[Body image and psychiatric comorbidity in patients with somatoform gastrointestinal disorders]

Orthorexic eating behavior in patients with somatoform disorders

PURPOSE

Although anecdotal reports suggest a relation between orthorexic eating behavior and symptoms of somatoform disorders, this issue has not yet been investigated. The aim of this study was to compare orthorexic eating behavior and other characteristics of disordered eating behavior in patients with somatoform disorders to a sample of healthy controls.

METHODS

31 patients with somatoform disorders and 30 matched controls completed eight questionnaires, i.a., the Düsseldorf Orthorexia Scale, three scales of the Eating Disorder Inventory-2, Eating Attitudes Test-26, Multidimensional Inventory of Hypochondriacal Traits, Attitudes Towards Body and Health Questionnaire, and Screening for Somatoform Disorders.

RESULTS

The patients displayed higher levels of orthorexic eating behavior, drive for thinness, body dissatisfaction, bulimia, and dieting than the control group. In both groups, orthorexic eating behavior was associated with higher levels of somatization in eating and health habits. The control group showed an association of orthorexic eating behavior with catastrophizing cognitions and the perceptual component of health anxiety.

CONCLUSION

The results support the hypothesis of a connection between orthorexic eating behavior and somatoform disorders. However, patients with somatoform disorders do not seem to be at particular risk for orthorexia. Future studies should investigate causes for the relationship between orthorexic eating behavior and characteristics of somatoform disorders in samples of healthy individuals.

LEVEL OF EVIDENCE

Level V, descriptive study with matched control group.

The Contributions of Interoceptive Awareness to Cognitive and Affective Facets of Body Experience

Experience of one’s own body relies on signals arising within the body as well as on exteroceptive information, and on appraisal of cognitive and affective aspects of these signals. The present study investigated the impact of sensitivity to internal signals, that is, interoceptive awareness, on interindividual differences in cognitive and emotional aspects of body experience. Subjects with accurate (n = 30) versus poor (n = 30) interoceptive awareness, classified via a heartbeat perception task, completed the Body Consciousness Questionnaire and the Body Appraisal Inventory. Possible effects of emotional state on body experience were controlled for using measures of mood and anxiety. While the groups did not differ in their emotional state, individuals with accurate cardiac interoceptive awareness exhibited higher subjective sensitivity to bodily sensations and a more positive body image, characterized by stronger body-related self-confidence, greater satisfaction with physical appearance, greater perceived bodily self-control, as well as reduced hypochondriacal concerns, sexual discontent, and shame. The present findings extend earlier research on the importance of perception of physical cues for emotion, cognition, and behavior regulation. Our results underline the contribution of interoceptive information to body experience, where interindividual differences in the accessibility of such information modulate cognitive and affective facets of body image.

Study protocol: psychological and physiological consequences of exposure to mass media in young women - an experimental cross-sectional and longitudinal study and the role of moderators

BACKGROUND

Repeated exposure to thin beauty ideals is part of the daily routine. Exposure to thin ideals via mass media plays an important role in the development and maintenance of eating disorders (EDs), low self-esteem, depressive or anxious feelings in young females. It is important to elucidate the circumstances under which exposure to thin ideals develops its detrimental impact and to investigate whether these features are more pronounced in EDs than in other mental disorders also related to negative body image.

METHODS/DESIGN

We investigate the following key questions: (1) Does laboratory induced exposure to thin ideals (waiting room design) relate to impairments in terms of body image, affect and eating behavior and biological stress response (salivary alpha-amylase, salivary cortisol, heart rate and heart rate variability) in 18 to 35 year old female suffering from anorexia and bulimia nervosa (AN, BN) compared to female healthy controls and to a sample of females suffering from mixed mental disorders (depression, anxiety and somatic symptom disorder (SSD) disorders)? (2) How do moderators such as cognitive distortions ("Thought-Shape Fusion, TSF"), and correlates of emotion regulation (ER) moderate the influence of the exposure? (3) Are these characteristics amenable to change after treatment? Altogether 250 female participants including patients with AN, BN, depressive, anxiety and SSD disorders, and healthy women will be recruited in Switzerland and Germany.

DISCUSSION

The findings will provide knowledge about the role of moderators influencing the effects of exposure to thin ideals promoted by mass media in eating disorder (ED) patients, patients suffering from mixed mental disorders and healthy controls. Evaluating their differential susceptibility will contribute to a better understanding of the role of negative body image in the maintenance of not only symptoms of ED, but also of depression, anxiety and SSD. Additionally our results will shed light on the stability of effects in healthy controls as well as in the patient groups before and after treatment as usual. Findings foster the development of tailored interventions including a training in specific ER strategies as well as cognitive restructuring of distorted beliefs about the own body when confronted with thin ideals.

TRIAL REGISTRATION

German Clinical Trials Register: DRKS00005709. Date of registration: 6(th) of February, 2014.