Reconnecting to Internal Sensations and Experiences
RISE is a four-part, tech-based intervention targeting interoception, or our ability to recognize and respond to internal bodily states and emotions. Poor interoception has been implicated in numerous negative psychological disorders and physical health outcomes, including eating disorders, self-injury, and suicidal behavior. This intervention is currently being piloted in undergraduates, and will implemented in the military in Fall 2019.
Therapeutic Evaluative Conditioning for Eating Disorders
TEC-ED is an app-based game designed to reduce eating disorder behaviors and identification with eating disorder cognitions. To this end, the app employs therapeutic evaluative conditioning to change associations between targeted symptoms and the self over time. In collaboration with Dr. Joseph Franklin, we are testing this app with students at Miami University. This study is ongoing, with recruitment expected to continue into Fall 2019.
Intra-individual Network Analysis of Suicidal Behavior
Suicidal behavior is complex, dynamic, and differs vastly for every affected person, making it difficult to both fully understand and accurately predict. This study seeks to further our understanding of suicidal behavior on an individual level by applying network theory to known correlates and precedents of suicide and assessing these symptoms using ecological momentary assessments. This study will be conducted within the military and is set to begin recruitment in Fall 2019.
In addition to the lab's ongoing projects, graduate students conduct a large proportion of the REDS research. These projects cover a wide range of topics under the umbrella of suicide and eating disorder research. Below is just a sampling of some of our graduate students' current projects.
Cognitive bias modification for perfectionism in eating disorders
Multiple facets of interoception in suicidal behavior
Applications of network analysis to eating disorders and suicidal behavior
Cognitive and interpersonal symptom interactions in eating disorders
Use of novel techniques and paradigms in understanding self-injury
Executive functioning in eating disorders
Comorbidity of self-injury and eating disorders
PAST RESEARCH AND FUTURE DIRECTIONS
Interface between eating disorders and suicidality
Interpersonal psychological theory of suicide: The capability to die by suicide is comprised of pain tolerance and fearlessness about death, and is acquired over time through repeated experience with painful and provocative events (Joiner, 2005). Our lab has proposed and found preliminary support for the hypothesis that people with eating disorders possess high levels of acquired capability for suicide due to their experiences with painful and provocative weight control methods, like over-exercise and restriction (Smith, et al., 2013; Selby, Smith, et al., 2010). In collaboration with the Witte Lab, we are also currently conducting projects examining the IPTS constructs within a residential eating disorder population.
Interoceptive Awareness: Interoception is crucial for recognizing sensations such as hunger and pain and responding accordingly. Recent research in the field of interoception has produced exciting findings that are applicable to disordered eating and suicide. For instance, interoceptive awareness has been found to have a negative relationship with body objectification, body objectification has a positive relationship with self-injury, and self-injury has a negative relationship with interoceptive awareness. Based on this research, we have conducted studies finding that individuals who are out of touch with their bodies and/or perceive their bodies in a negative way are more readily able to inflict pain upon their body in the form of suicidal behavior (Forrest, Smith, White, & Joiner, 2015). We are also conducting research developing techniques to improve interoceptive awareness.
Disgust sensitivity: Recent studies have found relationships between disgust and mental illnesses, such as posttraumatic stress disorder, borderline personality disorder, and obsessive-compulsive symptoms. Previous research in the lab has identified disgust sensitivity for death-related stimuli as a potential indicator of fearlessness about death (Velkoff, Forrest, Dodd, & Smith, 2016).
Implicit cognition: We are currently working on developing a novel implicit association task to measure suicidality and predict suicidal ideation and behavior.
Genetic markers: The first study to examine the influence of genetics and environment on the factors of Joiner’s (2005) theory of suicide found that environmental influences appear to play an important role in the etiology of belongingness and burdensomeness, whereas acquired capability for suicide appears to be influenced by a combination of both genetic and non-shared environmental factors (Smith, et al., 2012).
Prevention: We have conducted a set of studies (Smith, et al., 2014; Silva, Smith, Dodd, et al., 2016) investigating gatekeeper training among mental health care workers across the United States.
Psychophysiological markers: We have used facial EMG to examine the role of disgust response in the perception of emaciated and overweight bodies (Dodd, Velkoff, Forrest, Fussner, & Smith, 2017). Additionally, we are investigating cardiac impedance (i.e., challenge vs. threat responses) in relation to a lab based stressor among highly perfectionistic individuals.
Biological markers: Past work from our lab has tested the relationship between prenatal testosterone exposure and the development of disordered eating in women (Quinton, Smith, & Joiner, 2011) and men (Smith, et al., 2009
Cognitive bias modification: In conjunction with the Clerkin Lab, we are currently working to develop an interpretation retraining intervention for maladaptive perfectionism.
Over-exercise: We have a number of projects examining the effects of over-exercise on mental health outcomes (Smith, Yeager, & Dodd, 2015; Forrest, Smith, Fussner, Dodd, & Clerkin, 2016).
Web-based treatment for eating disorders: In collaboration with Dr. Joseph Franklin, we are testing a web app that uses therapeutic evaluative conditioning (TEC) to reduce eating disordered behaviors.
We strongly value understanding the cultural contexts that affect eating behavior and suicidality. To that end, we are conducting work in the following areas:
Cross-cultural work: In the past, we collected data on Japanese women to test how perfectionism and body dissatisfaction interact to produce disordered eating (Smith & Joiner, 2008). Upcoming research projects will examine experiences of burdensomeness and belongingness, along with collegiate stressors such as exclusion and academic stress, as predictors of suicide risk among Chinese international college students. Additionally, in collaboration with Dr. Vaishali Raval, we collected data from college students in India examining constructs related to suicidality and academic stressors to better understand suicidality in this population. We have several in prep projects stemming from this data.
Sexual minority populations: We found that body fat dissatisfaction was a better predictor of disordered eating behaviors than muscularity dissatisfaction in both gay and heterosexual men (Smith, et al., 2011). Previous work in the lab examined suicide risk factors among sexual minority women (Velkoff, Forrest, Dodd, & Smith, 2016), and ongoing research projects are investigating eating disorder symptoms among both sexual minority men and women.
Weight stigma: In collaboration with Dr. Jeff Hunger, we conducted several projects examining the impacts of weight stigma on suicidality (Hunger, Dodd, & Smith, in press; Hunger, Dodd, & Smith, invited revision). We continue to explore this line of research.