Longitudinal relationships between muscle dysmorphia symptoms and suicidal ideation

Introduction Muscle Dysmorphia (MD) is a severe subtype of body dysmorphic disorder (BDD) that shares symptomatic overlap with eating disorders. Although associations between eating disorders/BDD and suicidality are well documented, research has rarely examined associations between MD symptoms and suicidality, which is concerning given MD is associated with additional suicide risk factors compared with these disorders. Further, existing associations between MD symptoms and suicidality have yet to establish temporal ordering for these relationships. Therefore, the current study investigated longitudinal relationships between MD symptoms and suicidal ideation to establish the direction of the MD-suicidality relationship. Methods Participants were 272 US men displaying sub-clinical MD symptoms who completed self-report measurement at three time points over 6 weeks. Longitudinal relationships between MD symptoms and suicidal ideation were examined using a three-wave autoregressive cross-lagged model. Results Certain MD symptoms were longitudinally predicted by suicidal ideation. Specifically, suicidal ideation longitudinally predicted increased drive for size and appearance intolerance. Conclusions Results may suggest that individuals engage in MD symptoms potentially to cope with distressing thoughts of suicide. Clinicians should provide clients with comorbid MD and suicidality with appropriate coping tools to manage distress from suicidal thoughts outside of engaging in compulsive exercise characteristic of MD symptoms.