7 - (IOP 33) Eating Disorder Symptoms, Interpersonal Needs, and Suicide Ideation Among Iranian Adolescents: Multi-time-point Network Analysis

Suicidal ideation (SI) is strikingly prevalent in Iran, with over one-third of Iranian adults reporting a lifetime history of SI. Eating disorder (ED) symptoms commonly co-occur with SI, and recent research has focused on identifying transdiagnostic risk factors for both ED symptoms and SI. Interpersonal needs (i.e., thwarted belongingness, perceived burdensomeness) have demonstrated consistent associations with ED symptoms and SI in Western samples when using network analysis (i.e., a data analytic strategy that emphasizes direct interactions among symptoms rather than psychopathology stemming from latent variables). To our knowledge, no research in Iranian samples has applied longitudinal network analysis to examine the interplay between ED symptoms, SI, and interpersonal needs, which would increase our understanding of commonly comorbid mental health symptoms. Thus, the aim of this current study was to examine the dynamic associations between ED symptoms, SI and interpersonal needs using a network approach. Iranian adolescents (N=1,243) completed the Eating Pathology Symptoms Inventory, Interpersonal Needs Questionnaire, and Depressive Symptom Inventory Suicidality Subscale at three time points (baseline, one month, three months). We used network analysis to identify central symptoms and key connections across temporal, contemporaneous, and between-subject networks. We found that all three networks had satisfactory stability. In the temporal network, perceived burdensomeness (PB) exhibited the highest In-Expected Influence, while binge eating (BE) had the highest Out-Expected Influence. In the contemporaneous network, purging emerged as the most influential node, whereas muscle building was the most influential in the between-subject network. Regarding bridge expected influence (BEI; measures how strongly a node connects and influences different clusters in a network), BE showed the largest BEI1 and BEI2 in the temporal network, PB in the contemporaneous network, and SI in the between-subject network. These findings highlight key intervention targets for ED symptoms and SI. Reducing PB may help alleviate distress over time, while addressing BE could prevent the worsening or progression of other symptoms. Given the primary role of binge symptoms in both predicting other symptoms and bridging them over time, emphasizing interventions targeting BE may be particularly crucial. Targeting purging, muscle-building behaviors, and SI in relevant contexts may enhance treatment effectiveness and improve mental health outcomes.