of a two-arm randomized controlled trial with two conditions: FC-SBD or Treatment as usual optimized (TAU-O). Participants will be relatives of patients who meet DSM-5 criteria for SBD. The caregivers` primary outcome measures will be the BAS. Secondary outcomes will be DASS-21, FES, DERS, QoL. The patient's primary outcome measures will be the frequency of critical incidents with the family member with SBD. Secondary measures will be the INQ, PHQ-9, OASIS. Participants will be assessed at pretreatment, post-treatment, and 6-month follow-up. The intention-to-treat principle will be used when analyzing the data. DISCUSSION: This study will provide results that confirm the efficacy of the FC-SBD in relatives of people with SBD. These results will also confirm its good acceptance by family members and help us to find out whether it is a good program to improve the prevention of suicidal behaviors in the family environment. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05157607 . Registered 15 December 2021.

Trajectory Analysis of Suicidal Ideation in Spanish College Students Using Ecological Momentary Assessment.

Introduction: Suicide is a preventable death in young people. It is well known that suicide behavior is a multicausal phenomenon. However, suicidal ideation (SI) commonly underlies suicide, and Ecological Momentary Assessment (EMA) can help us to better characterize it and its risk and protective factors in the short term. We aimed, first, to investigate the estimated prevalence and trajectories of SI in a community sample of Spanish college students using an EMA methodology and, second, explore the associations between risk and protective factors and SI categorized as moderate or low. Materials and Methods: A total of 737 participants followed the EMA during a period of 6 months. We estimated the prevalence and trajectories of SI and the associations between depressive symptoms, positive and negative affect, thwarted belongingness, perceived burdensomeness, cognitive reappraisal, emotional suppression, and purpose in life with the MEmind smartphone App. SI was assessed 14 times during this period. Results: Twenty-eight participants referred to SI at least once in longitudinal assessments. We found a lack of curvature and, thus, a relatively stable trajectory of SI. Two groups of latent dimensions were observed related to risk and protective factors of SI. One latent dimension of the risk factors (higher levels of thwarted belongingness, perceived burdensomeness, depressive symptoms, negative affect, and emotional suppression) best represented the group with moderate levels of SI, and a second latent dimension of protective variables (positive affect, cognitive reappraisal, and purpose in life) best represented the group with lower levels of SI. Discussion: These findings may indicate that students with a sense of having a life worth living, in addition to having the ability to reevaluate their negative beliefs, are less likely to experience high levels of SI. Therefore, purpose in life would be a protective factor against the presence of SI.

Corrigendum: Meaning in Life Mediates Between Emotional Deregulation and Eating Disorders Psychopathology: A Research From the Meaning-Making Model of Eating Disorders.

[This corrects the article DOI: 10.3389/fpsyg.2021.635742.].

Meaning in Life Buffers the Association between Perceived Burdensomeness, Thwarted Belongingness, and Frequency of Non-Suicidal Self-Injuries in Spanish Adolescents.

BACKGROUND: Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) might be negatively associated with thwarted belongingness and perceived burdensomeness. To date, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of lifetime NSSI in Spanish adolescents. AIMS: (a) To test whether thwarted belongingness and perceived burdensomeness are associated with frequency of lifetime NSSI; (b) to test whether MIL moderates the association between thwarted belongingness and frequency of lifetime NSSI; and (c) to test whether MIL moderates the association between perceived burdensomeness and frequency of lifetime NSSI. METHOD: The sample consisted of N = 1531 participants (n = 736, 48.1%, were men, and n = 795, 51.9%, were women) between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescent Version, and Interpersonal Needs Questionnaire. Moderation analyses were performed. RESULTS: No statistically significant differences were found in the frequency of lifetime NSSI in the adolescents based on gender. Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of lifetime NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of lifetime NSSI, and between perceived burdensomeness and the frequency of lifetime NSSI. CONCLUSIONS: Thwarted belongingness and perceived burdensomeness might be positively associated with the frequency of lifetime NSSI, and MIL might be negatively associated with the frequency of lifetime NSSI. Thus, adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve assessment and treatment protocols for adolescents with NSSI.

Confirmatory factor analysis and psychometric properties of the Emotion Regulation Questionnaire in participants with personality disorders.

Emotional dysregulation is a key symptom in participants with personality disorders. The Emotional Regulation Questionnaire (ERQ) has been studied with nonclinical samples; however, it is necessary to confirm the factorial structure of the ERQ in participants with personality disorders. The aims of the present study were to confirm the factorial structure of the Spanish version of the ERQ and analyse its psychometric properties as well as the association between the ERQ and the Borderline Symptoms List (BSL-23) and the Difficulties in Emotion Regulation Scale (DERS). The overall sample was composed of 250 patients with personality disorders, of whom 195 met the criteria for borderline personality disorder. Confirmatory factor analysis was conducted. The two-factor model showed an acceptable fit, similar to the original structure, in the participants with personality disorders and with borderline personality disorder. Cognitive reappraisal was negatively correlated with the DERS and BSL-23, and expressive suppression was positively correlated with the BSL-23. The ERQ is a reliable and valid instrument to evaluate emotional dysregulation in participants with personality disorders and participants with borderline personality disorder.

Characteristics and Unidimensionality of Non-suicidal Self-injury in a Community Sample of Spanish Adolescents.

BACKGROUND: Few studies have explored the prevalence and unidimensional structure of Non-Suicidal Self-Injury (NSSI) in Spanish adolescents. METHOD: In this study, we estimated the prevalence, types, and functions of NSSI in 1,733 Spanish adolescents, and we tested the unidimensional factorial structure of non-suicidal self-injury. RESULTS: 24.6% of the adolescents referred to having self-injured at least once during their lifetime, and 12.7% had self-injured using more severe methods of NSSI. The most frequent types of NSSI were interfering with wounds (14.6%), scratching (12.5%), and hitting (11.7%). We found no differences between genders in NSSI frequency. The majority of the participants who self-injured referred to intrapersonal functions. The confirmatory factor analyses of the ISAS-I structure showed a single factor with 10 items, thus supporting the unidimensionality of the construct of NSSI. CONCLUSIONS: NSSIs reflect difficulties in regulating emotions or managing interpersonal relationships in young Spanish people, and these behaviours seem to constitute a unique and latent dimension. Thus, there is a need for intervention programmes focused on managing problems of emotional regulation and maladaptive self-injury behaviours.

Meaning in Life Mediates Between Emotional Deregulation and Eating Disorders Psychopathology: A Research From the Meaning-Making Model of Eating Disorders.

Emotional dysregulation, age, gender, and obesity are transdiagnostic risk factors for the development and maintenance of eating disorders (EDs). Previous studies found that patients with ED had less meaning in life than the non-clinical population, and that meaning in life acted as a buffer in the course of ED; however, to the data, there are no studies about the mediator role of meaning in life in association between the emotional dysregulation and the ED psychopathology. Objective: To analyze the mediating role of meaning in life in the relationship between emotional dysregulation and the ED psychopathology in three samples with diverse risk factors for ED. Method: Sample 1, n = 153 undergraduate young women; sample 2, n = 122 participants with obesity; and sample 3, n = 292 participants with ED. Multiple mediation analysis was performed. Results: Sample 1: meaning in life showed a mediation effect between emotional dysregulation and the ED psychopathology (direct effect ß = 0.390, p < 0.05) (indirect effect ß = 0.227, p < 0.05), body satisfaction (direct effect ß = -0.017, p < 0.05) (indirect effect ß = -0.013, p < 0.01), and depression symptoms (direct effect ß = 1.112, p < 0.001) (indirect effect ß = 0.414, p < 0.001); sample 2: meaning in life showed a mediation effect between emotional dysregulation and binge eating and purging behaviors (direct effect ß = 0.194, p < 0.01) (indirect effect ß = 0.054, p < 0.05) and depression symptoms (direct effect ß = 0.357, p < 0.001) (indirect effect ß = 0.063, p < 0.05); sample 3: meaning in life showed a mediation effect between emotional dysregulation and the ED psychopathology (direct effect ß = 0.884, p < 0.001) (indirect effect ß = 0.252, p < 0.007), body satisfaction (direct effect ß = -0.033, p < 0.05) (indirect effect ß = -0.021, p < 0.001), borderline symptoms (direct effect ß = 0.040, p < 0.001) (indirect effect ß = 0.025, p < 0.001), and hopelessness (direct effect ß = 0.211, p < 0.001) (indirect effect ß = 0.087, p < 0.001). Conclusions: These studies suggest the importance of considering meaning in life as a variable in the onset and maintenance of ED.

Meaning-making as a mediator of anxiety and depression reduction during cognitive behavioral therapy intervention in participants with adjustment disorders.

There is a consensus among researchers about the link between low meaning in life and anxiety and depressive symptoms. One unanswered question is whether meaning-making is a mediator of the change in anxiety and depression symptoms in participants with adjustment disorders during cognitive behavioural therapy (CBT) treatment. The aims of this study were (a) to analyse whether there was meaning-making during the application of the CBT, (b) to analyse whether meaning-making was a mediator of anxiety psychopathology and (c) to analyse whether meaning-making was a mediator of depressive symptoms. The sample was composed of 115 patients who satisfied the full Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for adjustment disorder as their primary diagnosis and completed CBT treatment in a primary care mental health service: 74.78% women, n = 86, and 25.22% men, n = 29, with a mean age of 41.89 (standard deviation [SD] = 10.39) years. The diagnosis was established using the Structured Clinical Interview for DSM-5 (SCID-5), and participants filled out the Beck Anxiety Inventory, the Beck Depression Inventory and Purpose in Life questionnaires. The therapists were clinical psychologists with experience in clinical assessment. A repeated-measures analysis of variance (ANOVA) and two mediation analyses using the bootstrap method were performed. The results indicated that (a) There was meaning-making during the CBT because the treated sample showed a statistically significant improvement in meaning in life, and (b) meaning-making during the CBT was a partial mediator between anxiety symptoms and depressive symptoms before and after the treatment. The present study suggests that meaning in life could be an important variable in the psychopathology of adjustment disorders.

Mindfulness-Based Cognitive Therapy for Spanish Oncology Patients: The Bartley Protocol.

OBJECTIVES: The aim of this study is to analyse whether MBCT will reduce the general level of psychopathology, increase the quality of life, and increase meta-knowledge about their emotional state in Spanish participants with cancer. METHOD: The sample consisted of n = 88 Spanish oncology patients. This was a non-randomized, two-group (experimental vs waiting list) trial conducted in a naturalistic setting. We evaluated psychological distress (BSI-18), quality of life (FACT-G), and meta-knowledge of emotions (TMMS-24). RESULTS: The participants who received the MBCT treatment improved more than the control group in distress (F= 6.79; p = .01, BSI-18), depression (F= 8.38; p = .005 ), quality of life -physical health (F = 5.56; p = .02), emotional state (F = 7.06; p= .01), and functional capacity (F = 7.98; p = .006), as well as meta-knowledge about their emotional state (F = 35.4; p = .01), and its subscales of perception, (F = 8.95; p = .004), comprehension, (F= 16.06; p = .01), and repair (F = 15.67; p = .01). CONCLUSIONS: The Bartley MBCT program was feasible and showed promise in improving general psychopathology (depression), improving patients' quality of life, and increasing meta-knowledge about their emotional state.

"Dissociation, posttraumatic stress symptoms, emotional dysregulation, and invalidating environments as correlates of NSSI in borderline personality disorder patients".

Theoretical models have proposed that inadequate caregiving environments undermine the development of adaptive regulation strategies at early stages and can lead children to inadequate regulation skills for coping with distress, such as dissociation, posttraumatic stress, and NSSI. The main aim of this work was to examine NSSI types and functions and the relationship between the aforementioned variables and lifetime NSSI in 102 patients with BPD diagnoses or BPD subthreshold symptoms. In addition, we explored the moderator role of dissociation between invalidating environments and NSSI. Results showed that 83.7% of the sample self-injured more than 5 times during their lifetime; 62.7% swallowed dangerous substances; 58.8% hit themselves; and 46% cut themselves. Regression analyses revealed that the model including variables with significant correlations with NSSI explained 27% of the variance in NSSI, with dissociation and invalidating behaviors of the father best explaining the variance in NSSI. In addition, dissociation moderated the association between invalidating behaviors of the father and NSSI. These results highlight the important role of invalidating environments, dissociation, and posttraumatic stress symptoms in NSSI in patients with BPD, and the need to assess and treat dissociation and posttraumatic symptoms in this population.

Confirmatory factor analysis of the Inventory of Statements About Self-injury in a Spanish clinical sample.

OBJECTIVES: The main aim of the present study was to confirm the two-factor structure of the Inventory of Statements About Self-injury- Part II (ISAS-II), analyze its psychometric properties and test-retest reliability of Parts I and II of the ISAS. METHOD: The sample was composed of 355 Spanish participants diagnosed with eating disorders or borderline personality disorder (mean age 27.89, standard deviation = 13.31; 315 women, 40 men). Two models proposed for the ISAS-II were analyzed by means of confirmatory factorial analysis. RESULTS: A two-factor model was confirmed, and a model with self-care included in the intrapersonal factor was preferable. The ISAS-II showed positive correlations with emotional dysregulation. Test-retest reliability showed statistically significant correlations at 7 months (n = 123). CONCLUSION: The ISAS-II is a valid instrument to assess nonsuicidal self-injury in Spanish populations, making it possible to assess these behaviors, which require valid and reliable measures worldwide.

Early intervention with cognitive behavioral therapy reduces sick leave duration in people with adjustment, anxiety and depressive disorders.

Background: Early intervention in workers diagnosed with mental disorders is associated with a lower incidence of relapse and shorter sick leave. However, no studies have been carried out on the effect of early intervention using an evidence-based therapy, Cognitive Behavioral Therapy (CBT), on people with sick leave.Aims: The objectives of the present study are to study whether the type of intervention (early or late) will affect the total duration of the sick leave, the partial duration of the sick leave, the duration of the psychotherapy and the time until return to work after the psychotherapy ends. The sample was composed of 167 participants who were on sick leave for adjustment disorders, anxiety disorders or depressive disorder.Results: The participants who had early intervention with CBT had a significantly shorter duration of total sick leave and partial sick leave, and a shorter time until returning to work after the psychotherapy ended than those who had late intervention. There were no statistically differences in the duration or efficacy of the psychotherapy.Conclusion: We can suggest that providing early access to CBT significantly reduces the length of sick leave in patients with mental disorders.

Meaning in life moderates hopelessness, suicide ideation, and borderline psychopathology in participants with eating disorders: A longitudinal study.

Participants with eating disorders (EDs) experience identity problems, hopelessness, and suicide ideation. Research has confirmed the link between the experience of low meaning in life (MIL) and psychopathology. However, there is a lack of research focusing on MIL in ED. OBJECTIVES: The objectives of this study are as follows: (a) to analyze whether MIL at baseline moderates the association between ED psychopathology at baseline and borderline symptoms, hopelessness, and suicide ideation at follow-up and (b) to analyze whether MIL moderates the association between suicide ideation, hopelessness, and borderline symptoms at baseline and at the 7-month follow-up. METHOD: The sample was composed of 300 participants with ED at baseline and 122 at the 7-month follow-up. The participants filled out the Purpose in Life, Eating Attitude Test, Borderline Symptoms List, Hopelessness Scale, and Suicide Ideation Scale. RESULTS: (a) MIL at baseline moderated the association between ED psychopathology at baseline and borderline symptoms, hopelessness, and suicide ideation at the follow-up; (b) MIL moderated the association between suicide ideation, hopelessness, and borderline symptoms at baseline and at the 7-month follow-up. CONCLUSION: MIL could be a relevant variable in the ED psychopathology.

Psychometric properties of the Spanish version of the involvement evaluation questionnaire in caregivers of patients with borderline personality disorders.

The involvement evaluation questionnaire (IEQ) was created to evaluate the caregiver's experience of burden and the consequences of providing care to people with psychotic disorders. To date, the IEQ has not been validated with caregivers of people diagnosed with borderline personality disorder (BPD). The main objective of the study was to confirm the psychometric properties and factorial structure of the Spanish version of the IEQ in 151 caregivers of people with BPD, with an average age of 54.52 (SD = 9.91). Two models were tested by means of confirmatory factor analysis, following the original factor structure. The Models 1 and 2 displayed adequate fit, with comparative fit index and Tucker-Lewis index > 0.90 and root-mean-square root of approximation < 0.08; however, Model 2 was more parsimonious. The Cronbach's alphas are adequate, ranging from 0.70 to 0.85. The consequences of providing care to people with BPD had a low or moderate association with the Level of Expressed Emotion scores. IEQ scores of caregivers of people diagnosed with BPD with psychiatric comorbidity did not differ from those of caregivers of people diagnosed with BPD without psychiatric comorbidity. The IEQ has adequate psychometric properties and can be utilized to assess burden in caregivers of people with BPD.

Meaning in life is associated with the psychopathology of eating disorders: differences depending on the diagnosis.

Previous studies indicated that meaning in life was inversely associated with eating behaviors and a negative attitude toward food, body satisfaction, and borderline symptoms. However, research on the association between meaning in life and eating disorder psychopathology is scarce, and there are no studies on the association between meaning in life and the eating disorder psychopathology depending on the diagnosis. The aim of the present study is to verify whether meaning in life is differentially associated with a broad range of psychopathology symptoms commonly observed in people with ED, depending on the diagnosis, in a sample of 240 ED patients. We found that meaning in life was negatively associated with eating behaviors and a negative attitude toward food, body satisfaction, borderline symptoms, and hopelessness in all types of eating disorders, regardless of the specific diagnosis. Moreover, the association with meaning in life was different depending on the type of eating disorders. Specifically in the participants with Anorexia Nervosa Restrictive, meaning in life had a higher percentage of explained variance in the eating disorders psychopathology (between 30% and 65%). Therefore, these results seem to indicate that, although meaning in life is an important variable in all the eating disorders subtypes, it is especially relevant in participants with the Anorexia Nervosa Restrictive subtype.

Non-suicidal Self-injury Differentiates Suicide Ideators and Attempters and Predicts Future Suicide Attempts in Patients with Eating Disorders.

OBJECTIVE: We aimed first to identificate psychopathological variables differentiating between suicide ideators, suicide attempters and patients without suicide ideation or attempts, and second to identificate better predictors of suicide attempts longitudinally. METHOD: We compared suicide ideation, hopelessness, borderline symptoms, frequency, types, number of different non-suicidal self-injury (NSSI) methods, intrapersonal and interpersonal functionality of NSSI in a sample of 238 patients with Eating Disorders (1) with no history of suicide ideation or suicide attempts (n = 150); (2) with recent suicide ideation (n = 65); and (3) with suicide attempts in the previous year (n = 23). In addition, we analyzed the predictive power of the mentioned variables over the number of suicide attempts 7 months after the first assessment. RESULTS: The group of suicide attempters showed a major number of different methods of NSSI, higher frequency of NSSI, cutting, and more NSSI intra and interpersonal functions than the group of ideators. Unlike in previous studies, hopelessness did not differentiate between patients with ideation and suicide attempts. In addition, the best predictor of suicide attempts 7 months later was frequency of NSSI at T1 (N = 123). CONCLUSIONS: Cutting, frequency and different methods of NSSI, intra and interpersonal functions were risk factors that differentiated ideators from attempters, being frequency of NSSI the best predictor of suicide attempts longitudinally. Thus, patients with ED with NSSI should be the focus of preventive interventions for suicidal behavior.