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Symposia

Suicide and Self-Injury

Daily Life Research on Self-Injurious Thoughts and Behaviors among LGBTQ+ Individuals: Towards Understanding Momentary Mechanisms in a High-Risk Population

4 - (SYM 76) Time-varying Associations Between Interoception, Eating Disorder Symptoms, and Self-injurious Thoughts in Transgender or Gender Expansive Adults with an Eating Disorder

Sunday, November 23, 2025
2:56 PM - 3:13 PM CST
Location: Strand 13A&B, Level 2
Keywords: Suicide, Self-Injury, LGBTQ+
Recommended Readings: Testa, R. J., Michaels, M. S., Bliss, W., Rogers, M. L., Balsam, K. F., & Joiner, T. (2017). Suicidal ideation in transgender people: Gender minority stress and interpersonal theory factors. Journal of Abnormal Psychology, 126(1), 125.,   Nicholas, J., & Bresin, K. (2024). Everyday sexual and gender minority stress and health: A systematic review of experience sampling studies. Archives of Sexual Behavior, 53(4), 1221-1243.,   Kohnepoushi, P., Nikouei, M., Cheraghi, M., Hasanabadi, P., Rahmani, H., Moradi, M., ... & Moradi, Y. (2023). Prevalence of suicidal thoughts and attempts in the transgender population of the world: a systematic review and meta-analysis. Annals of General Psychiatry, 22(1), 28.,   Mereish, E. H., Peters, J. R., Brick, L. A., Killam, M. A., & Yen, S. (2023). A daily diary study of minority stressors, suicidal ideation, nonsuicidal self-injury ideation, and affective mechanisms among sexual and gender minority youth. Journal of Psychopathology and Clinical Science, 132(4), 372.,  
Abstract Body

Due to minority stressors, transgender and gender-expansive (TGE) adults are at elevated risk for eating disorder (ED) symptoms, non-suicidal self-injury (NSSI), and suicidal ideation (SI; Connolly et al., 2016; Randall et al., 2022). ED symptoms and self-injurious thoughts and behaviors (SITBs) fluctuate nonlinearly within a person (Wang et al., 2023). Additionally, low body trust may be associated with ED symptoms and SITBs in TGE adults (Frietchen et al., 2025). However, limited research has examined the time-varying associations between ED symptoms, SITBs, and body connection/trust in TGE adults, which is the aim of the current study. 



 



Three TGE adults with a restrictive ED and SI participated in an ecological momentary assessment (EMA) study (i.e., prompts five times a day for 21 days) that assessed body connection, body trust, SI, NSSI urges, and restrictive eating (urges and behavior). Idiographic time-varying vector autoregressive analysis was conducted for each participant, as this method does not assume static prediction patterns over time (Haslbeck et al., et al., 2021). 



 



All participants reported low body trust scores throughout the EMA period; participant means ranged from 0 to 21.9. Prediction patterns were largely idiographic. The most consistent findings were that: restriction urges positively predicted passive SI; active SI positively predicted itself; passive SI positively predicted NSSI urges; restriction urges and body trust negatively predicted NSSI urges; and restriction urges positively predicted itself. 



 



These results highlight the complexity of predicting ED symptoms and SITBs, particularly in TGE samples where risk for ED symptoms and SITBs may be amplified by minority stress. These results also emphasize that SITBs and ED symptoms influence each other over time and within people. Notably, all three participants reported relatively low body trust throughout the EMA period. Further research should consider external factors (e.g., gender affirmation) and therapeutic interventions (e.g., LGBTQ-affirmative CBT) and their efficacy in improving body trust amongst TGE individuals seeking treatment for EDs and SITBs.