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Hamamoto Y, Suzuki S, Motoki K, Oba K, Kawashima R, Sugiura M. Neural mechanisms of perceptual and affective body-image disturbance during own-body and ideal-body estimation. Behav Brain Res 2023; 444:114349. [PMID: 36801426 DOI: 10.1016/j.bbr.2023.114349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/04/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
Body-image disturbance is a core feature of eating disorders and can predict their development in healthy individuals. There are two components of body-image disturbance: perceptual disturbance (associated with overestimation of body size) and affective disturbance (associated with body dissatisfaction). Previous behavioral studies have hypothesized that attention to particular body parts and negative body-related emotions resulting from social pressure are associated with the respective degrees of perceptual and affective disturbance; however, the neural representations that underlie this hypothesis have not been elucidated. Thus, this study investigated the brain regions and connectivity associated with the degree of body-image disturbance. Specifically, we examined the brain activations associated with participants' estimation of the width of their actual and ideal bodies; we sought to determine which brain regions and functional connectivity from body-related visual processing regions were correlated with the degree of each component of body-image disturbance. The degree of perceptual disturbance was positively correlated with excessive width-dependent brain activations in the left anterior cingulate cortex when estimating one's body size; it was positively correlated with the functional connectivity between the left extrastriate body area and left anterior insula. The degree of affective disturbance was positively correlated with excessive width-dependent brain activation in the right temporoparietal junction and negatively correlated with functional connectivity between the left extrastriate body area and right precuneus when estimating one's ideal body size. These results support the hypothesis that perceptual disturbance is associated with attentional processing, whereas affective disturbance is associated with social processing.
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Affiliation(s)
- Yumi Hamamoto
- School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
| | - Shinsuke Suzuki
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Frontier Research Institute for Interdisciplinary Science, Tohoku University, 6-3 Aramaki aza Aoba, Aoba-ku, Sendai 980-8578, Japan; Centre for Brain, Minds and Markets, Department of Finance, Faculty of Business and Economics, The University of Melbourne, 198 Berkeley St, Carlton, VIC 3053, Australia; Center for the Promotion of Social Data Science Education and Research, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo 186-8601, Japan
| | - Kosuke Motoki
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan; Department of Management, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kentaro Oba
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Ryuta Kawashima
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Motoaki Sugiura
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai 980-8572, Japan
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2
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Hahn SL, Barry MR, Weeks HM, Miller AL, Lumeng JC, Sonneville KR. Parental perceptions of actual and ideal body weight in early childhood prospectively predict adolescent perceptions of actual and ideal body weight among a low-income population. Eat Weight Disord 2021; 26:2371-2379. [PMID: 33389717 PMCID: PMC10370320 DOI: 10.1007/s40519-020-01088-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the longitudinal associations between parental perceptions of their child's actual weight (PPCA = parental perception of child's actual) and ideal weight (PPCI = parental perception of child ideal) in early childhood and the child's own perceptions of their actual weight (APA = adolescent perceived actual) and ideal weight (API = adolescent perceived ideal) during early adolescence among a low-income population. METHODS Using a longitudinal study design, 136 child/parent pairs were asked to assess the child's actual and ideal weight using figure rating scales. When children were 4-7 years old, parents reported on their perception of their child's weight; when children were 10-12 years old, the child reported on their own weight perceptions. Actual weight, ideal weight, and the difference between ideal and actual weight perception were assessed at the respective timepoints. Regressions were used to examine the relationship between parental weight perceptions (PPCA and PPCI) and later adolescent weight perception (APA and API). RESULTS On average, PPCI was higher than PPCA, whereas API was lower than APA. We found a positive relationship between PPCI and API (β = 0.309, p = .029). PPCA was positively associated with API (β = 0.304, p = .015) and marginally positively associated with the APA (β = 0.242, p = .077). However, the difference between PPCI and PPCA did not predict either APA or API. CONCLUSIONS Parental perception of their child's weight may relate to the adolescent's weight perception, particularly ideal weight. However, several null and marginal associations suggest that parental weight perception in early childhood may not be the most salient factor in determining weight perception in early adolescence. LEVEL OF EVIDENCE Level III, well-designed longitudinal cohort study.
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Affiliation(s)
- Samantha L Hahn
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA.
- Department of Psychiatry and Behavioral Health, Medical School, University of Minnesota, Minneapolis, MN, 55454, USA.
| | - Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Julie C Lumeng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
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Dissociation and Suicidality in Eating Disorders: The Mediating Function of Body Image Disturbances, and the Moderating Role of Depression and Anxiety. J Clin Med 2021; 10:jcm10174027. [PMID: 34501475 PMCID: PMC8432476 DOI: 10.3390/jcm10174027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 12/22/2022] Open
Abstract
In patients with eating disorders (EDs), elevated dissociation may increase the risk of suicide. Bodily related disturbances, depression, and anxiety may intervene in the association between dissociation and suicidality. In this study we aimed to examine the influence of bodily related disturbances, depression, anxiety, severity of ED symptoms, body mass index (BMI), and type and duration of the ED on the relationship between elevated dissociation and elevated suicidality. The study included 172 inpatients: 65 with anorexia nervosa restricting type, 60 with anorexia nervosa binge/purge type, and 37 with bulimia nervosa. Participants were assessed using self-rating questionnaires for dissociation, suicidality, bodily related parameters, and severity of ED symptomatology, depression, and anxiety. We found that dissociation and suicidality were directly associated. In addition, depression and anxiety moderated the mediating role of body image parameters in the association between increased dissociation and increased suicidality. Thus, only in inpatients with high depression and anxiety, i.e., above the median range, body image disturbances were found to mediate the association between dissociation and suicidality. ED-related parameters did not moderate these relationships. Our study demonstrates that in inpatients with EDs, increased dissociation may be significantly associated with increased suicidality, both directly and via the intervening influence of body image, depression, and anxiety.
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Cornelissen KK, Widdrington H, McCarty K, Pollet TV, Tovée MJ, Cornelissen PL. Are attitudinal and perceptual body image the same or different? Evidence from high-level adaptation. Body Image 2019; 31:35-47. [PMID: 31430603 DOI: 10.1016/j.bodyim.2019.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/16/2022]
Abstract
We used a high-level adaptation paradigm to distinguish between two hypotheses: (1) perceptual and attitudinal body image measurements reflect conceptually different mechanisms which are statistically independent of each other; (2) attitudinal (e.g., questionnaire) and perceptual (e.g., visual yes-no) body image tasks represent two different ways of measuring exactly the same construct. Forty women, with no history of eating disorders, carried out the experiment. Each participant carried out five adaptation blocks, with adapting stimuli representing female bodies at: extreme-low body mass index (BMI), mid-low BMI, actual BMI of the observer, mid-high BMI, and extreme-high BMI. Block order was randomized across participants. The main outcome variable was percentage error in participants' self-estimates of body size, measured post-adaption. In regressions of this percentage error on the strength of the adapting stimuli together with observers' attitudinal body image as a covariate, we found positive regression slopes and no evidence for any interaction between the fixed effects. Therefore, we conclude that perceptual and attitudinal body image mechanisms are indeed independent of each other. In the light of this evidence, we discuss how people with eating disorders, like anorexia nervosa, may come to over-estimate their body size.
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Affiliation(s)
- Katri K Cornelissen
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Helena Widdrington
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Kristofor McCarty
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Thomas V Pollet
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Martin J Tovée
- School of Psychology, College of Social Science, University of Lincoln, Lincolnshire, LN6 7TS, UK
| | - Piers L Cornelissen
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
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Ergüney Okumuş FE, Sertel Berk HÖ, Yücel B. Body image, depression and eating behaviour: a comparative study in eating disordered women and healthy controls. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1637327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
| | | | - Başak Yücel
- Department of Psychiatry, Istanbul University, Istanbul, Turkey
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6
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Abstract
Our body is a volumetric, three-dimensional (3-D) object in the world, and we experience it as such. Existing methods for measuring the perceptual body image, however, have been based on judgments of one-dimensional (1-D) length or two-dimensional images. We developed a new approach to the 3-D perceptual body image of the fingers by asking people to judge whether each finger would fit through rings of varying diameter. This task requires participants to conceptualize their finger as a volumetric object entering the ring. In two experiments, we used an adaptive staircase procedure to estimate the perceived size of each finger. There were systematic distortions of perceived 3-D finger size, with the size of index finger and (to a lesser extent) the middle finger underestimated. These distortions were unaffected by changes in hand posture. Notably, the pattern of distortions is qualitatively different from that found in previous research investigating 1-D finger length, suggesting that 3-D judgments of the body may differ in fundamental ways from 1-D judgments of individual body dimensions.
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Affiliation(s)
- Ebru Ecem Tavacioglu
- Department of Psychological Sciences, Birkbeck, University of London, UK; Department of Psychology, Ludwig-Maximilians-Universität Munchen, Munich, Germany; Psychology Department, Istanbul Sehir University, Turkey
| | - Elena Azañón
- Department of Psychological Sciences, Birkbeck, University of London, UK; Institute of Psychology, Otto von Guericke University Magdeburg, Germany; Center for Behavioral Brain Sciences, Otto von Guericke University Magdeburg, Germany; Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Matthew R Longo
- Department of Psychological Sciences, Birkbeck, University of London, UK
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Irvine KR, McCarty K, McKenzie KJ, Pollet TV, Cornelissen KK, Tovée MJ, Cornelissen PL. Distorted body image influences body schema in individuals with negative bodily attitudes. Neuropsychologia 2018; 122:38-50. [PMID: 30500663 DOI: 10.1016/j.neuropsychologia.2018.11.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 10/10/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
There is now a considerable body of evidence to suggest that internal representations of the body can be meaningfully separated into at least two general levels; body image as a perceptual construct and body schema as a motor metric. However, recent studies with eating disordered individuals have suggested that there may in fact be more interaction between these two representations than first thought. We aimed to investigate how body image might act to influence body schema within a typical, healthy population. 100 healthy adult women were asked to judge the smallest gap between a pair of sliding doors that they could just pass through. We then determined whether these estimates were sufficient to predict the size of the smallest gap that they could actually pass through, or whether perceptual and attitudinal body image information was required in order to make these predictions. It was found that perceptual body image did indeed mediate performance on the egocentric (but not allocentric) motor imagery affordance task, but only for those individuals with raised body image concerns and low self-esteem; body schema was influenced by both the perceptual and attitudinal components of body image in those with more negative bodily attitudes. Furthermore, disparities between perceived versus actual size were associated with body parts that had larger variations in adipose/muscle-dependent circumference. We therefore suggest that it may be the affective salience of a distorted body representation that mediates the degree to which it is incorporated into the current body state.
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Affiliation(s)
- Kamila R Irvine
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Kirsten J McKenzie
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom
| | - Thomas V Pollet
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Katri K Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Martin J Tovée
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom
| | - Piers L Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom.
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8
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Via E, Goldberg X, Sánchez I, Forcano L, Harrison BJ, Davey CG, Pujol J, Martínez-Zalacaín I, Fernández-Aranda F, Soriano-Mas C, Cardoner N, Menchón JM. Self and other body perception in anorexia nervosa: The role of posterior DMN nodes. World J Biol Psychiatry 2018; 19:210-224. [PMID: 27873550 DOI: 10.1080/15622975.2016.1249951] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Body image distortion is a core symptom of anorexia nervosa (AN), which involves alterations in self- (and other's) evaluative processes arising during body perception. At a neural level, self-related information is thought to rely on areas of the so-called default mode network (DMN), which, additionally, shows prominent synchronised activity at rest. METHODS Twenty female patients with AN and 20 matched healthy controls were scanned using magnetic resonance imaging when: (a) viewing video clips of their own body and another's body; (b) at rest. Between-group differences within the DMN during task performance were evaluated and further explored for task-related and resting-state-related functional connectivity alterations. RESULTS AN patients showed a hyperactivation of the dorsal posterior cingulate cortex during their own-body processing but a response failure to another's body processing at the precuneus and ventral PCC. Increased task-related connectivity was found between dPCC-dorsal anterior cingulate cortex and precuneus-mid-temporal cortex. Further, AN patients showed decreased resting-state connectivity between the dPCC and the angular gyrus. CONCLUSIONS The PCC and the precuneus are suggested as key components of a network supporting self-other-evaluative processes implicated in body distortion, while the existence of DMN alterations at rest might reflect a sustained, task-independent breakdown within this network in AN.
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Affiliation(s)
- Esther Via
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia.,d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain
| | - Ximena Goldberg
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Isabel Sánchez
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain
| | - Laura Forcano
- f Clinical research group in human pharmacology and neuroscience , IMIM Research Institute at the Hospital de Mar , Barcelona , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Ben J Harrison
- c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia
| | - Christopher G Davey
- c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia.,h Orygen, The National Centre of Excellence in Youth Mental Health , Melbourne , Australia
| | - Jesús Pujol
- i MRI Research Unit , Hospital del Mar, CIBERSAM G21 , Barcelona , Spain
| | - Ignacio Martínez-Zalacaín
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain
| | - Fernando Fernández-Aranda
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Carles Soriano-Mas
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain.,j Department of Psychobiology and Methodology in Health Sciences , Universitat Autònoma de Barcelona , Spain
| | - Narcís Cardoner
- d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain.,k Department of Psychiatry , Universitat Autònoma de Barcelona , Spain
| | - José M Menchón
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain
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Mölbert SC, Thaler A, Streuber S, Black MJ, Karnath HO, Zipfel S, Mohler B, Giel KE. Investigating Body Image Disturbance in Anorexia Nervosa Using Novel Biometric Figure Rating Scales: A Pilot Study. EUROPEAN EATING DISORDERS REVIEW 2018; 25:607-612. [PMID: 29057601 DOI: 10.1002/erv.2559] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/05/2017] [Accepted: 09/14/2017] [Indexed: 11/08/2022]
Abstract
This study uses novel biometric figure rating scales (FRS) spanning body mass index (BMI) 13.8 to 32.2 kg/m2 and BMI 18 to 42 kg/m2 . The aims of the study were (i) to compare FRS body weight dissatisfaction and perceptual distortion of women with anorexia nervosa (AN) to a community sample; (ii) how FRS parameters are associated with questionnaire body dissatisfaction, eating disorder symptoms and appearance comparison habits; and (iii) whether the weight spectrum of the FRS matters. Women with AN (n = 24) and a community sample of women (n = 104) selected their current and ideal body on the FRS and completed additional questionnaires. Women with AN accurately picked the body that aligned best with their actual weight in both FRS. Controls underestimated their BMI in the FRS 14-32 and were accurate in the FRS 18-42. In both FRS, women with AN desired a body close to their actual BMI and controls desired a thinner body. Our observations suggest that body image disturbance in AN is unlikely to be characterized by a visual perceptual disturbance, but rather by an idealization of underweight in conjunction with high body dissatisfaction. The weight spectrum of FRS can influence the accuracy of BMI estimation. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Simone C Mölbert
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Anne Thaler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | | | - Michael J Black
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Betty Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
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10
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Cornelissen KK, McCarty K, Cornelissen PL, Tovée MJ. Body size estimation in women with anorexia nervosa and healthy controls using 3D avatars. Sci Rep 2017; 7:15773. [PMID: 29150646 PMCID: PMC5693901 DOI: 10.1038/s41598-017-15339-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/16/2017] [Indexed: 01/22/2023] Open
Abstract
A core feature of anorexia nervosa is an over-estimation of body size. However, quantifying this over-estimation has been problematic as existing methodologies introduce a series of artefacts and inaccuracies in the stimuli used for judgements of body size. To overcome these problems, we have: (i) taken 3D scans of 15 women who have symptoms of anorexia (referred to henceforth as anorexia spectrum disorders, ANSD) and 15 healthy control women, (ii) used a 3D modelling package to build avatars from the scans, (iii) manipulated the body shapes of these avatars to reflect biometrically accurate, continuous changes in body mass index (BMI), (iv) used these personalized avatars as stimuli to allow the women to estimate their body size. The results show that women who are currently receiving treatment for ANSD show an over-estimation of body size which rapidly increases as their own BMI increases. By contrast, the women acting as healthy controls can accurately estimate their body size irrespective of their own BMI. This study demonstrates the viability of combining 3D scanning and CGI techniques to create personalised realistic avatars of individual patients to directly assess their body image perception.
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Affiliation(s)
- Katri K Cornelissen
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Piers L Cornelissen
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, NE1 8ST, United Kingdom
| | - Martin J Tovée
- School of Psychology, Lincoln University, Lincoln, LN6 7TS, United Kingdom.
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11
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Phillipou A, Rossell SL, Gurvich C, Castle DJ, Troje NF, Abel LA. Body Image in Anorexia Nervosa: Body Size Estimation Utilising a Biological Motion Task and Eyetracking. EUROPEAN EATING DISORDERS REVIEW 2015; 24:131-8. [DOI: 10.1002/erv.2423] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/08/2015] [Accepted: 11/06/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Andrea Phillipou
- Department of Optometry & Vision Sciences; The University of Melbourne; Melbourne Australia
- Department of Psychiatry; The University of Melbourne; Melbourne Australia
- Department of Mental Health; The Austin Hospital; Melbourne Australia
| | - Susan Lee Rossell
- Brain and Psychological Sciences Research Centre; Swinburne University of Technology; Melbourne Australia
- Monash Alfred Psychiatry Research Centre; Melbourne Australia
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
| | | | - David Jonathan Castle
- Department of Psychiatry; The University of Melbourne; Melbourne Australia
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
- Faculty of Health Sciences; Australian Catholic University; Melbourne Australia
| | | | - Larry Allen Abel
- Department of Optometry & Vision Sciences; The University of Melbourne; Melbourne Australia
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Cornelissen KK, Bester A, Cairns P, Tovée MJ, Cornelissen PL. The influence of personal BMI on body size estimations and sensitivity to body size change in anorexia spectrum disorders. Body Image 2015; 13:75-85. [PMID: 25697956 DOI: 10.1016/j.bodyim.2015.01.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 01/16/2015] [Accepted: 01/17/2015] [Indexed: 10/24/2022]
Abstract
In this cross-sectional study, we investigated the influence of personal BMI on body size estimation in 42 women who have symptoms of anorexia (referred to henceforth as anorexia spectrum disorders, ANSD), and 100 healthy controls. Low BMI control participants over-estimate their size and high BMI controls under-estimate, a pattern which is predicted by a perceptual phenomenon called contraction bias. In addition, control participants' sensitivity to size change declines as their BMI increases as predicted by Weber's law. The responses of women with ANSD are very different. Low BMI participants who have ANSD are extremely accurate at estimating body size and are very sensitive to changes in body size in this BMI range. However, as BMI rises in the ANSD participant group, there is a rapid increase in over-estimation concurrent with a rapid decline in sensitivity to size change. We discuss the results in the context of signal detection theory.
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Affiliation(s)
| | | | - Paul Cairns
- Department of Computer Science, University of York, York, UK
| | - Martin J Tovée
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
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Coker E, Abraham S. Body weight dissatisfaction: a comparison of women with and without eating disorders. Eat Behav 2014; 15:453-9. [PMID: 25064299 DOI: 10.1016/j.eatbeh.2014.06.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 04/07/2014] [Accepted: 06/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Body dissatisfaction is present in a majority of women without eating disorders (EDs), and almost all women with EDs. We compared body dissatisfaction in women with and without EDs to determine at which BMI women are content with their weight, and to determine if body dissatisfaction is affected by the presence of purging behaviours. METHODS We assessed women, age 18 to 55 with an ED (N=431) and without an ED (N=719) using the discrepancy between their current and desired BMI. This measure of body weight dissatisfaction (BWD) has been validated as being representative of overall body dissatisfaction. We also measured perceptions of (i) Body Appearance and (ii) Body Image to confirm our results. RESULTS Women with and without EDs wished to lose weight until very low weights were achieved (BMI 15-16 kg/m(2) and BMI 18-19 kg/m(2) respectively). BWD is higher in women with EDs (median 1.77, IQR 0-4.61) than women without EDs (median 0.85, IQR 0-1.80, p<0.001). Purging behaviours in women with EDs were associated with lower BMIs to achieve body satisfaction (BMI 15-16 kg/m(2)) than women who did not purge (16-17 kg/m(2)). CONCLUSIONS Body weight dissatisfaction is highly prevalent amongst women with and without EDs. Understanding body weight dissatisfaction in women with EDs and its association with purging may assist in the prevention, detection and treatment of these disorders. Women with EDs should be informed that body weight dissatisfaction will not resolve with the cessation of their disorder, as it is prevalent within the general population.
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Affiliation(s)
- Elise Coker
- Department of Women's Health, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia; Northside Clinic, 2 Greenwich Road, Greenwich, NSW 2065, Australia.
| | - Suzanne Abraham
- Department of Women's Health, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia; Northside Clinic, 2 Greenwich Road, Greenwich, NSW 2065, Australia
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14
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Gunnard K, Krug I, Jiménez-Murcia S, Penelo E, Granero R, Treasure J, Tchanturia K, Karwautz A, Collier D, Menchón JM, Fernández-Aranda F. Relevance of social and self-standards in eating disorders. EUROPEAN EATING DISORDERS REVIEW 2011; 20:271-8. [PMID: 21861273 DOI: 10.1002/erv.1148] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 06/21/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare the importance given to self/other standards by eating disorder (ED) patients and healthy controls. METHODS A total of 392 individuals (240 consecutively referred and 152 healthy controls) took part in this study. All subjects were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and were female patients. Participants completed the Family Style, Self-Expectations and Emotional related subscales of the Cross-Cultural Questionnaire. RESULTS Three domains (namely, family standards, self-achievement and physical appearance) were associated with ED. Family standards scores discriminated for the presence of an ED (area under receiver operating characteristic curve equals 0.89), the main predictors being a higher level of importance of physical appearance (p < .001), family standards (p = .029) and conflicts with parents about physical appearance (p < .001). Higher self-standards, in physical appearance, were more relevant in bulimia nervosa and ED not otherwise specified, whereas higher family standards were more associated with anorexia nervosa. CONCLUSIONS High self-standards and social standards are common features in ED. The parallelism that ED may establish between reaching them and their life success may have a crucial role as a developing and maintaining factor in ED.
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Affiliation(s)
- Katarina Gunnard
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
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15
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Roy M, Meilleur D. Body image distortion change during inpatient treatment of adolescent girls with restrictive anorexia nervosa. Eat Weight Disord 2010; 15:e108-15. [PMID: 20571314 DOI: 10.1007/bf03325289] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Body image distortion is one core symptom of anorexia nervosa. However, little is known concerning its fluctuation over time. This paper pursues two objectives: (1) to assess body image distortion change during inpatient treatment of adolescent girls with restrictive anorexia nervosa (n=10), and (2) to identify associations between this change and the change observed to other measures of eating and weight-related disorders. A Quantification of Body Image Distortion computerized tool (Q-BID) and paper-and-pencil questionnaires were used at both beginning and end of inpatient treatment. Pearson correlations and linear regression analyses were conducted to identify associations between body image distortion change and the change observed to other measures of eating and weight-related disorders. The results indicate that all adolescents experienced a body image distortion change. This change corresponds to a body image distortion decrease for 70% of them. The body image distortion change measure was highly correlated with the change observed in the score to the Eating Attitude Test (EAT-26) and to the Eating Disorder Examination Questionnaire (EDEQ-4) during the inpatient treatment. These two measures of change indeed explained 88.4% of the body image distortion change variance in the multivariate model. We concluded that the Q-BID is an interesting tool for the assessment of body image distortion change. More research is needed concerning the correlates of this outcome in order to elaborate appropriate interventions for both clinical and community settings.
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Affiliation(s)
- M Roy
- Department of Social & Preventive Medicine, Université de Montréal, PO Box 6128 Downtown Station, Montréal, Quebec H3C3JT, Canada.
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16
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Abstract
The aim of the present study was to analyze the psychometric characteristics of the Body Image Assessment Software (BIAS), an innovative interactive computer program developed to assess body image disturbances. The program was tested on 252 psychology students at the University of Barcelona and 51 patients with an eating disorder (ED). The subjects filled in the Eating Attitudes Test-26, the Body Shape Questionnaire, the body dissatisfaction scale of the Eating Disorders Inventory-2, and the Body Image Assessment-Revised (a test of silhouettes). Results showed good validity and very high reliability. Furthermore, BIAS was able to discriminate between people who were at risk of an ED and those who were not, as well as between people with and without a history of an ED. Those at risk of having an ED and those with a current ED showed more body image distortion (overestimation of body size) and higher levels of body image dissatisfaction.
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17
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Hewig J, Cooper S, Trippe RH, Hecht H, Straube T, Miltner WHR. Drive for thinness and attention toward specific body parts in a nonclinical sample. Psychosom Med 2008; 70:729-36. [PMID: 18606732 DOI: 10.1097/psy.0b013e31817e41d3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the differences between participants scoring high versus low on a drive for thinness construct concerning their visual attention toward specific body parts. We hypothesized that participants scoring high on the drive for thinness subscale would show increased attention to body regions, which are important in the assessment of body weight and thinness like the waist, hips, legs, and arms. METHOD We examined eye-gaze behavior of a nonclinical sample of 51 male and female college students with an eye-tracking system as they were looking at pictures of young, attractive males and females. In addition, we used the Eating Disorder Inventory to measure drive for thinness. RESULTS Participants with increased scores on the drive for thinness subscale looked longer and more often to the waist, hips, legs, and arms as compared with low scorers. In addition, they showed decreased attention toward the head or face. CONCLUSION The results indicate that participants scoring high on drive for thinness show an attentional bias toward body regions that are associated with assessing changes in weight. However, they neglected the face, which is the most important source of social and affective information when looking at others.
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Affiliation(s)
- Johannes Hewig
- Department of Biological and Clinical Psychology, Friedrich-Schiller-University Jena, Am Steiger 3, Haus 1, D-07743 Jena, Germany.
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18
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Assessment of adolescent body perception: development and characterization of a novel tool for morphing images of adolescent bodies. Behav Res Methods 2007; 39:651-66. [PMID: 17958179 DOI: 10.3758/bf03193037] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We developed a computer-based method of distorting adolescent body images, which incorporates the covariation between body parts found during growth and sexual maturation. An adolescent body-shape database (AdoBSD) and adolescent body morphing tool (AdoBMT) are described; the AdoBSD comprises real (n=320) and morphed (n approximately 41,000) images (front and side view) of 160 adolescents (9-17 years). We used a point distribution model, based upon principal components analysis, to characterize the covariation between predefined body tag-points manually positioned on the body images and to morph the body images in a realistic manner. Eight principal components (PCs) were found to characterize 96.3% of the covariation between body tag-point. Application of the PCs to the body images resulted in the manipulation of body parts including shoulder width, waist, hip, belly, thigh and calf sizes. The AdoBMT and AdoBSD may be used to investigate changes in body perception during adolescence, and the role of body perception in adolescent obesity and eating disorders. The AdoBSD is available to the research community (www.brainbody.nottingham.ac.uk).
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19
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Lewis V, Donaghue N. The Embeddedness of Body Image: A Study of Women With and Without Eating Disorders. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1751-9861.2005.tb00012.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Vocks S, Legenbauer T, Rüddel H, Troje NF. Static and dynamic body image in bulimia nervosa: mental representation of body dimensions and biological motion patterns. Int J Eat Disord 2007; 40:59-66. [PMID: 16941626 DOI: 10.1002/eat.20336] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of the present study was to find out whether in bulimia nervosa the perceptual component of a disturbed body image is restricted to the overestimation of one's own body dimensions (static body image) or can be extended to a misperception of one's own motion patterns (dynamic body image). METHOD Participants with bulimia nervosa (n = 30) and normal controls (n = 55) estimated their body dimensions by means of a photo distortion technique and their walking patterns using a biological motion distortion device. RESULTS Not only did participants with bulimia nervosa overestimate their own body dimensions, but also they perceived their own motion patterns corresponding to a higher BMI than did controls. Static body image was correlated with shape/weight concerns and drive for thinness, whereas dynamic body image was associated with social insecurity and body image avoidance. CONCLUSION In bulimia nervosa, body image disturbances can be extended to a dynamic component.
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Affiliation(s)
- Silja Vocks
- Department of Psychology, Clinical Psychology and Psychotherapy, Ruhr-University, Bochum, Germany.
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21
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Holder MD, Keates J. Size of drawings influences body size estimates by women with and without eating concerns. Body Image 2006; 3:77-86. [PMID: 18089211 DOI: 10.1016/j.bodyim.2005.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Revised: 09/06/2005] [Accepted: 10/07/2005] [Indexed: 10/25/2022]
Abstract
Research has inconsistently shown that women, particularly those with eating concerns, inaccurately estimate their body size. In the present study, drawings of female bodies, ranging from emaciated to obese, were presented to women with and without eating concerns. Drawings approximated the women's actual height or were reduced (15.7cm). Women selected the drawing that represented how they thought they looked (cognitive rating), felt they looked (affective rating), and would like to look (desired rating). Women tended to select larger drawings when reduced-size drawings were used. Participants with eating concerns overestimated their body size and were more dissatisfied with their body size than participants without eating concerns. Size of drawings and the presence of eating concerns did not affect ratings of the size of a neutral object. Women did not demonstrate a generalized problem in estimating size. Overestimation of body size may be exaggerated in research that used reduced-size drawings.
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Affiliation(s)
- Mark D Holder
- University of British Columbia, Okanagan 3333 University Way, Kelowna, BC, Canada VIV 1V7.
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22
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Farrell C, Lee M, Shafran R. Assessment of body size estimation: a review. EUROPEAN EATING DISORDERS REVIEW 2005. [DOI: 10.1002/erv.622] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Jarry JL, Berardi K. Characteristics and effectiveness of stand-alone body image treatments: a review of the empirical literature. Body Image 2004; 1:319-33. [PMID: 18089164 DOI: 10.1016/j.bodyim.2004.10.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2004] [Revised: 10/20/2004] [Accepted: 10/22/2004] [Indexed: 01/08/2023]
Abstract
This literature review examined the characteristics and effectiveness of treatments dedicated exclusively to body image. A total of 18 studies met selection criteria. All but one involved at least one cognitive-behavioural therapy (CBT) condition and only three compared CBT to another treatment approach. Twelve studies were conducted with non-clinical, body dissatisfied, participants and only one focussed on eating disordered women. Overall, the interventions were highly effective in improving body image and psychological variables and, to a lesser extent, eating attitude and behaviour. Changes were generally maintained at follow-up. Given their efficacy, more controlled trials of stand-alone body image treatments in clinical populations are needed. Investigating approaches other than CBT may open fruitful avenues of body image treatment.
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Affiliation(s)
- Josée L Jarry
- Department of Psychology, University of Windsor, 401 Sunset Avenue, Windsor, Ont., Canada N9B 3P4
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24
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Peterson CB, Wimmer S, Ackard DM, Crosby R, Cavanagh LC, Engbloom S, Mitchell JE. Changes in body image during cognitive-behavioral treatment in women with bulimia nervosa. Body Image 2004; 1:139-53. [PMID: 18089147 DOI: 10.1016/s1740-1445(03)00022-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2003] [Revised: 11/01/2003] [Accepted: 11/09/2003] [Indexed: 11/17/2022]
Abstract
The purposes of this study were: (1) to examine multidimensional aspects of body image of individuals with bulimia nervosa (BN) at pre-treatment, post-treatment, and at follow-up, compared to a group of participants without BN; and (2) to investigate whether measures of body image predicted outcome at post-treatment and follow-up. The clinical sample consisted of 109 females with BN who were enrolled in a 12-week cognitive-behavioral group treatment program. Participants were assessed at baseline, at the completion of treatment, and at 1- and 6-month follow-up visits. The 82 females who comprised the non-bulimic sample were assessed at comparable time intervals. At baseline, the participants with BN reported greater body dissatisfaction and overestimated body size to a significantly greater degree than the comparison group, and reported a significantly smaller ideal size relative to perceived size. Results at the end of treatment indicated significant improvement in self-reported attitudinal disturbance and size overestimation, with continued reductions at follow-up. Logistic regression analyses did not demonstrate a predictive relationship between body image measures at baseline and outcome at post-treatment or follow-up, or between post-treatment and follow-up. Implications for treatment include specifying the source of body image-related distress and enhancing treatment efforts for perceptual and attitudinal aspects of body image.
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Affiliation(s)
- Carol B Peterson
- Eating Disorders Research Program, Department of Psychiatry, University of Minnesota, 606 24th Avenue South, Suite #602, Minneapolis, MN 55454, USA
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25
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Magri F, Borza A, del Vecchio S, Chytiris S, Cuzzoni G, Busconi L, Rebesco A, Ferrari E. Nutritional assessment of demented patients: a descriptive study. Aging Clin Exp Res 2003; 15:148-53. [PMID: 12889847 DOI: 10.1007/bf03324493] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS It is well-known that subclinical and overt malnutrition are strong predictive indices of morbidity and mortality in old subjects, particularly in demented ones, and may deeply affect the quality of life. The aim of this study was evaluation of nutritional status in demented patients, as a whole and according to type of dementia, at the moment of hospital admission and before discharge. METHODS The study concerns 174 old demented patients, aged 80.2 +/- 8 SD, diagnosed as having Alzheimer's disease, vascular dementia, degenerative and vascular dementia, reversible dementia, and other types of dementia. In each subject, anthropometric measures, body composition analysis by the bioelectric impedance technique, Mini Nutritional Assessment (MNA) and cognitive, functional and affective assessment by conventional geriatric instruments were performed. A blood sample allowed assay of the main biochemical nutritional markers. At the end of the hospitalization period, the same cognitive, functional and nutritional assessment was repeated, in order to evaluate the effects of vitamin and protein supplements and of care during meals. RESULTS In all subgroups of demented patients, obtained according to type of dementia, the mean MNA score was indicative of risk for malnutrition. Furthermore, the MNA score was significantly related to severe cognitive impairment, functional status, comorbidity, BMI values, and transferrin and total protein serum levels. Malnourished patients and demented elderly at risk for malnutrition (according to the MNA score) were given oral nutritional supplements during hospitalization, lasting a mean of 45 days. Before discharge, these two subtypes of demented patients showed substantial maintenance of their cognitive, functional and nutritional status, whereas the subgroup of well-nourished demented patients exhibited significant worsening of the nutritional pattern. CONCLUSIONS Demented patients show a high percentage of malnutrition, particularly evident in subjects with deeper cognitive impairment. Nutritional status seems to be linked more to functional abilities than to duration of disease. However, nutritional intervention or special care during meals may act in synergy with specific pharmacologic therapy of dementia.
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Affiliation(s)
- Flavia Magri
- Department of Internal Medicine and Medical Therapy, Chair of Geriatrics, University of Pavia, Pavia, Italy.
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26
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Fernández-Aranda F, Dahme B, Meermann R. Body image in eating disorders and analysis of its relevance: a preliminary study. J Psychosom Res 1999; 47:419-28. [PMID: 10624840 DOI: 10.1016/s0022-3999(99)00027-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of the present study was to assess body perception in eating disorders and its meaning in therapy. A total of 44 patients, 25 bulimia nervosa and 19 anorexia nervosa, admitted at a specialized in-patient treatment center participated in the present study. Body size estimation procedures (video-distortion and image-marking techniques) and self-report questionnaires were used for the assessment. No significant differences were found in actual body size estimation between the two eating disorder groups, either before or after therapy. It emerged after therapy that the outcome was not related to body size estimation. These findings suggest that there is no evidence for a serious impairment of body perception (size estimation) in eating-disordered patients, but rather for a disturbance in the emotional aspect of body image, as expressed in negative body attitudes. Body size perception does not appear to be a predictor of treatment outcome in eating disorders.
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Affiliation(s)
- F Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
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27
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Affiliation(s)
- C Bergh
- Section of Applied Neuroendocrinology, Karolinska Institute, Novum, Huddinge, Sweden
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28
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Monteath SA, McCabe MP. The influence of societal factors on female body image. THE JOURNAL OF SOCIAL PSYCHOLOGY 1997; 137:708-27. [PMID: 9414624 DOI: 10.1080/00224549709595493] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study was designed to identify factors associated with the perceptual and attitudinal components of female body image. The influence of society and factors thought to mediate the relationship between body image and society (field dependence, locus of control, and self-esteem) were investigated. Age and body mass index (BMI) were also included as independent variables. A total of 101 female university students in Australia ranging in age from 18 to 55 years (M = 24.11) participated in the study. A video camera apparatus (VCA) was used to assess perceptual distortion of body size. The VCA, the Body Esteem Scale, and the Appearance Evaluation subscale of the Multidimensional Body Self Relations Questionnaire were used to assess body satisfaction. On average, women underestimated their body sizes by 4%, and they typically wanted to be smaller than their actual body sizes. About two fifths of the women expressed moderate to strong negative feelings about both individual body parts and their bodies as a whole. Multiple regression analyses revealed that perceptual distortion of body size could not be predicted from the independent variables. Body satisfaction was best explained by societal factors, self-esteem, and BMI.
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Affiliation(s)
- S A Monteath
- School of Psychology, Deakin University, Burwood, Victoria, Australia
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29
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Rushford N, Ostermeyer A. Body image disturbances and their change with videofeedback in anorexia nervosa. Behav Res Ther 1997; 35:389-98. [PMID: 9149447 DOI: 10.1016/s0005-7967(96)00118-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Disturbance in the way the body is experienced is a diagnostic criterion for anorexia nervosa, and impedes recovery. A method relatively free of external prompts, to reduce the potential for experimentally induced biases, evaluated body image distortions (BID) in 18 patients with anorexia nervosa soon after admission to an inpatient unit, and 18 normal controls, before and after a videofeedback session. The BID were assessed in the affective and self/social domains by visual analogue scales in which the instructional set oriented subjects to (a) the sensation of fatness (Affective Response, AR), and (b) size compared with other young women (Comparative Size Response, CSR). The AR and CSR were significantly greater than normal in anorexia but decreased significantly with videofeedback, while values for controls were stable. The AR and CSR were only partially independent, indicating overlap of the domains. In anorexia only, the responses were related to two DSM-IV diagnostic criteria for anorexia, fear of gaining weight and health-weight concerns, as well as to drive for thinness and body dissatisfaction. Fear of gaining weight occupied a central position in determining the magnitudes of BID and the other measures, including anxiety and depression.
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Affiliation(s)
- N Rushford
- Department of Psychology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Vic., Australia
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30
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Rolland K, Farnill D, Griffiths RA. Children's perceptions of their current and ideal body sizes and body mass index. Percept Mot Skills 1996; 82:651-6. [PMID: 8724942 DOI: 10.2466/pms.1996.82.2.651] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
244 Australian schoolchildren aged between 8 and 12 years indicated their current and ideal body sizes by means of Collins' pictorial figures. Children's height and weight were also measured. Body-mass indices were calculated from these data, and percentile ranks estimated according to international reference data. Consistent with Collins' findings, 39% of girls and 26% of boys wanted to be thinner than they perceived themselves to be; however, this desire was strongly related to actual body size so the percentages were very different for weight categories established on the basis of Body Mass Index. In the overweight quartile, 76% of girls and 56% of boys wanted to be thinner, whereas in the underweight quartile only 10% of girls and no boys wanted to be thinner. The response of overweight children may be sensible, but the desire of some underweight girls to be even thinner is of concern. Some recent literature suggests that underweight individuals tend to overestimate their body sizes. About a half of our underweight children slightly overestimated their body sizes but only one child overestimated grossly.
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Affiliation(s)
- K Rolland
- Department of Behavioural Sciences in Medicine, University of Sydney, NSW, Australia
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31
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Probst M, Vandereycken W, Van Coppenolle H, Pieters G. Body size estimation in eating disorder patients: testing the video distortion method on a life-size screen. Behav Res Ther 1995; 33:985-90. [PMID: 7487859 DOI: 10.1016/0005-7967(95)00037-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The video distortion method on a life-size screen is a new method for studying eating disordered patients' estimations of their own body width. Testing this method in female patients (53 with anorexia nervosa, 38 with bulimia nervosa) and 36 normal females, yielded high to very high reliability scores (consistency and test-retest stability). A careful analysis of the 'just noticeable difference' showed that a 5% deviation from the undistorted image should be considered as within the range of accuracy. Taking this into account, anorectic patients appear to score below, above, as well as within the normal range. Bulimia nervosa patients are either accurate in their body estimations or overestimate their body width. All control Ss are correct in their estimations. With this method no significant differences were found between the anorectic patients and the controls. Bulimics differ significantly from anorectics and controls on their optative responses (i.e. what they wanted to look like) and their affective responses (i.e. what they felt they looked like).
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Affiliation(s)
- M Probst
- University Center St. Joseph, Kortenberg, Belgium
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