RESEARCH ARTICLE Eating Disorder Symptoms and Suicidal Ideation: The Moderating Role of Disgust Carol Chu * , Lindsay P. Bodell, Jessica D. Ribeiro & Thomas E. Joiner Department of Psychology, Florida State University, Tallahassee, FL, USA Abstract Disgust has been implicated as a factor that maintains and exacerbates eating disorder (ED) symptoms. Emerging research sug- gests that disgust may be a risk factor for suicidality. Given the high rates of suicidality among individuals with EDs, we propose that disgust may contribute to the link between EDs and suicidality. To test this hypothesis, self-report data were collected from 341 young adults (66% women). Cross-sectional associations between disgust with the self, others and the world and disgust sen- sitivity and propensity, ED symptoms and suicidal ideation were examined using multivariate regression analyses. ED symptoms and body dissatisfaction were associated with increased suicidal ideation at high levels of disgust with the self and the world; at low levels of disgust, ED symptoms and body dissatisfaction did not significantly relate to suicidal ideation. Disgust may indicate risk for suicidal ideation among individuals with eating psychopathology. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. Received 27 February 2015; Revised 18 April 2015; Accepted 1 May 2015 Keywords eating disorder symptoms; disgust; suicidal ideation; suicide risk *Correspondence Carol Chu, Department of Psychology, Florida State University, 1107 West Call St., Tallahassee, FL 32306, USA. Email: chu@psy.fsu.edu Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/erv.2373 Although high rates of suicidal ideation and behaviour (suicidality) exist among individuals with eating disorders (EDs; Preti, Rocchi, Sisti, Camboni, & Miotto, 2011), little research has focused on factors that maintain symptoms of suicidality in this population. Recent evidence suggests that the basic emotion of disgust is central to the development and maintenance of a range of psychopathology, including ED symptoms (Olatunji & McKay, 2007). Although a recent review has implicated disgust as a risk factor for suicidality (Chu, Buchman-Schmitt, Michaels, Ribeiro, & Joiner, 2013), no research has examined whether dis- gust maintains symptoms of suicidality in individuals with eating disorders. It is crucial to understand factors contributing to sui- cidal ideation in this population in order to identify effective treatment targets and reduce deaths by suicide. Disgust, which has been linked to food ingestion, avoidance behaviours and nausea (Rozin, Haidt, & McCauley, 1999), is par- ticularly salient to individuals with EDs. Disgust has been impli- cated as a factor that maintains and/or exacerbates ED symptoms. Individuals with EDs often report a heightened sense of disgust with body shape and functions (Szmukler, Dare, & Treasure, 1995). Studies have found a relationship between trait disgust sensitivity (i.e. how easily one experiences the emotion) and propensity (i.e. how negatively the emotion is perceived) and EDs in some domains, particularly related to high-calorie foods and overweight body shapes in both nonclinical (Davey, Buckland, Tantow, & Dallos, 1998; Harvey, Troop, Treasure, & Murphy, 2002) and clinical samples (Aharoni & Hertz, 2012; Hay & Katsikitis, 2014; Troop, Treasure, & Serpell, 2002). Some studies have also provided support for a relationship between specific facets of disgust (e.g. disgust with the self) and EDs. Studies of shame and guilt towards the self, which are facets re- lated to self-disgust (Tangney, Miller, Flicker, & Barlow, 1996), indicate a potential relationship between disgust with the self and EDs (Sanftner, Barlow, Marschall, & Tangney, 1995; Troop, Allan, Serpell, & Treasure, 2008). Research studies examining self-objectification, or the tendency to view oneself as an object, have also reported that increases in self-objectification in women have been shown to elicit shame, body dissatisfaction, self-disgust and restricted eating (Harper & Tiggemann, 2008). Although these findings suggest that individuals with ED symptoms may be particularly vulnerable to experiencing disgust, the specific na- ture of this relationship is not well understood. Despite the prominence of symptoms of disgust among individuals with EDs, to our knowledge, only a handful of studies have directly examined the relationship between disgust with the self and EDs (see Fox, Grange, & Power, 2015 for review). These studies reported high levels of disgust with the self are associated with more significant ED symptoms in clinical samples of individuals with EDs (Ille et al., 2014) and depressive symptoms (Powell, Overton, & Simpson, 2014). However, these studies lack details Eur. Eat. Disorders Rev. (2015)© 2015 John Wiley & Sons, Ltd and Eating Disorders Association.