1
|
Gadsby S, Zopf R, Brooks KR, Schumann A, de la Cruz F, Rieger K, Murr J, Wutzler U, Bär KJ. Testing visual self-misperception in anorexia nervosa using a symmetrical body size estimation paradigm. Int J Eat Disord 2023; 56:2149-2154. [PMID: 37578207 DOI: 10.1002/eat.24030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE Individuals diagnosed with anorexia nervosa (AN) often report seeing themselves as overweight. While body size estimation tasks suggest that such individuals overestimate their body size, these tasks have failed to establish whether this misestimation stems from visual misperception. Misestimation might, instead, be due to response bias. We designed a paradigm to distinguish between visual and response bias contributions to body size misestimation: the symmetrical body size estimation (s-BSE) paradigm. METHOD The s-BSE paradigm involves two tasks. In the conventional task, participants estimate the width of their photographed body by adjusting the size of a rectangle to match. In the transposed task, participants adjust the size of a photograph of their body to match the rectangle. If overestimation stems exclusively from visual misperception, then errors in each task would be equal and opposite. Using this paradigm, we compared the performance of women diagnosed with AN (n = 14) against women without any eating disorder (n = 40). RESULTS In the conventional task, we replicated previous findings indicating that both women with AN and women without any eating disorder overestimate their body size. In the transposed task, neither group adjusted the bodies to be narrower than the rectangle. Participants with AN set their photographs to be significantly wider. DISCUSSION While we replicated previous findings of body size overestimation amongst women with AN and those without any eating disorder, our results are inconsistent with the hypothesis that such overestimation stems exclusively from visual misperception and instead suggest a substantial response bias effect. PUBLIC SIGNIFICANCE Women with anorexia nervosa overestimate their own body size. Research has not yet determined whether this overestimation stems from them seeing themselves as larger or other, non-visual factors. We employ a new method for distinguishing these possibilities and find that non-visual factors influence size estimates for women with and without anorexia nervosa. This method can help future research control for non-perceptual influences on participant responses.
Collapse
Affiliation(s)
- Stephen Gadsby
- Centre for Philosophical Psychology, Department of Philosophy, University of Antwerp, Antwerp, Belgium
| | - Regine Zopf
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kevin R Brooks
- School of Psychological Sciences, Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health & Wellbeing Research Centre, Macquarie University, Sydney, New South Wales, Australia
| | - Andy Schumann
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Feliberto de la Cruz
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Katrin Rieger
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Julia Murr
- Asklepios Fachklinikum Stadtroda, Clinic for Psychotherapy and Psychosomatic Medicine, Stadtroda, Germany
| | - Uwe Wutzler
- Asklepios Fachklinikum Stadtroda, Clinic for Psychotherapy and Psychosomatic Medicine, Stadtroda, Germany
| | - Karl-Jürgen Bär
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| |
Collapse
|
2
|
Reichenberger J, Radix AK, Blechert J, Legenbauer T. Further support for the validity of the social appearance anxiety scale (SAAS) in a variety of German-speaking samples. Eat Weight Disord 2022; 27:929-943. [PMID: 34085203 PMCID: PMC8964605 DOI: 10.1007/s40519-021-01171-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/12/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Eating disorders (ED) and social anxiety disorder are highly comorbid with potentially shared symptoms like social appearance anxiety (SAA) referring to a fear of being negatively evaluated by others' because of overall appearance. SAA constitutes a risk factor for eating psychopathology and bridges between EDs and social anxiety disorder. METHODS The present studies examined internal consistency, factor structure, test-retest reliability, gender and age invariance, convergent validity and differences between individuals with and without an ED of a German version of the social appearance anxiety scale (SAAS) in four independent samples (n1 = 473; n2 = 712; n3 = 79; n4 = 33) including adolescents and patients with EDs. RESULTS Consistently, the SAAS showed excellent internal consistency (ωs ≥ 0.947) and a one-factorial structure. Convergent validity was shown via high correlations of the SAAS with social anxiety (e.g., social interaction anxiety r = 0.642; fear of negative evaluation rs ≥ 0.694), body image disturbance measures (e.g., shape concerns rs ≥ 0.654; weight concerns rs ≥ 0.607; body avoidance rs ≥ 0.612; body checking rs ≥ 0.651) and self-esteem (r = -0.557) as well as moderate correlations with general eating psychopathology (e.g., restrained rs ≥ 0.372; emotional r = 0.439; external eating r = 0.149). Additionally, the SAAS showed gender and age invariance and test-retest reliability after 4 weeks with r = 0.905 in Study 2 and was able to discriminate between individuals with and without an ED in Study 4. CONCLUSION Hence, the German version of the SAAS can reliably and validly assess SAA in female and male adolescents or adults with or without an ED. Additionally, the SAAS might be used in a therapeutic context to especially target patient groups suffering from EDs with comorbid social anxiety. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
Collapse
Affiliation(s)
- Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria.
| | - Anne Kathrin Radix
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr-University Bochum, Hamm, Germany
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron University of Salzburg, Hellbrunnerstrasse 34, 5020, Salzburg, Austria
| | - Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr-University Bochum, Hamm, Germany
| |
Collapse
|
3
|
Engel MM, Gadsby S, Corcoran AW, Keizer A, Dijkerman HC, Hohwy J. Waiting longer, feeling fatter: Effects of response delay on tactile distance estimation and confidence in females with anorexia nervosa. Brain Behav 2022; 12:e2422. [PMID: 34841723 PMCID: PMC8933789 DOI: 10.1002/brb3.2422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/03/2021] [Accepted: 10/10/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Research suggests that patients with anorexia nervosa (AN) exhibit differences in the perceptual processing of their own bodies. However, some researchers suggest that these differences are better explained with reference to non-perceptual factors, such as demand characteristics or emotional responses to the task. In this study, we investigated whether overestimation of tactile distances in participants with AN results from differences in tactile processing or non-perceptual factors, by measuring the role of allowed response time in an adapted version of the tactile distance estimation task (TDE-D). We further investigated the relationship between allowed response time and participants' confidence in their tactile judgments. METHOD Our sample consisted of females: participants with AN (n = 30), recovered (REC) participants (n = 29) and healthy controls (HC) (n = 31). Participants were asked to estimate tactile distances presented on the skin of either a salient (abdomen) or non-salient (arm) body part, either directly after stimulus presentation (direct condition) or after a 5 s delay (delayed condition). Confidence of estimation accuracy was measured after each response. RESULTS Results showed that allowing AN and REC more time to respond caused them to estimate tactile distances as larger. Additionally, participants with AN became less confident when given more time to respond. CONCLUSIONS These results suggest that non-perceptual influences cause participants with AN to increase their estimates of tactile distances and become less certain of these estimates. We speculate that previous findings-where participants with AN estimate tactile distances as larger than HC-may be due to non-perceptual differences.
Collapse
Affiliation(s)
- Manja M Engel
- Dijkermanlab, Department of Experimental Psychology, Faculty of Social and Behavioural Sciences, Heidelberglaan 1, Utrecht, 3584 CS, The Netherlands
| | - Stephen Gadsby
- Cognition and Philosophy Lab, Department of Philosophy, Monash University, 20 Chancellors Walk, Clayton, Victoria, 3800, Australia
| | - Andrew W Corcoran
- Cognition and Philosophy Lab, Department of Philosophy, Monash University, 20 Chancellors Walk, Clayton, Victoria, 3800, Australia
| | - Anouk Keizer
- Dijkermanlab, Department of Experimental Psychology, Faculty of Social and Behavioural Sciences, Heidelberglaan 1, Utrecht, 3584 CS, The Netherlands
| | - H Chris Dijkerman
- Dijkermanlab, Department of Experimental Psychology, Faculty of Social and Behavioural Sciences, Heidelberglaan 1, Utrecht, 3584 CS, The Netherlands
| | - Jakob Hohwy
- Cognition and Philosophy Lab, Department of Philosophy, Monash University, 20 Chancellors Walk, Clayton, Victoria, 3800, Australia
| |
Collapse
|
4
|
Longo MR. Distortion of mental body representations. Trends Cogn Sci 2022; 26:241-254. [PMID: 34952785 DOI: 10.1016/j.tics.2021.11.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 01/07/2023]
Abstract
Our body is central to our sense of self, and distorted body representations are found in several serious medical conditions. This paper reviews evidence that distortions of body representations are also common in healthy individuals, and occur in domains including tactile spatial perception, proprioception, and the conscious body image. Across domains, there is a general tendency for body width to be overestimated compared to body length. Intriguingly, distortions in both eating disorders and chronic pain appear to be exaggerations of this baseline pattern of distortions, suggesting that these conditions may relate to dysfunction of mechanisms for body perception. Distortions of body representations provide a revealing window into basic aspects of self-perception.
Collapse
Affiliation(s)
- Matthew R Longo
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London WC1E 7HX, UK.
| |
Collapse
|
5
|
Brown TA, Shott ME, Frank GKW. Body size overestimation in anorexia nervosa: Contributions of cognitive, affective, tactile and visual information. Psychiatry Res 2021; 297:113705. [PMID: 33472094 DOI: 10.1016/j.psychres.2021.113705] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
Body image disturbance (BID) in anorexia nervosa (AN) is poorly understood and the individual contribution of perceptual, cognitive, and affective components remains unclear. This study compared females with AN and matched healthy controls (HC) on a perceptual size estimation task. Participants (AN n=19 M[SD] age=16.97[2.24], HC n=19, age=15.77[2.17]) were blindfolded and estimated the size of neutral objects, safe foods, unsafe foods, and parts of their bodies (hips, waist, knees, ankle) over three blocks using: 1) no sensory information (baseline), 2) tactile information, and 3) added visual information. There were no significant differences between AN and HC on neutral and safe or unsafe food objects. Participants with AN were significantly more likely to overestimate their body size across blocks compared to HC. Both groups made fewer errors on unsafe foods and body parts when using tactile or visual information compared to baseline. Exploratory analyses revealed significant correlations between body size overestimation and drive for thinness and body dissatisfaction in the AN group, with body dissatisfaction being the most robust. Results suggest that both deficits in tactile and visual perception and affective factors play a role in BID for young women with AN.
Collapse
Affiliation(s)
- Tiffany A Brown
- University of California, UCSD Eating Disorder Center for Treatment and Research, 4510 Executive Dr., Suite 315, San Diego, CA 92121, United States
| | - Megan E Shott
- University of California, UCSD Eating Disorder Center for Treatment and Research, 4510 Executive Dr., Suite 315, San Diego, CA 92121, United States
| | - Guido K W Frank
- University of California, UCSD Eating Disorder Center for Treatment and Research, 4510 Executive Dr., Suite 315, San Diego, CA 92121, United States.
| |
Collapse
|
6
|
Predicting the restrictive eating, exercise, and weight monitoring compulsions of anorexia nervosa. Eat Weight Disord 2020; 25:701-707. [PMID: 30900140 PMCID: PMC7256099 DOI: 10.1007/s40519-019-00674-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/13/2019] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Compulsions surrounding restrictive eating, exercise, and weight monitoring are thought to maintain abnormal eating behaviour in individuals with anorexia nervosa (AN). This study aimed to determine if AN psychopathology and trait anxiety explain the presence of restrictive eating, exercise, and weight monitoring compulsions in a mixed sample. METHODS Participants were 31 females with AN and 31 age and gender-matched healthy individuals (HC). Restrictive eating, exercise and weight monitoring compulsion presence was compared between AN and HC groups. Multivariable poisson regression analyses, adjusted for diagnostic status, were conducted to assess the association of both AN psychopathology and trait anxiety with compulsions across the mixed group. RESULTS Individuals with AN endorsed a greater number of restrictive eating, exercise and weight monitoring compulsions compared to HC. In adjusted poisson regression analyses neither AN psychopathology nor trait anxiety predicted compulsion presence: incidence rate ratio (IRR) for AN psychopathology = 1.15 [95% CI 0.84, 1.57], p = 0.39; IRR for trait anxiety = 1.01 [95% CI 0.97, 1.06], p = 0.50. CONCLUSIONS Greater presence of restrictive eating, exercise and weight monitoring compulsions was reported by individuals with AN, supporting the conceptualisation of disorder behaviours as compulsive. The study was underpowered to robustly evaluate the association between predictors of interest and the compulsions outcome, largely owing to the small sample size. Further investigation is required, ideally using methods able to identify causal and mediation effects. LEVEL OF EVIDENCE Level V, cross-sectional study.
Collapse
|
7
|
Comparison of body image evaluation by virtual reality and paper-based figure rating scales in adolescents with anorexia nervosa: retrospective study. Eat Weight Disord 2020; 25:735-743. [PMID: 30977098 DOI: 10.1007/s40519-019-00680-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/15/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Assessment of the symptoms of body image disorder (BID) is crucial in anorexia nervosa (AN). Recent technological advancements such as virtual reality (VR) have improved the visual perception with 3D avatars and the feeling to be the avatar with the immersive conditions. This retrospective study examines the hypothesis that VR with standardized 3D avatars would improve body image perception and then body image evaluation by adolescents with AN, compared to the paper-based figure rating scales (FRS). METHODS Data of 31 female adolescents with AN were retrospectively studied. Paired data of perceived and desired body forms in addition to body perception index (BPI) (p = 0.2) and body dissatisfaction (p = 0.6), obtained by both VR and FRS were compared. Furthermore, correlation with validated psychometric questionnaires was also studied. Head-tracking technology allowed for the implicit measurement of explicit choices of patients. RESULTS Participants with AN overestimated own body size regardless of the assessment tool used. BPI and body dissatisfaction did not differ significantly between FRS and VR. VR-based evaluation was correlated with the psychometric parameters BID and body dissatisfaction. Head tracking revealed significantly longer participant engagement with avatars representing malnutrition and underweight states, while those least engaged corresponded to obesity. CONCLUSIONS Results of BID evaluation by VR standardized 3D avatars are comparable to those obtained by paper-based FRS. These findings suggest that comparable results obtained by both tools of evaluation reflect primarily the role of affective-cognitive perturbation in BID. The perceptive component could be better evaluated using biometric-enhanced assessment tools. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study (evaluation data retrospectively studied).
Collapse
|
8
|
Ambroziak KB, Azañón E, Longo MR. Body Size Adaptation Alters Perception of Test Stimuli, Not Internal Body Image. Front Psychol 2019; 10:2598. [PMID: 31824381 PMCID: PMC6882410 DOI: 10.3389/fpsyg.2019.02598] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 11/01/2019] [Indexed: 01/25/2023] Open
Abstract
Recent studies have reported that adaptation to extreme body types produces aftereffects on judgments of body normality and attractiveness, and also judgments of the size and shape of the viewer's own body. This latter effect suggests that adaptation could constitute an experimental model of media influences on body image. Alternatively, adaptation could affect perception of test stimuli, which should produce the same aftereffects for judgments about participant's own body or someone else's body. Here, we investigated whether adaptation similarly affects judgments about one's body and other bodies. We were interested in participants' own body image judgments, i.e., we wanted to measure the mental representations to which the test stimuli were compared and not the perception of test stimuli per se. Participants were adapted to pictures of thin or fat bodies and then rated whether bodies were fatter or thinner than either: their own body, an average body (Experiment 1), or the body of another person (Experiments 2 and 3). By keeping the visual stimuli constant but changing the task/type of judgment, i.e., the internal criterion participants are asked to judge the bodies against, we investigated how adaptation affects different stored representations of bodies, specifically own body image vs. representations of others. After adaptation, a classic aftereffect was found, with judgments biased away from the adapting stimulus. Critically, aftereffects were nearly identical for judgments of one's own body and for other people's bodies. These results suggest that adaptation affects body representations in a generic way and may not be specific to the own body image.
Collapse
Affiliation(s)
- Klaudia B Ambroziak
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom.,School of Advanced Study, The Warburg Institute, University of London, London, United Kingdom
| | - Elena Azañón
- Department of Experimental Psychology, Institute of Psychology II, Otto-von-Guericke University, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany.,Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Matthew R Longo
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| |
Collapse
|
9
|
Carey M, Preston C. Investigating the Components of Body Image Disturbance Within Eating Disorders. Front Psychiatry 2019; 10:635. [PMID: 31620027 PMCID: PMC6759942 DOI: 10.3389/fpsyt.2019.00635] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022] Open
Abstract
Body image disturbance has been highlighted as a common characteristic within the development and maintenance of clinical eating disorders (EDs), represented by alterations in an individual's bodily experience. However, whilst the perceptual stability of the sense of body ownership has been investigated in ED patients, the stability of the sense of body agency in those with ED is yet to be examined. Therefore, body ownership and body agency were investigated using the moving rubber hand illusion, alongside measures of explicit and implicit body satisfaction. Furthermore, with evidence demonstrating a direct link between perceptual and cognitive-affective components of body image in the healthy population, the relationship between measures of body perception and body satisfaction was investigated. Results showed that both ED and healthy individuals displayed a similar subjective experience of illusory ownership and agency towards the fake hand, following voluntary movement. However, whilst both groups initially overestimated their own hand width prior to the illusion, the ED group displayed a significant reduction in hand size estimation following the illusion, which was not matched to the same degree in healthy individuals. In addition, ED individuals displayed a significantly lower body satisfaction compared with healthy females, on both an explicit and implicit level. Such implicit outcomes were shown to be driven specifically by a weaker association between the self and attractiveness. Finally, a significant relationship was observed between specific perceptual measures and implicit body satisfaction, which highlights the important link between perceptual and cognitive-affective components of one's body image. Together, such findings provide a useful foundation for further research to study the conditions in which these two components relate with regard to body image and its disturbance, particularly in relation to the prognosis and treatment of EDs.
Collapse
Affiliation(s)
- Mark Carey
- Department of Psychology, University of York, York, United Kingdom
| | | |
Collapse
|
10
|
Yokokura M, Terada T, Bunai T, Nakaizumi K, Kato Y, Yoshikawa E, Futatsubashi M, Suzuki K, Yamasue H, Ouchi Y. Alterations in serotonin transporter and body image-related cognition in anorexia nervosa. NEUROIMAGE-CLINICAL 2019; 23:101928. [PMID: 31491815 PMCID: PMC6627582 DOI: 10.1016/j.nicl.2019.101928] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/17/2019] [Accepted: 07/01/2019] [Indexed: 01/09/2023]
Abstract
The serotonin system has been implicated in the pathophysiology of anorexia nervosa (AN). A recent report proposed that body image distortion (BID), a core symptom of AN, may relate to abnormalities of the serotonin system, especially the serotonin transporter (5HTT). Positron emission tomography (PET) studies of underweight patients with active AN reported alterations in serotonin receptors, but not 5HTT. Here, we aimed to disclose the clinicopathophysiology of AN by focusing on 5HTT and cognitive functions, including BID, in groups with active AN. Twenty-two underweight female patients with AN (12 restricting-type AN (ANR); 10 binge-eating/purging-type AN (ANBP)) and 20 age-matched healthy female subjects underwent PET with a 5HTT radioligand [11C]DASB. The binding potential (BPND) of [11C]DASB was estimated semiquantitatively, and clinical data from Raven's colored progressive matrices for general intelligence, the Stroop test for focused attention, the Iowa gambling task for decision making and a dot-probe task designed for BID were compared with the levels of BPND in different groups. [11C]DASB BPND was significantly decreased in the medial parietal cortex in patients with AN and in the dorsal raphe in patients with ANR compared with healthy subjects (p < .05 corrected). Patients with ANR showed a significantly negative correlation between [11C]DASB BPND in the dorsal raphe and performance on the dot-probe task (p < .05 corrected). While reduced 5HTT in the medial parietal cortex (the somatosensory association area) is pathophysiologically important in AN in general, additional 5HTT reduction in the dorsal raphe as seen in ANR is implicated for the clinicopathophysiological relevance. 5HTT decreased in the parietal cortex in patients with AN. 5HTT decreased in the parietal cortex in patients with ANBP. 5HTT decreased in the parietal cortex and the dorsal raphe in patients with ANR. Patients with AN were poor at responding to the test for body image distortion (BID). 5HTT in the dorsal raphe was associated with cognitive performance of BID.
Collapse
Affiliation(s)
- Masamichi Yokokura
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tatsuhiro Terada
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoyasu Bunai
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kyoko Nakaizumi
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuhiko Kato
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Etsuji Yoshikawa
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan
| | - Masami Futatsubashi
- Hamamatsu PET Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan
| | - Katsuaki Suzuki
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| |
Collapse
|
11
|
Radix AK, Rinck M, Becker ES, Legenbauer T. The Mediating Effect of Specific Social Anxiety Facets on Body Checking and Avoidance. Front Psychol 2019; 9:2661. [PMID: 30671002 PMCID: PMC6331477 DOI: 10.3389/fpsyg.2018.02661] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022] Open
Abstract
Objective: Body checking (BC) and avoidance (BA) form the behavioral component of body image disturbance. High levels of BC/BA have often been documented to hold a positive and potentially reinforcing relationship with eating pathology. While some researchers hypothesize, that patients engage in BC/BA to prevent or reduce levels of anxiety, little is known about the mediating factors. Considering the great comorbidity between eating disorders (ED) and in particular social anxieties, the present study investigated whether socially relevant types of anxiety mediate the relationship between eating pathology and BC/BA. Methods: 83 participants reporting an eating disorder and 323 healthy participants (14–25 years) took part in an online survey. Eating pathology was measured with the Eating Disorder Examination Questionnaire and Body Checking and Avoidance Questionnaire. Trait and social anxiety were assessed by means of the State Trait Anxiety Inventory (STAI-T), the Fear of Negative Evaluation (FNE) and the Social Appearance and Anxiety Scale (SAAS). Separate mediation analyses were carried out with eating pathology as independent variable, BC/BA as dependent variable and STAI, FNE, and SAAS as mediating variables. Results: Anxieties correlated highly positive with eating pathology in both groups. SAAS mediated the relationship between ED pathology and BC/BA in participants with ED and mediated the relationship between ED pathology and BA in healthy participants. FNE mediated the relationship between eating pathology and BA for participants with eating pathology. Discussion: SAAS mediated the relationship between eating pathology and BC/BA. Being afraid of bodily evaluations may represent a particular relevant fear that triggers safety behaviors.
Collapse
Affiliation(s)
- Anne Kathrin Radix
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Eni Sabine Becker
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| |
Collapse
|
12
|
Mazzurega M, Marisa J, Zampini M, Pavani F. Thinner than yourself: self-serving bias in body size estimation. PSYCHOLOGICAL RESEARCH 2018; 84:932-949. [PMID: 30467818 DOI: 10.1007/s00426-018-1119-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 11/07/2018] [Indexed: 11/30/2022]
Abstract
The self-serving bias is the tendency to consider oneself in unrealistically positive terms. This phenomenon has been documented for body attractiveness, but it remains unclear to what extent it can also emerge for own body size perception. In the present study, we examined this issue in healthy young adults (45 females and 40 males), using two body size estimation (BSE) measures and taking into account inter-individual differences in eating disorder risk. Participants observed pictures of avatars, built from whole body photos of themselves or an unknown other matched for gender. Avatars were parametrically distorted along the thinness-heaviness dimension, and individualised by adding the head of the self or the other. In the first BSE task, participants indicated in each trial whether the seen avatar was thinner or fatter than themselves (or the other). In the second BSE task, participants chose the best representative body size for self and other from a set of avatars. Greater underestimation for self than other body size emerged in both tasks, comparably for women and men. Thinner bodies were also judged as more attractive, in line with standard of beauty in modern western society. Notably, this self-serving bias in BSE was stronger in people with low eating disorder risk. In sum, positive attitudes towards the self can extend to body size estimation in young adults, making own body size closer to the ideal body. We propose that this bias could play an adaptive role in preserving a positive body image.
Collapse
Affiliation(s)
- Mara Mazzurega
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Corso Bettini 31, 38068, Rovereto (Trento), Italy.
| | - Jlenia Marisa
- Department of Psychology and Cognitive Science, University of Trento, Rovereto (Trento), Italy
| | - Massimiliano Zampini
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Corso Bettini 31, 38068, Rovereto (Trento), Italy
- Department of Psychology and Cognitive Science, University of Trento, Rovereto (Trento), Italy
| | - Francesco Pavani
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Corso Bettini 31, 38068, Rovereto (Trento), Italy
- Department of Psychology and Cognitive Science, University of Trento, Rovereto (Trento), Italy
| |
Collapse
|
13
|
Thaler A, Geuss MN, Mohler BJ. The Role of Visual Information in Body Size Estimation. Iperception 2018; 9:2041669518796853. [PMID: 30202510 PMCID: PMC6128079 DOI: 10.1177/2041669518796853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 11/16/2022] Open
Abstract
The conscious representation of our physical appearance is important for many aspects of everyday life. Here, we asked whether different visual experiences of our bodies influence body width estimates. In Experiment 1, width estimates of three body parts (foot, hips, and shoulders) without any visual access were compared to estimates with visual feedback available in a mirror or from a first-person perspective. In the no visual access and mirror condition, participants additionally estimated their head width. There was no influence of viewing condition on body part width estimates. Consistent with previous research, all body part widths were overestimated with greater overestimation of hip and head width. In Experiment 2, participants estimated the size of unfamiliar noncorporeal objects to test whether this overestimation was partially due to the metric body size estimation method or our experimental conditions. Object width was overestimated with visual feedback in a mirror available as compared to when directly looking at the object, but only for objects placed at shoulder and head height. We conclude that at least some of the overestimation of body part width seems to be body specific and occurs regardless of the visual information provided about the own body.
Collapse
Affiliation(s)
- Anne Thaler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Michael N. Geuss
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Betty J. Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| |
Collapse
|
14
|
Mölbert SC, Thaler A, Mohler BJ, Streuber S, Romero J, Black MJ, Zipfel S, Karnath HO, Giel KE. Assessing body image in anorexia nervosa using biometric self-avatars in virtual reality: Attitudinal components rather than visual body size estimation are distorted. Psychol Med 2018; 48:642-653. [PMID: 28745268 PMCID: PMC5964466 DOI: 10.1017/s0033291717002008] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN. METHODS We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants' weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity. RESULTS Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1. CONCLUSIONS Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.
Collapse
Affiliation(s)
- S. C. Mölbert
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - A. Thaler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - B. J. Mohler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
| | - S. Streuber
- École Polytechnique Fédérale de Lausanne, Brain
Mind Institute, Lausanne,
Switzerland
| | - J. Romero
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - M. J. Black
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - S. Zipfel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
| | - H.-O. Karnath
- Division of Neuropsychology,
Center of Neurology, Hertie-Institute for Clinical Brain Research, University
of Tübingen, Tübingen, Germany
| | - K. E. Giel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
| |
Collapse
|
15
|
Body representation disturbances in visual perception and affordance perception persist in eating disorder patients after completing treatment. Sci Rep 2017; 7:16184. [PMID: 29170439 PMCID: PMC5701063 DOI: 10.1038/s41598-017-16362-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/09/2017] [Indexed: 11/23/2022] Open
Abstract
Body image disturbances (BID) are a key feature of eating disorders (ED). Clinical experience shows that BID exists in patients who Completed their Eating Disorder Treatment (CEDT), however studies concerning BID in CEDT patients are often limited to cognition and affect, measured by interviews and questionnaires. The current study is the first systematic study investigating the full scope of the mental body representation, including bodily attitudes, visual perception of body size, tactile perception, and affordance perception in CEDT patients. ED patients (N = 22), CEDT patients (N = 39) and healthy controls (HC; N = 30) were compared on BID tasks including the Body Attitude Test (BAT), Visual Size Estimation (VSE), Tactile Estimation Task (TET), and Hoop Task (HT). Results on the BAT show higher scores for ED patients compared to CEDT patients and HC but no difference between CEDT patients and HC. Both ED and CEDT patients show larger overestimations on the VSE and HT compared to HC, where ED patients show the largest overestimations. No group differences were found on the TET. The results indicate the existence of disturbances in visual perception and affordance perception in CEDT patients. Research focussing on more effective treatments for ED addressing multiple (sensory) modalities is advised.
Collapse
|
16
|
Mölbert SC, Klein L, Thaler A, Mohler BJ, Brozzo C, Martus P, Karnath HO, Zipfel S, Giel KE. Depictive and metric body size estimation in anorexia nervosa and bulimia nervosa: A systematic review and meta-analysis. Clin Psychol Rev 2017; 57:21-31. [PMID: 28818670 DOI: 10.1016/j.cpr.2017.08.005] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 07/06/2017] [Accepted: 08/09/2017] [Indexed: 12/28/2022]
Abstract
A distorted representation of one's own body is a diagnostic criterion and core psychopathology of both anorexia nervosa (AN) and bulimia nervosa (BN). Despite recent technical advances in research, it is still unknown whether this body image disturbance is characterized by body dissatisfaction and a low ideal weight and/or includes a distorted perception or processing of body size. In this article, we provide an update and meta-analysis of 42 articles summarizing measures and results for body size estimation (BSE) from 926 individuals with AN, 536 individuals with BN and 1920 controls. We replicate findings that individuals with AN and BN overestimate their body size as compared to controls (ES=0.63). Our meta-regression shows that metric methods (BSE by direct or indirect spatial measures) yield larger effect sizes than depictive methods (BSE by evaluating distorted pictures), and that effect sizes are larger for patients with BN than for patients with AN. To interpret these results, we suggest a revised theoretical framework for BSE that accounts for differences between depictive and metric BSE methods regarding the underlying body representations (conceptual vs. perceptual, implicit vs. explicit). We also discuss clinical implications and argue for the importance of multimethod approaches to investigate body image disturbance.
Collapse
Affiliation(s)
- Simone Claire Mölbert
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany; Max Planck Institute for Biological Cybernetics, Tübingen, Germany; Center of Neurology, Division of Neuropsychology, University of Tübingen, Tübingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany.
| | - Lukas Klein
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, 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
| | - Betty J Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Chiara Brozzo
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Peter Martus
- Institute for Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| |
Collapse
|
17
|
Gadsby S. Distorted body representations in anorexia nervosa. Conscious Cogn 2017; 51:17-33. [DOI: 10.1016/j.concog.2017.02.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/16/2017] [Accepted: 02/22/2017] [Indexed: 01/20/2023]
|
18
|
Caspi A, Amiaz R, Davidson N, Czerniak E, Gur E, Kiryati N, Harari D, Furst M, Stein D. Computerized assessment of body image in anorexia nervosa and bulimia nervosa: comparison with standardized body image assessment tool. Arch Womens Ment Health 2017; 20:139-147. [PMID: 27796596 DOI: 10.1007/s00737-016-0687-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED Body image disturbances are a prominent feature of eating disorders (EDs). Our aim was to test and evaluate a computerized assessment of body image (CABI), to compare the body image disturbances in different ED types, and to assess the factors affecting body image. The body image of 22 individuals undergoing inpatient treatment with restricting anorexia nervosa (AN-R), 22 with binge/purge AN (AN-B/P), 20 with bulimia nervosa (BN), and 41 healthy controls was assessed using the Contour Drawing Rating Scale (CDRS), the CABI, which simulated the participants' self-image in different levels of weight changes, and the Eating Disorder Inventory-2-Body Dissatisfaction (EDI-2-BD) scale. Severity of depression and anxiety was also assessed. Significant differences were found among the three scales assessing body image, although most of their dimensions differentiated between patients with EDs and controls. Our findings support the use of the CABI in the comparison of body image disturbances in patients with EDs vs. CONTROLS Moreover, the use of different assessment tools allows for a better understanding of the differences in body image disturbances in different ED types.
Collapse
Affiliation(s)
- Asaf Caspi
- Department of Psychiatry, The Chaim Sheba, Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Revital Amiaz
- Department of Psychiatry, The Chaim Sheba, Medical Center, Tel Hashomer, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Noa Davidson
- Department of Psychology, The Hebrew University at Jerusalem, Jerusalem, Israel
| | - Efrat Czerniak
- Department of Psychiatry, The Chaim Sheba, Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Gur
- The Eating Disorders Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Nahum Kiryati
- Electrical Engineering-Systems Department, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Harari
- Electrical Engineering-Systems Department, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Furst
- Electrical Engineering-Systems Department, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Pediatric Psychosomatic Department, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| |
Collapse
|
19
|
Keizer A, van Elburg A, Helms R, Dijkerman HC. A Virtual Reality Full Body Illusion Improves Body Image Disturbance in Anorexia Nervosa. PLoS One 2016; 11:e0163921. [PMID: 27711234 PMCID: PMC5053411 DOI: 10.1371/journal.pone.0163921] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 09/17/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Patients with anorexia nervosa (AN) have a persistent distorted experience of the size of their body. Previously we found that the Rubber Hand Illusion improves hand size estimation in this group. Here we investigated whether a Full Body Illusion (FBI) affects body size estimation of body parts more emotionally salient than the hand. In the FBI, analogue to the RHI, participants experience ownership over an entire virtual body in VR after synchronous visuo-tactile stimulation of the actual and virtual body. METHODS AND RESULTS We asked participants to estimate their body size (shoulders, abdomen, hips) before the FBI was induced, directly after induction and at ~2 hour 45 minutes follow-up. The results showed that AN patients (N = 30) decrease the overestimation of their shoulders, abdomen and hips directly after the FBI was induced. This effect was strongest for estimates of circumference, and also observed in the asynchronous control condition of the illusion. Moreover, at follow-up, the improvements in body size estimation could still be observed in the AN group. Notably, the HC group (N = 29) also showed changes in body size estimation after the FBI, but the effect showed a different pattern than that of the AN group. CONCLUSION The results lead us to conclude that the disturbed experience of body size in AN is flexible and can be changed, even for highly emotional body parts. As such this study offers novel starting points from which new interventions for body image disturbance in AN can be developed.
Collapse
Affiliation(s)
- Anouk Keizer
- Experimental Psychology/Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- * E-mail:
| | - Annemarie van Elburg
- Altrecht Center for Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
- Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Rossa Helms
- Experimental Psychology/Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - H. Chris Dijkerman
- Experimental Psychology/Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands
| |
Collapse
|
20
|
Feusner JD, Dervisic J, Kosidou K, Dhejne C, Bookheimer S, Savic I. Female-to-Male Transsexual Individuals Demonstrate Different Own Body Identification. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:525-536. [PMID: 26292839 DOI: 10.1007/s10508-015-0596-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 06/04/2023]
Abstract
Transsexualism is characterized by feelings of incongruity between one's natal sex and one's gender identity. It is unclear whether transsexual individuals have a body image that is more congruent with their gender identity than their sex assigned at birth (natal sex) and, if so, whether there are contributions from perceptual dysfunctions. We compared 16 pre-hormone treatment female-to-male transsexual (FtM) individuals to 20 heterosexual female and 20 heterosexual male controls on a visual identification task. Participants viewed photographs of their own body that were morphed by different degrees to bodies of other females or males, and were instructed to rate "To what degree is this picture you?" We also tested global vs. local visual processing using the inverted faces task. FtM differed from both control groups in demonstrating higher self-identification ratings for bodies morphed to the sex congruent with their gender identity, and across a broad range of morph percentages. This difference was more pronounced for longer viewing durations. FtM showed reduced accuracy for upright faces compared with female controls for short duration stimuli, but no advantage for inverted faces. These results suggest different own body identification in FtM, consisting of a relatively diffuse identification with body images congruent with their gender identity. This is more likely accounted for by conscious, cognitive factors than perceptual differences.
Collapse
Affiliation(s)
- Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at the University of California Los Angeles, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA, 90095-8346, USA.
| | - Jasenko Dervisic
- Department of Women's and Children's Health and Neurology Clinic, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Kyriaki Kosidou
- Gender Team, Psychiatry Southwest, Center for Epidemiology and Community Medicine, Karolinska University Hospital Huddinge, Stockholm County Council, Solna, Sweden
| | - Cecilia Dhejne
- Gender Team, Department of Clinical Neuroscience, Center for Andrology and Sexual Medicine and Centre for Psychiatry Research, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Susan Bookheimer
- Center for Cognitive Neuroscience, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | - Ivanka Savic
- Department of Women's and Children's Health and Neurology Clinic, Karolinska Institute and University Hospital, Stockholm, Sweden
| |
Collapse
|
21
|
Abstract
Studies published between the beginning of 2013 and May 2015 on the neuropsychological functioning of patients with anorexia nervosa compared with healthy participants framed in the context of the Research Domain Criteria matrix identifies evidence for functional differences in three domains: Negative Valance Systems-negative attentional biases and lack of neural responsivity to hunger; Cognitive Systems-limited congruence between clinical and cognitive performance, poorer non-verbal than verbal performance, altered attentional styles to disorder related stimuli, perceptual processing impairment in discriminating body images, weaknesses in central coherence, set shifting weaknesses at low weight status, decision-making weaknesses, and greater neural resources required for working memory; Systems for Social Processes-patients appear to have a different attentional response to faces, and perception and understanding of self and others. Hence, there is evidence to suggest that patients with anorexia nervosa have a specific neuropsychological performance style across tasks in three domains of functioning. Some current controversies and areas for future development are identified.
Collapse
Affiliation(s)
- Marie-Claire Reville
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
| | - Lorna O'Connor
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Ian Frampton
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| |
Collapse
|
22
|
Keizer A, Smeets MA, Postma A, van Elburg A, Dijkerman HC. Does the experience of ownership over a rubber hand change body size perception in anorexia nervosa patients? Neuropsychologia 2014; 62:26-37. [DOI: 10.1016/j.neuropsychologia.2014.07.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 07/06/2014] [Accepted: 07/09/2014] [Indexed: 01/10/2023]
|