# Cutting into the Mirror: Association of Body Image Concerns with Non-Suicidal Self-Injury in Adolescents and Young Adults with Eating Disorders

## TL;DR

This study shows that adolescents and young adults with eating disorders and self-harm behaviors have greater body image concerns and more severe mental health issues.

## Contribution

The study identifies body image concerns as a shared risk factor between eating disorders and non-suicidal self-injury.

## Key findings

- Participants with eating disorders and self-injury had higher body image concerns on all BUT-a and EDI-2 scales.
- The ED + NSSI group showed higher scores in Ineffectiveness, Social Insecurity, and Asceticism traits.
- Patients with ED and NSSI had a higher prevalence of depressive disorders.

## Abstract

Non-suicidal self-injury (NSSI) is a transdiagnostic behavior often found in patients with eating disorders (EDs). Both conditions plateau in adolescence and share psychopathological traits. Our study focuses on body image concerns, a complex psychopathological construct associated with both NSSI and ED, as a shared risk factor between the two. This study included 73 participants aged 14–24 recruited from the Eating Disorders Day Hospital, University Hospital of Bari, Italy, divided into two groups: those with an ED and NSSI (ED + NSSI) and those with an ED without NSSI (ED-only). Using standardized assessments such as clinical and demographical data, the Body Uneasiness Test (BUT-a), and the Eating Disorder Inventory (EDI-2), this study found that the ED + NSSI group exhibited significantly higher body image concerns in all main scales and subscales of BUT-a and EDI-2. Moreover, the ED + NSSI group presented higher scores on psychopathological traits associated with a more severe ED, namely Ineffectiveness, Social Insecurity, and Asceticism. Finally, patients in the ED + NSSI group were diagnosed with a higher degree of depressive disorders. These findings highlight significant associations between body image concerns and NSSI in patients with an ED, also showing a higher risk of psychiatric comorbidities and a more severe ED profile in these patients.