Personalized models of eating disorder symptoms and suicide risk in anorexia nervosa spectrum disorders: protocol for a longitudinal, passive-sensing study.

BACKGROUND: Individuals with Anorexia Nervosa and Atypical Anorexia (termed here Anorexia Nervosa Spectrum Disorder, or ANSD) are at elevated suicide risk, yet limited research has explored the progression from suicidal ideation to suicide attempts among individuals with ANSD. Leveraging intensive real-time data, the present study will identify the behavioral, physiological, and psychological mechanisms linking ANSD and suicide. METHODS: Our sample will comprise 230 adults with ANSD and current and/or lifetime suicidality. Participants will complete 21 days of ecological momentary assessment while wearing a sensor band that continuously monitors physiological indices of emotion regulation and arousal. Follow-up assessments will be conducted at one month, six months, and 12 months after baseline. Using a novel network analytic approach, we will integrate self-report and physiological data to develop group- and individual-level symptom models. These models will allow us to identify features that (1) maintain comorbid ANSD and suicidality, and (2) predict future suicidal thoughts and behaviors, at both the group and individual level. DISCUSSION: Ultimately, findings from this project will facilitate the development of highly personalized intervention strategies that prevent suicidal behaviors before they occur, as well as personalized treatments that effectively treat ANSD symptoms in real-time.