(PS9-D100) Associations Between Pro Eating Disorder Website Use and Self-injurious Thoughts and Behaviours

Background: Online platforms promoting eating disorder behaviours are widespread, with one estimate suggesting that pro-eating disorder search terms are entered in Google over 10 million times every year. One type of commonly used platform—pro-anorexia (“pro-ana”) and pro-bulimia (“pro-mia”) websites—provides users with graphic visual content (e.g., “thinspiration”) and eating disorder techniques to promote the maintenance of extremely low body weight and the normalization of eating disorder behaviours among online community members. Engagement with these websites is associated with poorer psychological outcomes such as depression and anxiety as well as lower quality of life; however, less is known about the relationship between the use of pro-ana/pro-mia websites and a range of self-injurious thoughts and behaviours.

Aims: The aims of the current study were three-fold. First, we aimed to examine the association between pro-ana/pro-mia websites and self-injurious thoughts and behaviours, including non-suicidal self-injury (NSSI), suicide ideation and suicide attempts. Second, we aimed to examine whether the use of pro-ana/pro-mia websites was associated with the transition from suicidal thinking to suicide attempts. Third, as eating disorder behaviours tend to co-occur with self-injurious thoughts and behaviours, we aimed to examine these associations controlling for overall eating pathology.

Method: Participants were adults (N =320) recruited via an online platform (MTurk) who completed questionnaires assessing use of pro-ana/pro-mia websites, eating disorder behaviours (as measured by the Eating Pathology Symptoms Inventory), history of suicide ideation (i.e., “Have you ever seriously thought about killing yourself?”), attempts (i.e., “Have you ever tried to kill yourself?”) and NSSI (i.e., “Have you ever purposely hurt yourself without wanting to die, known as non-suicidal self-injury?”). Partial correlations were used to examine whether past use of pro-ana/pro-mia websites was associated with a history of NSSI, suicide ideation and suicide attempts, while controlling for overall eating pathology.

Results: Past usage of pro-ana/pro-mia websites was associated with a history of suicide ideation relative to non-ideators (r = .16, p =.01), NSSI relative to non-self-injurers (r = .18, p =.002), and suicide attempts relative to non-attempters (r = .15, p =.009). Past use of pro ana/mia websites was not associated with a history of suicide attempts relative to suicide ideators (r = .08, p =.29). All partial correlations controlled for overall eating pathology.

Conclusions: Use of pro-ana/pro-mia websites is associated with a range of self-injurious thoughts and behaviours but does not appear to be associated with the transition from suicidal thought to attempts. Clinicians working with individuals endorsing eating disorder behaviours should engage their clients in conversation surrounding their use of online platforms, as certain platforms such as pro-ana/pro-mia websites may promote maladaptive behaviours and are associated with self-injurious thoughts and actions, whereas other platforms may promote help seeking behaviours such as crisis support or online therapy.