1
|
Boucher JD, Bourgin J, Lassiaz J, Propice K, Metral M. The impact of weight and negative body image on the body schema in undergraduate women. Exp Brain Res 2024; 242:1373-1385. [PMID: 38565782 DOI: 10.1007/s00221-024-06827-6] [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: 10/11/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND AND OBJECTIVES Alterations of the sensory-motor body schema question the origins of such distortions. For example, in anorexia nervosa where patients think they are broader than they really are (body image) but act as if it was really the case (body schema). To date, the results of studies about what hinders the updating of the body schema so much (weight, body image) have been contradictory. METHODS We therefore conducted two studies that aimed to assess the impact of weight and body image problems on body schema in 92 young women without anorexia nervosa. For this purpose, we used a new body schema assessment tool (SKIN) that is sensitive enough to detect fine alterations of body schema in seven different body parts. RESULTS In Study 1, the thinness or overweight of the young women had a major impact on their tactile perception, especially because the assessed body part was a sensitive area for body dissatisfaction in young women (e.g., belly, thigh). In Study 2, the level of body dissatisfaction of the participants in its attitudinal and perceptual dimension also had a negative impact on their body schema, again in interaction with weight and body part. CONCLUSIONS These results imply that body dissatisfaction and thinness are predictors of massive body schema distortions. An oversized body schema could maintain various weight-control behaviors, thus risking the development, maintenance, or relapse of an eating disorder.
Collapse
Affiliation(s)
- Jean-David Boucher
- Univ. Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, 38000, Grenoble, France
| | - Jessica Bourgin
- Univ. Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, 38000, Grenoble, France
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | | | - Klervi Propice
- Univ. Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, 38000, Grenoble, France
| | - Morgane Metral
- Univ. Savoie Mont Blanc, Univ. Grenoble Alpes, LIP/PC2S, 38000, Grenoble, France.
| |
Collapse
|
2
|
Vabba A, Porciello G, Panasiti MS, Aglioti SM. Development and validation of the Exteroceptive Body Awareness (EBA-q) questionnaire. PeerJ 2023; 11:e15382. [PMID: 37641601 PMCID: PMC10460568 DOI: 10.7717/peerj.15382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/18/2023] [Indexed: 08/31/2023] Open
Abstract
The conscious processing of body signals influences higher-order psychological and cognitive functions, including self-awareness. Dysfunctions in the processing of these signals has been connected to neurological and psychiatric disorders characterized by altered states of self-consciousness. Studies indicate that perceiving the body through interoceptive signals (e.g., from internal organs such as heartbeat and breathing) is distinct from perceiving the body through exteroceptive signals (e.g., by relying on visual, tactile and olfactory cues). While questionnaires are available for assessing interoception, there are no validated self-report instruments for measuring bodily exterception. To fill this gap, we performed three studies to develop and validate a novel scale designed to assess bodily self-consciousness based on the processing of exteroceptive bodily signals. Exploratory factor analysis (Study 1, N = 302) led to an 18-item questionnaire comprised of four factors. We called this instrument Exteroceptive Body Awareness questionnaire (EBA-q). Confirmatory factor analysis (Study 2, N = 184) run on a second sample showed an acceptable fit for a bifactor model, suggesting researchers may use the questionnaire as a unidimensional scale reflecting exteroceptive bodily self-consciousness, or use each of its four sub-scales, reflecting "visuo-tactile body awareness", "spatial coordination", "awareness of body changes" and "awareness of clothing fit". Overall EBA-q showed good internal consistency. Convergent and divergent validity were assessed via cross-validation with existing body awareness questionnaires (Study 3, N = 366) and behavioral measures (Study 3, N = 64) of exteroceptive and interoceptive bodily self-consciousness. Research applications are discussed within a multi-faceted model of exteroception and interoception as distinct, but at the same time interconnected, dimensions of bodily self-consciousness.
Collapse
Affiliation(s)
- Alisha Vabba
- Department of Psychology, Sapienza University of Rome and CLN2S@Sapienza, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
| | - Giuseppina Porciello
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Maria Serena Panasiti
- IRCCS, Santa Lucia Foundation, Rome, Italy
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Salvatore Maria Aglioti
- Department of Psychology, Sapienza University of Rome and CLN2S@Sapienza, Rome, Italy
- IRCCS, Santa Lucia Foundation, Rome, Italy
| |
Collapse
|
3
|
Impact of an overweight body representation in virtual reality on locomotion in a motor imagery task. PSYCHOLOGICAL RESEARCH 2023; 87:462-473. [PMID: 35338404 DOI: 10.1007/s00426-022-01675-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
Virtual reality immersion enables a person to embody avatars that strongly deviate from his/her biological body. Interestingly, the person's expectations about the embodied avatar lead to congruous behavior, phenomenon referred to as the Proteus effect. The objective of the present study was to investigate, in virtual reality, the relationship between body-shape representation and expected physical abilities in a locomotor imagery task, in the context of overweight avatar embodiment. Given the negative stereotypes concerning overweight people's physical abilities, we expected overweight avatar embodiment to have a negative impact on performance in the locomotor imagery task. Thirty-five healthy-weight participants, with a body mass index between 16.5 and 30 at the time of the experiment or in the past, embodied both a healthy-weight avatar and an overweight avatar on two different experimental sessions while performing the imagery task (walking four different distances on two different slopes). In accordance with our hypothesis, participants took longer to perform the locomotor imagery task when embodying an overweight avatar than when embodying a healthy-weight one (the "avatar effect")-especially so when the distance to be covered was long. We conclude that, as has already been reported for people with anorexia nervosa, considering one's own body to be fatter than it really is leads to congruent weight-related behavior.
Collapse
|
4
|
Varlı Ü, Naz İ, Yılmaz H. Investigation of Body Awareness and Affecting Factors in Patients with Bariatric Surgery. Obes Surg 2022; 32:829-836. [PMID: 34988896 DOI: 10.1007/s11695-021-05864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Major weight loss after bariatric surgery (BS) makes the body sensitive to the environment. The factors associated with body awareness are unknown in patients with BS. In this study, we aimed to investigate the body awareness and the affecting factors in patients with BS. METHODS Our study included 81 patients who had BS at least 6 months ago and 40 people of the same age and gender who had not. Participants' body awareness was evaluated with the Body Awareness Questionnaire, body compositions with bioelectric impedance device, joint position sensation (JPS) with photography method, physical activity level with International Physical Activity Questionnaire, quality of life with the Short Form-36, depression status with the Beck Depression Inventory, and cognition with the Montreal Cognitive Assessment Scale. Mann-Whitney U and Chi-square tests were used for the comparison of the groups, and Spearman correlation analysis was used for in-group correlation analysis. RESULTS Body awareness was found to be higher in patients with BS compared to the control group (p = 0.002). Body awareness had a positive correlation with cognition (r = 0.277, p = 0.012), quality of life sub-scales (r = 0.245-0.374, p < 0.05), the amount of change in total body weight (r = 0.241, p = 0.027), and body mass index (BMI) (r = 0.269, p = 0.032); negative correlation with depression (r = - 0.409, p = 0.016) and deviation in the JPS (r = - 0.223, p = 0.046). CONCLUSION Body awareness of patients with BS was found to be high after surgery. Body awareness in patients with BS is associated with the amount of weight loss and BMI, depression, cognition, JPS, and health-related quality of life.
Collapse
Affiliation(s)
- Ümit Varlı
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, İzmir Katip Çelebi University, 35620, Çiğli İzmir, Turkey. .,Physiotherapy and Rehabilitation Clinic, EMOT Hospital, İzmir, Turkey.
| | - İlknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Katip Çelebi University, İzmir, Turkey
| | - Hüsnü Yılmaz
- Department of Endocrinology and Metabolic Diseases, Private Can Hospital, İzmir, Turkey
| |
Collapse
|
5
|
Baumann P, Beckmann N, Herpertz S, Trojan J, Diers M. Influencing the body schema through the feeling of satiety. Sci Rep 2022; 12:2350. [PMID: 35149735 PMCID: PMC8837638 DOI: 10.1038/s41598-022-06331-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/21/2022] [Indexed: 11/09/2022] Open
Abstract
The body schema is a much discussed aspect of body awareness. Although there is still no single definition, there is widespread consensus that the body schema is responsible for movement and interaction with the environment. It usually remains outside of active consciousness. There are only few investigations on influences on the body schema and none of them investigated feeling of satiety or hunger. Thirty-two healthy women were investigated twice, one time sat and the other time hungry. To measure the body schema, we used a door-like-aperture and compared the critical aperture-to-shoulder-ratio (cA/S). A cover story was used to ensure that the unconscious body schema has been measured. We found a significantly higher cA/S for satiety compared to hungry, which indicates that during satiety participants rotate their shoulders for relatively larger door compared to hunger, unconsciously estimating their body size to be larger. We showed that even a moderate rated feeling of hunger or satiety leads to an adjustment in body-scaled action and consequently also an adaptation of body schema. It suggests that, in addition to the visual-spatial and the proprioceptive representation, somatic information can also be relevant for the body schema.
Collapse
Affiliation(s)
- Patricia Baumann
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Nina Beckmann
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Jörg Trojan
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
| |
Collapse
|
6
|
Scarpina F, Paschino C, Scacchi M, Mauro A, Sedda A. EXPRESS: Does physical weight alter the mental representation of the body? Evidence from motor imagery in obesity. Q J Exp Psychol (Hove) 2022; 75:2349-2365. [PMID: 35001709 DOI: 10.1177/17470218221075038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Obesity is a clinical condition that impacts severely the physical body. However, evidence related to the mental representation of the body in action is scarce. The few available studies only focus on avoiding obstacles, rather than participants imagining their own body. METHOD To advance knowledge in this field, we assessed the performance of twenty-two individuals with obesity compared to thirty individuals with a healthy weight in two tasks that implied different motor (more implicit vs. more explicit) imagery strategies. Two tasks were also administered to control for visual imagery skills, to rule out confounding factors. Moreover, we measured body uneasiness, through a standard questionnaire, as body image negativity could impact on other body representation components. RESULTS Our findings do not show differences in the motor imagery tasks between individuals with obesity and individuals with healthy weight. On the other hand, some differences emerge in visual imagery skills. Crucially, individuals with obesity did report a higher level of body uneasiness. CONCLUSIONS Despite a negative body image and visual imagery differences, obesity per se does not impact on the representation of the body in action. Importantly, this result is independent from the level of awareness required to access the mental representation of the body.
Collapse
Affiliation(s)
- Federica Scarpina
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy 9314.,I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Clara Paschino
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy 9354
| | - Massimo Scacchi
- I.R.C.C.S. Istituto Auxologico Italiano, Divisione di Endocrinologia e Malattie Metaboliche, Ospedale San Giuseppe, Piancavallo (VCO), Italy 155032.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Alessandro Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy 155032.,I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Anna Sedda
- Psychology Department, School of Social Sciences, Heriot-Watt University, Edinburgh, UK 3120.,Centre for Applied Behavioural Sciences, School of Social Sciences, Heriot-Watt University
| |
Collapse
|
7
|
Goossens N, Geraerts I, Vandenplas L, Van Veldhoven Z, Asnong A, Janssens L. Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum. BMC Pregnancy Childbirth 2021; 21:219. [PMID: 33736613 PMCID: PMC7977601 DOI: 10.1186/s12884-021-03704-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP. Methods A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum. Results Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p < 0.001) during late pregnancy, and with pain intensity 6 weeks postpartum (σ = 0.403, p = 0.015). A disturbed body perception during late pregnancy nearly significantly predicted having postpartum LPP (Odds Ratio = 1.231, p = 0.052). Conclusions Body perception disturbance was greater in women experiencing LPP during late pregnancy and postpartum compared to pain-free women, and correlated with pain intensity and disability. Though non-significant (p = 0.052), the results of the regression analysis suggest that greater body perception disturbance during late pregnancy might predict having LPP postpartum. However, future studies should follow up on this. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03704-w.
Collapse
Affiliation(s)
- Nina Goossens
- REVAL Rehabilitation Research Center, UHasselt - Hasselt University, Agoralaan A, 3590, Diepenbeek, Belgium.
| | - Inge Geraerts
- Department of Rehabilitation Sciences, KU Leuven, ON IV Herestraat 49 - box 1510, 3000, Leuven, Belgium
| | - Lizelotte Vandenplas
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Zahra Van Veldhoven
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Anne Asnong
- Department of Rehabilitation Sciences, KU Leuven, ON IV Herestraat 49 - box 1510, 3000, Leuven, Belgium
| | - Lotte Janssens
- REVAL Rehabilitation Research Center, UHasselt - Hasselt University, Agoralaan A, 3590, Diepenbeek, Belgium
| |
Collapse
|
8
|
Barra J, Giroux M, Metral M, Cian C, Luyat M, Kavounoudias A, Guerraz M. Functional properties of extended body representations in the context of kinesthesia. Neurophysiol Clin 2020; 50:455-465. [PMID: 33176990 DOI: 10.1016/j.neucli.2020.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022] Open
Abstract
A person's internal representation of his/her body is not fixed. It can be substantially modified by neurological injuries and can also be extended (in healthy participants) to incorporate objects that have a corporeal appearance (such as fake body segments, e.g. a rubber hand), virtual whole bodies (e.g. avatars), and even objects that do not have a corporeal appearance (e.g. tools). Here, we report data from patients and healthy participants that emphasize the flexible nature of body representation and question the extent to which incorporated objects have the same functional properties as biological body parts. Our data shed new light by highlighting the involvement of visual motion information from incorporated objects (rubber hands, full body avatars and hand-held tools) in the perception of one's own movement (kinesthesia). On the basis of these findings, we argue that incorporated objects can be treated as body parts, especially when kinesthesia is involved.
Collapse
Affiliation(s)
- Julien Barra
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Marion Giroux
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Morgane Metral
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, Grenoble, France
| | - Corinne Cian
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France; Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France
| | - Marion Luyat
- Univ. Lille, URL 4072 - PSITEC - Psychologie : Interactions, Temps, Emotions, Cognition, F-59000 Lille, France
| | - Anne Kavounoudias
- Aix-Marseille University, CNRS, LNSC UMR 7260, F-13331 Marseille, France
| | - Michel Guerraz
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France.
| |
Collapse
|
9
|
Majority of female bariatric patients retain an obese identity 18-30 months after surgery. Eat Weight Disord 2020; 25:357-364. [PMID: 30382542 DOI: 10.1007/s40519-018-0601-3] [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: 05/18/2018] [Accepted: 10/19/2018] [Indexed: 01/25/2023] Open
Abstract
PURPOSE When bariatric surgery is performed, a successful outcome is usually described as % total weight lost (EWL) or a change in BMI. These definitions fail to address the importance of post-operative psychosocial adjustment. Previous research has alluded to a 'mind-body lag' where the patient's experienced body feels larger than their physically smaller post-operative body, perhaps as a result of amygdalae conditioning. The purpose of this study is to further investigate this psychological issue and assess its relationship to health locus of control, alexithymia, health quality of life and weight regain in bariatric surgery patients. METHODS Forty female bariatric surgery patients between 18 and 30 months post-op completed demographic data, survey instruments and anthropometric testing. Their evolving self-view, health locus of control, tendency toward alexithymic thought, and health quality of life were measured to identify significant relationships. Hermans' Dialogical Self Theory was used to understand the conflicted self-view of the participants. RESULTS The majority of participants retained an obese view of self despite weight loss. Those who retained an 'I-obese' viewpoint were significantly more likely to see external situations and powerful others as controlling their weight, have difficulty identifying their feelings and score significantly lower in vitality, social functioning and mental health. CONCLUSION Despite losing weight, the majority of participants retained an obese view of self that was significantly associated with a lessened health quality of life. Use of the Evolving Self-View (ESV) exploratory tool may allow early identification of post-operative patients with a prolonged 'I-obese' self-view and provide an opportunity for intervention. LEVEL OF EVIDENCE Level III, cross-sectional case-control study.
Collapse
|
10
|
The Effect of a Virtual-Reality Full-Body Illusion on Body Representation in Obesity. J Clin Med 2019; 8:jcm8091330. [PMID: 31466376 PMCID: PMC6780081 DOI: 10.3390/jcm8091330] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/26/2022] Open
Abstract
Background. The effective illusory ownership over an artificial body in modulating body representations in healthy and eating disorders population has been repeatedly reported in recent literature. In this study, we extended this research in the field of obesity: specifically, we investigated whether ownership over a virtual body with a skinny abdomen might be successfully experienced by participants affected by obesity. Methods. Fifteen participants with obesity and fifteen healthy-weight participants took part at this study in which the VR-Full-Body Illusion was adopted. The strength of illusion was investigated through the traditional Embodiment Questionnaire, while changes in bodily experience were measured through a body size estimation task. Results. Participants with obesity as well as healthy-weight participants reported to experience the illusion. About the body size estimation task, both groups reported changes only in the estimation of the abdomen’s circumference after the experimental condition, in absence of any another difference. Discussion. Participants with obesity reported to experience the illusion over a skinny avatar, but the modulation of the bodily experience seems controversial. Future lines of research exploiting this technique for modulating body representations in obesity, specifically in terms of potential therapeutic use, were discussed.
Collapse
|
11
|
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: 3] [Impact Index Per Article: 0.6] [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
|
12
|
Perdue TO, Schreier A, Swanson M, Neil J, Carels R. Evolving self view and body image concerns in female postoperative bariatric surgery patients. J Clin Nurs 2018; 27:4018-4027. [PMID: 29776012 DOI: 10.1111/jocn.14527] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To explore the experience of postoperative bariatric surgery patients as they adjust to diminished weight and differentiate that adjustment from the more general concept of body image. BACKGROUND Bariatric surgery is an effective way to reduce weight and comorbidities associated with obesity. Complete success requires that patients must adjust psychologically as they lose weight. If this does not occur, bariatric patients may experience a "mind-body lag," in which the patient's internal body image lags behind the external changes. Hermans' Dialogical Self Theory of "I-positions" is a foundation with which to understand this problem. DESIGN Descriptive correlational study of postoperative bariatric patients explored the concept of "I-obese" and "I-ex-obese" in an effort to quantify previous qualitative findings and develop a survey questionnaire. METHODS Bariatric patients (N = 55) between 18-30 months postoperative completed one-hour interviews. Cluster analysis and chi-squared analysis compared mean scores and explored the prevalence of "I-positions" and body image concerns in the participants. RESULTS Cluster analysis of the survey data identified participants as falling into either "I-obese," "I-ex-obese" or "mixed I-obese" categories. There were significantly higher body image concerns in the "I-obese" participants than those identified as "I-ex-obese." The majority of female participants reported high body image concerns. There was no significant association with weight loss percentage. CONCLUSION This research establishes a connection in this study sample of women who experience body image concerns and prolonged "I-obese" identification 18-30 months after their bariatric surgery. RELEVANCE TO CLINICAL PRACTICE To date, the primary measure of bariatric surgery success has focused almost exclusively on the amount of weight loss. Implementing psychological as well as physiological care, however, may be the key to full recovery and long-term success. Practitioners can use this new information to plan effective pre- and postoperative psychological preparation and support.
Collapse
Affiliation(s)
- Tamara O Perdue
- Metabolic Surgery Research Group, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Ann Schreier
- College of Nursing, East Carolina University, Greenville, North Carolina
| | - Melvin Swanson
- College of Nursing, East Carolina University, Greenville, North Carolina
| | - Janice Neil
- College of Nursing, East Carolina University, Greenville, North Carolina
| | - Robert Carels
- Department of Psychology, East Carolina University, Greenville, North Carolina
| |
Collapse
|
13
|
Perdue TO, Schreier A, Neil J, Carels R, Swanson M. A Concept Analysis of Disturbed Body Image in Bariatric Surgery Patients. Int J Nurs Knowl 2018; 31:74-81. [PMID: 30040231 DOI: 10.1111/2047-3095.12220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE This article describes the concept of disturbed body image in bariatric surgery patients. METHOD Walker and Avant's (2011) method of concept analysis is used in this study. FINDINGS After bariatric surgery, the patient's body may change more rapidly than their allocentric ("inside, lived") view of themselves, leading to physical and psychosocial sequelae. CONCLUSION If not prepared physically and psychologically for body image challenges after bariatric surgery, patients may experience disturbed body image in the postoperative phase. IMPLICATIONS FOR NURSING PRACTICE Understanding the concept of disturbed body image in postoperative bariatric surgery patients may allow health providers to provide preoperative teaching and preparation, as well as postoperative interventions to create congruence between the patient's internal and external selves.
Collapse
Affiliation(s)
- Tamara O Perdue
- Metabolic Surgery Research Group, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Ann Schreier
- Professor in College of Nursing, East Carolina University, Greenville, North Carolina
| | - Janice Neil
- Associate Professor in College of Nursing, East Carolina University, Greenville, North Carolina
| | - Robert Carels
- Professor in the Department of Psychology, East Carolina University, Greenville, North Carolina
| | - Melvin Swanson
- Professor in the College of Nursing at East Carolina University, Greenville, North Carolina
| |
Collapse
|
14
|
Natvik E, Groven KS, Råheim M, Gjengedal E, Gallagher S. Space perception, movement, and insight: attuning to the space of everyday life after major weight loss. Physiother Theory Pract 2018; 35:101-108. [PMID: 29485300 DOI: 10.1080/09593985.2018.1441934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Physiotherapists are well placed to help people adjust and engage meaningfully with the world following major weight loss. Recent research indicates that the body size a patient has lived with for years can continue to affect movement and perception even after largescale weight loss. This article explores this discrepancy in depth from the perspective of phenomenology and space perception and through the concepts of body image, body schema, and affordances. It draws on an empirical example in which a nautical engineer described his lived experience of returning to work following bariatric surgery and the discrepancies he experienced while adjusting to his new situation, particularly when moving his smaller body around the ship's engine room, previously inaccessible to him. Analysis of this empirical example suggests that transitions in weight and size following bariatric surgery are both highly explicit in awareness (i.e., body image) and outside awareness (i.e., body schema). Major weight loss can open up new affordances and possibilities of being in the world, but only after adjustments in body image and body schema. The article suggests ways in which such insights can contribute to physiotherapists' clinical development and practice when working with patients undergoing major weight loss.
Collapse
Affiliation(s)
- Eli Natvik
- a Faculty of Health Studies, Department of Health and Caring Sciences , Western Norway University of Applied Sciences , Førde , Norway
| | - Karen Synne Groven
- b Faculty of Health, Institute of Physiotherapy , Oslo Metropolitan University, Oslo, Norway
| | - Målfrid Råheim
- c Faculty of Medicine and Dentistry, Department of Global Health and Primary Care , University of Bergen , Bergen, Norway
| | - Eva Gjengedal
- c Faculty of Medicine and Dentistry, Department of Global Health and Primary Care , University of Bergen , Bergen, Norway
| | - Shaun Gallagher
- d Department of Philosophy , University of Memphis , Memphis , TN , USA.,e Faculty of Law, Humanities and the Arts , University of Wollongong , Wollongong , Australia
| |
Collapse
|
15
|
Scarpina F, Cau N, Cimolin V, Galli M, Castelnuovo G, Priano L, Pianta L, Corti S, Mauro A, Capodaglio P. Body-scaled action in obesity during locomotion: Insights on the nature and extent of body representation disturbances. J Psychosom Res 2017; 102:34-40. [PMID: 28992895 DOI: 10.1016/j.jpsychores.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/23/2017] [Accepted: 09/01/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Conscious perception of our own body, also known as body image, can influence body-scaled actions. Certain conditions such as obesity are frequently accompanied by a negative body image, leaving open the question if body-scaled actions are distorted in these individuals. METHODS To shed light on this issue, we asked individuals affected by obesity to process dimensions of their own body in a real action: they walked in a straight-ahead direction, while avoiding collision with obstacles represented by door-like openings that varied in width. RESULTS Participants affected by obesity showed a body rotation behavior similar to that of the healthy weighted, but differences emerged in parameters such as step length and velocity. CONCLUSION When participants with obesity walk through door-like openings, their body parts rotation is scaled according to their physical body dimensions; however, they might try to minimize risk of collision. Our study is in line with the hypothesis that unconscious body-scaled actions are related to emotional, cognitive and perceptual components of a negative body image.
Collapse
Affiliation(s)
- Federica Scarpina
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy; Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy.
| | - Nicola Cau
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy; IRCCS "San Raffaele Pisana", Tosinvest Sanità, Rome, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Lorenzo Priano
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy; Division of Neurology and Neuro-Rehabilitation, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Lucia Pianta
- Division of Neurology and Neuro-Rehabilitation, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy; Research Laboratory in Biomechanics and Rehabilitation, Orthopedic Rehabilitation Unit, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Stefania Corti
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Alessandro Mauro
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy; Division of Neurology and Neuro-Rehabilitation, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Paolo Capodaglio
- Research Laboratory in Biomechanics and Rehabilitation, Orthopedic Rehabilitation Unit, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| |
Collapse
|
16
|
Serino S, Scarpina F, Keizer A, Pedroli E, Dakanalis A, Castelnuovo G, Chirico A, Novelli M, Gaudio S, Riva G. A Novel Technique for Improving Bodily Experience in a Non-operable Super-Super Obesity Case. Front Psychol 2016; 7:837. [PMID: 27378965 PMCID: PMC4909741 DOI: 10.3389/fpsyg.2016.00837] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/18/2016] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The available clinical guidelines for super-super obese patients (i.e., with body mass index (BMI) > 60 kg/m(2)) that are not suitable for bariatric surgery mandate a palliative multidisciplinary treatment (i.e., production and maintenance of weight loss) provided in a center of excellence. However, the modality and the impact of this approach are still controversial. Moreover, it is not able to address the high level of body dissatisfaction and body distortions that are common among these patients. CLINICAL PRESENTATION We report the case of a non-operable super-super obesity - a 37 year old woman with a BMI of 62 kg/m(2) - receiving a specialized treatment for her obstructive sleep apnea. She entered a multidisciplinary program that promoted healthy behaviors, including physical activities and psychological intervention. To improve body dissatisfaction, which was linked to a significant multisensory impairment of body perception, she also entered a virtual reality (VR) body-swapping illusion protocol. At the end of the current investigation, the patient continued her multidisciplinary program, reporting an increase in the motivation for undertaking healthy behavior and a decrease in the anxiety feelings associated with her clinical condition. CONCLUSION This case provides preliminary evidence that both body dissatisfaction and body-size distortions of non-operable super-super obesity patients could be addressed by a VR body-swapping protocol, which is important because the palliative multidisciplinary treatment recommended for these patients is not able to address them. Interestingly, the use of a VR body-swapping illusion protocol seems to be able to improve not only the experience of the body in these patients but their motivation for change, too.
Collapse
Affiliation(s)
- Silvia Serino
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, MilanItaly; Department of Psychology, Università Cattolica del Sacro Cuore, MilanItaly
| | - Federica Scarpina
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, TurinItaly; Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, PiancavalloItaly
| | - Anouk Keizer
- Department of Experimental Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht Netherlands
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan Italy
| | - Antonios Dakanalis
- Department of Brain and Behavioral Sciences, University of Pavia, PaviaItaly; Department of Surgery and Interdisciplinary Medicine, University of Milano-Bicocca, MilanItaly
| | - Gianluca Castelnuovo
- Department of Psychology, Università Cattolica del Sacro Cuore, MilanItaly; Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, PiancavalloItaly
| | - Alice Chirico
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan Italy
| | - Margherita Novelli
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo Italy
| | - Santino Gaudio
- Centre for Integrated Research, Area of Diagnostic Imaging, University Campus Bio-Medico, RomeItaly; Department of Neuroscience, Functional Pharmacology, Uppsala University, UppsalaSweden
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, MilanItaly; Department of Psychology, Università Cattolica del Sacro Cuore, MilanItaly
| |
Collapse
|
17
|
Metral M, Guardia D, Bauwens I, Guerraz M, Lafargue G, Cottencin O, Luyat M. Painfully thin but locked inside a fatter body: abnormalities in both anticipation and execution of action in anorexia nervosa. BMC Res Notes 2014; 7:707. [PMID: 25298129 PMCID: PMC4201671 DOI: 10.1186/1756-0500-7-707] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 10/02/2014] [Indexed: 11/25/2022] Open
Abstract
Background People with anorexia nervosa (AN) usually report feeling broader than they really are. The objective of the present study was to better understand the body schema's involvement in this false self-representation in AN. We tested the potential for correction of the body schema impairment via the sensorimotor feedback provided by a real, executed action and relative to an imagined action. We also took account of the impact of the AN patients’ weight variations on the task outcomes. Methods Fourteen inpatient participants with AN and fourteen control participants were presented with a doorway-like aperture. The participants had to (i) judge whether or not various apertures were wide enough for them to pass through in a motor imagery task and then (ii) actually perform the action by passing through various apertures. Results We observed a higher passability ratio (i.e. the ratio between the critical aperture size and shoulder width) in participants with AN (relative to controls) for both motor imagery and real action. Moreover, the magnitude of the passability ratio was positively correlated with weight recovery. Conclusion The body schema alteration in AN appears to be strong enough to affect the patient's actions. Furthermore, the alteration resists correction by the sensorimotor feedback generated during action. This bias is linked to weight variations. The central nervous system might be locked to a false representation of the body that cannot be updated. Moreover, these results prompt us to suggest that emotional burden during weight recovery could also alter sensorimotor aspects of body representation. New therapeutic methods should take account of body schema alterations in AN as adjuncts to psychotherapy.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Marion Luyat
- LNFP (Laboratory of Functional Neuroscience and Pathology) EA4559, F-59000 Lille, France.
| |
Collapse
|
18
|
Riva G. Out of my real body: cognitive neuroscience meets eating disorders. Front Hum Neurosci 2014; 8:236. [PMID: 24834042 PMCID: PMC4018545 DOI: 10.3389/fnhum.2014.00236] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/01/2014] [Indexed: 12/15/2022] Open
Abstract
Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models—the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory—identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies—body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric).
Collapse
Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano Milan, Italy ; Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| |
Collapse
|
19
|
Riva G, Gaudio S, Dakanalis A. I'm in a virtual body: a locked allocentric memory may impair the experience of the body in both obesity and anorexia nervosa. Eat Weight Disord 2014; 19:133-4. [PMID: 24068525 DOI: 10.1007/s40519-013-0066-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 08/31/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | | | | |
Collapse
|
20
|
Virtual Reality Based Treatments in Eating Disorders and Obesity: A Review. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2013. [DOI: 10.1007/s10879-013-9240-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|