Illusory changes in body size modulate body satisfaction in a way that is related to non-clinical eating disorder psychopathology

Gender differences in bodily experience: Insights from virtual reality body illusion

Virtual Reality has significantly improved the understanding of body experience, through techniques such as Body Illusion. Body Illusion allows individuals to perceive an artificial body as their own, changing body perceptual and affective components. Prior research has predominantly focused on female participants, leaving the impact of Body Illusion on males less understood. This study seeks to fill this gap by examining the nuanced bodily experiences of men in comparison to women. 40 participants (20 females and 20 males) were proposed with visuo-tactile synchronous and asynchronous Body Illusion to explore changes in body satisfaction and body size estimation across three critical areas: shoulders, hips, and waist. Results revealed significant initial disparities, with females displaying greater body dissatisfaction and a tendency to overestimate body size. After Body Illusion, females adjusted the hips perceived body size closer to that of the virtual body and reported increased body satisfaction independent of the condition. Conversely, males showed changes only in waist size estimation only after synchronous stimulation without significant shifts in body satisfaction. These results suggest a higher sensitivity of women to embodied experiences, potentially due to societal influences and a greater inclination towards self-objectification. These insights pave the way for creating more refined and effective interventions for body image issues, highlighting the importance of incorporating gender-specific considerations in VR-based prevention and therapeutical programs.

Embodiment of underweight and normal-weight avatars affects bodily self-representations in anorexia nervosa

Body image distortion (BID) is a crucial aspect of anorexia nervosa (AN), leading to body overestimation, dissatisfaction, and low self-esteem. BID significantly influences the onset, maintenance, and relapse of the pathology. We assessed whether a Full Body Illusion (FBI) using under and normal-weight avatars' bodies affects perceptual body image and body schema estimations in both individuals with anorexia nervosa (AN) and healthy controls (HC). After each embodiment procedure, we asked participants to estimate the width of their hips (Perceptual Body Image Task) and the minimum aperture width of a virtual door necessary to pass through it (Body Schema Task). Additionally, we asked participants to rate the avatars in terms of self-similarity, attractiveness, and implicit disgust (i.e., pleasant/unpleasant body odour). Whereas participants with AN (N = 26) showed changes in body schema estimations after embodying the normal-weight avatar, no changes were found in HC (N = 25), highlighting increased bodily self-plasticity in AN. Notably, individuals with AN rated the normal weight avatar as the most similar to their real body, which was also considered the least attractive and the most repulsive. These ratings correlated with BID severity. Furthermore, at the explicit level, all participants reported feeling thinner than usual after embodying the underweight avatar. Overall, our findings suggest that BID in AN engages multiple sensory channels (from visual to olfactory) and components (from perceptual to affective), offering potential targets for innovative non-invasive treatments aimed at modifying flexible aspects of body representation.

Role of telerehabilitation in the rehabilitation of children with cerebral palsy during COVID-19: A review

Individuals with cerebral palsy (CP) have limited mobility and are unable to actively participate in tasks that are part of their daily living. Thus, continuous therapeutic sessions are required to keep such individuals active and engaged in the environment. Due to the coronavirus disease of 2019 (COVID-19) lockdowns, rehabilitation for children with CP was inhibited which consequently put them at risk of losing their functional gains which were obtained through previous in-person therapies. In order to avoid this, an alternate to conventional therapy was required and this rendered it necessary to review the role of telerehabilitation (TR) and its various modes for the rehabilitation of children with CP. This study aimed to explore the effectiveness of TR for children with CP during COVID-19 through the present literature and to determine if TR is an alternate to conventional physical therapy in children with CP during the coronavirus outbreak. This scoping review was conducted by searching different databases such as PubMed, Cochrane Collaboration, Medline, and Google Scholar on the basis of inclusion criteria. Screening was performed from January 2019 to June 2022 and the initial screening attempt returned 469 studies. After applying the aforementioned criteria, all impertinent studies were excluded which resulted in 28 studies being included for this review as they contained information about the effectiveness of TR on children with CP during COVID-19. These 28 articles included randomised controlled trials, surveys, reviews, clinical trials, case reports, prospective studies, editorials, and longitudinal studies. Three out of the 7 randomised controlled trial studies revealed that action observation treatment can be a useful approach for TR in child with CP during similar pandemics. The other 3 studies supported the use of computer-based games, robots, nonimmersive virtual reality, and wearable haptic devices as a significant means of TR in child with CP as an alternate to routine therapy during COVID-19. TR is an affable mode of rehabilitation specifically for the pediatric population. In the future, it can be an alternate to routine therapy for those who are unlikely to get daily access to in-person therapeutic sessions due to various reasons or circumstances.

Understanding and treating body image disturbances in eating disorders through body illusion interventions: a scoping review protocol

BACKGROUND

We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research.

METHODS/DESIGN

The scoping review process will be guided by the methodological framework of Arksey and O'Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles.

DISCUSSION

A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/3bcm6/?view_only=83b2e8a2445d4266909992e3dfb51929.

Did you skip leg day? The neural mechanisms of muscle perception for body parts

While the neural mechanisms underpinning the perception of muscularity are poorly understood, recent progress has been made using the psychophysical technique of visual adaptation. Prolonged visual exposure to high (low) muscularity bodies causes subsequently viewed bodies to appear less (more) muscular, revealing a recalibration of the neural populations encoding muscularity. Here, we use visual adaptation to further elucidate the tuning properties of the neural processes underpinning muscle perception for the upper and lower halves of the body. Participants manipulated the apparent muscularity of upper and lower bodies until they appeared 'normal', prior to and following exposure to a series of top/bottom halves of bodies that were either high or low in muscularity. In Experiment 1, participants were adapted to isolated own-gender body halves from one of four conditions; increased (muscularity) upper (body half), increased lower, decreased upper, or decreased lower. Despite the presence of muscle aftereffects when the body halves the participants viewed and manipulated were congruent, there was only weak evidence of muscle aftereffect transfer between the upper and lower halves of the body. Aftereffects were significantly weaker when body halves were incongruent, implying minimal overlap in the neural mechanisms encoding muscularity for body half. Experiment 2 examined the generalisability of Experiment 1's findings in a more ecologically valid context using whole-body stimuli, producing a similar pattern of results as Experiment 1, but with no evidence of cross-adaptation. Taken together, the findings are most consistent with muscle-encoding neural populations that are body-half selective. As visual adaptation has been implicated in cases of body size and shape misperception, the present study furthers our current understanding of how these perceptual inaccuracies, particularly those involving muscularity, are developed, maintained, and may potentially be treated.

The multisensory mind: a systematic review of multisensory integration processing in Anorexia and Bulimia Nervosa

Individuals with Anorexia Nervosa and Bulimia Nervosa present alterations in the way they experience their bodies. Body experience results from a multisensory integration process in which information from different sensory domains and spatial reference frames is combined into a coherent percept. Given the critical role of the body in the onset and maintenance of both Anorexia Nervosa and Bulimia Nervosa, we conducted a systematic review to examine multisensory integration abilities of individuals affected by these two conditions and investigate whether they exhibit impairments in crossmodal integration. We searched for studies evaluating crossmodal integration in individuals with a current diagnosis of Anorexia Nervosa and Bulimia Nervosa as compared to healthy individuals from both behavioral and neurobiological perspectives. A search of PubMed, PsycINFO, and Web of Sciences databases was performed to extract relevant articles. Of the 2348 studies retrieved, 911 were unique articles. After the screening, 13 articles were included. Studies revealed multisensory integration abnormalities in patients affected by Anorexia Nervosa; only one included individuals with Bulimia Nervosa and observed less severe impairments compared to healthy controls. Overall, results seemed to support the presence of multisensory deficits in Anorexia Nervosa, especially when integrating interoceptive and exteroceptive information. We proposed the Predictive Coding framework for understanding our findings and suggested future lines of investigation.

Body Dissatisfaction Directs Avatar Perception: Embodiment and Selective Visual Attention in Body Mass-Modified Self-Avatars

Human agents immersed in metaverse technologies such as virtual reality (VR) are routinely disconnected from their actual physical appearance and embodied in another virtual body, referred to as self-avatar. Such body transformations can have implications for patients with eating disorders, or persons with extreme body dissatisfaction (BD). Changes in BD, weight anxiety, or body image are theoretically linked to visual selective attention, which can be measured with eye tracking. In the present study, 43 women with high or low BD were immersed in animated body weight-manipulated self-avatars in VR. Before a brief mirror exposure with their self-avatars, they experienced synchronous visuomotor and visuo-tactile contingencies in VR to increase embodiment, delivered through small movement exercises with real-time animation from first-person perspective and passive haptics. In a crossover study design, self-avatar weight was manipulated (normal weight vs. overweight) in both groups (low BD vs. high BD), and subjective experience was assessed before and after exposure. In contrast to our hypotheses, BD was not affected by the self-avatar condition. Embodiment decreased during mirror exposure, possibly due to the avatars wearing head-mounted displays. Interestingly, disembodiment was stronger in women with low BD. Furthermore, eye tracking showed that participants with high BD looked longer at weight-related body parts when immersed in the overweight self-avatar, whereas participants with low BD looked longer at weight-related body parts when immersed in the normal weight self-avatar. Overall, the results support body-specific visual attention and suggest that particularly participants with low BD show stronger disembodiment during self-avatar mirror exposure, possibly alleviating momentary body experience. Preregistration: https://doi.org/10.23668/psycharchives.4949.

Proprioceptive uncertainty promotes the rubber hand illusion

Body ownership is the multisensory perception of a body as one's own. Recently, the emergence of body ownership illusions like the visuotactile rubber hand illusion has been described by Bayesian causal inference models in which the observer computes the probability that visual and tactile signals come from a common source. Given the importance of proprioception for the perception of one's body, proprioceptive information and its relative reliability should impact this inferential process. We used a detection task based on the rubber hand illusion where participants had to report whether the rubber hand felt like their own or not. We manipulated the degree of asynchrony of visual and tactile stimuli delivered to the rubber hand and the real hand under two levels of proprioceptive noise using tendon vibration applied to the lower arm's antagonist extensor and flexor muscles. As hypothesized, the probability of the emergence of the rubber hand illusion increased with proprioceptive noise. Moreover, this result, well fitted by a Bayesian causal inference model, was best described by a change in the a priori probability of a common cause for vision and touch. These results offer new insights into how proprioceptive uncertainty shapes the multisensory perception of one's own body.

Relating different Dimensions of Bodily Experiences: Review and proposition of an integrative model relying on phenomenology, predictive brain and neuroscience of the self

How we mentally experience our body has been studied in a variety research domains. Each of these domains focuses in its own ways on different aspects of the body, namely the neurophysiological, perceptual, affective or social components, and proposes different conceptual taxonomies. It is therefore difficult to find one's way through this vast literature and to grasp the relationships between the different dimensions of bodily experiences. In this narrative review, we summarize the existing research directions and present their limits. We propose an integrative framework, grounded in studies on phenomenal consciousness, self-consciousness and bodily self-consciousness, that can provide a common basis for evaluating findings on different dimensions of bodily experiences. We review the putative mechanisms, relying on predictive processes, and neural substrates that support this model. We discuss how this model enables a conceptual assessment of the interrelationships between multiple dimensions of bodily experiences and potentiate interdisciplinary approaches.

An Attentional Bias Modification Task, through Virtual Reality and Eye-Tracking Technologies, to Enhance the Treatment of Anorexia Nervosa

Mirror exposure therapies (METs) have been shown to be effective in reducing body image disturbances through the habituation process. Virtual reality (VR) combined with eye-tracking techniques can provide innovative solutions to some of METs’ limitations reported with patients with anorexia nervosa (AN), especially the negative influence of body-related attentional bias (AB). This pilot study aimed to assess the preliminary efficacy of a new VR-based AB modification task (ABMT) among healthy women and the procedure’s user experience. AB levels towards weight- and non-weight-related body parts, using complete fixation time (CFT) and number of fixations (NF), were assessed throughout the ABMT procedure (300 trials). The user experience was evaluated at the end of the procedure. The results showed that VR-based ABMT was effective in reducing AB significantly after 150 trials for both CFT- and NF-based measures, although 225 trials were necessary to get the same result for women with an NF initially more oriented towards weight-related body parts. Overall, the software received a “C-rating” on a scale from “A” (most usable) to “F” (least usable). These results provide evidence of the opportunity to use a VR-based ABMT procedure to reduce AB and improve existing treatments for AN.

Effect of connection induced upper body movements on embodiment towards a limb controlled by another during virtual co-embodiment

Even if we cannot control them, or when we receive no tactile or proprioceptive feedback from them, limbs attached to our bodies can still provide indirect proprioceptive and haptic stimulations to the body parts they are attached to simply due to the physical connections. In this study we investigated whether such indirect movement and haptic feedbacks from a limb contribute to a feeling of embodiment towards it. To investigate this issue, we developed a 'Joint Avatar' setup in which two individuals were given full control over the limbs in different sides (left and right) of an avatar during a reaching task. The backs of the two individuals were connected with a pair of solid braces through which they could exchange forces and match the upper body postures with one another. Coupled with the first-person view, this simulated an experience of the upper body being synchronously dragged by the partner-controlled virtual arm when it moved. We observed that this passive synchronized upper-body movement significantly reduced the feeling of the partner-controlled limb being owned or controlled by another. In summary, our results suggest that even in total absence of control, connection induced upper body movements synchronized with the visible limb movements can positively affect the sense of embodiment towards partner-controlled or autonomous limbs.

Changes in self-other boundaries modulate children's body image attitudes

One's own face is a key distinctive feature of our physical appearance, yet multisensory visuo-tactile stimulation can alter self-other boundaries, eliciting changes in adult's self-face representation and social cognition processes. This study tested whether changing self-face representation by altering self-other boundaries with the enfacement illusion modulates body image attitudes toward others in 6-11-year-old children (N = 51; 31 girls; predominantly White). Across all ages, congruent multisensory information led to stronger enfacement (η²_p = 0.06). Participants who experienced a stronger enfacement illusion showed preference for larger body size, suggesting increased positive body size attitudes. This effect was stronger in 6-7-year-olds compared to 8-9-year-olds. Thus, blurring self-other boundaries successfully modulates self-face representation and body image attitudes toward others in children. Our results suggest that increased self-resemblance through self-other blurring resulting from the enfacement illusion may reduce social comparisons between self and other and result in positive body size attitudes.

The structure of eating disorder and somatic symptoms

Individuals with eating disorders (EDs) often present with somatic concerns in treatment, such as bloating, fullness, and feeling tight clothes on skin. However, most research generally focuses on general interoception (e.g., heartbeat) rather than sensations relevant to EDs (e.g., sensations related to the gastrointestinal system or body movement). In the current study (N = 181), we used network analysis to model the structure of ED symptoms and somatic concerns among individuals with anorexia nervosa, bulimia nervosa, and other specified feeding and eating disorder. Results showed that heightened sensitivity to somatic concerns had the highest strength centrality within a symptom network comprising ED and somatic symptoms. Exploratory graph analysis identified four symptom dimensions: cognitive-affective ED symptoms, behavioral ED symptoms, general interoception, and ED-specific proprioception. Findings suggest that heightened sensitivity to somatic concerns may maintain ED symptoms and mutually reinforce other somatic concerns. Implications concerning assessment and treatment of EDs are discussed.

Combination of visuo-tactile and visuo-vestibular correlations in illusory body ownership and self-motion sensations

Previous studies have shown that illusory ownership over a mannequin's body can be induced through synchronous visuo-tactile stimulation as well as through synchronous visuo-vestibular stimulation. The current study aimed to elucidate how three-way combinations of correlated visual, tactile and vestibular signals contribute to the senses of body ownership and self-motion. Visuo-tactile temporal congruence was manipulated by touching the mannequin's body and the participant's unseen real body on the trunk with a small object either synchronously or asynchronously. Visuo-vestibular temporal congruence was manipulated by synchronous or asynchronous presentation of a visual motion cue (the background rotating around the mannequin in one direction) and galvanic stimulation of the vestibular nerve generating a rotation sensation (in the same direction). The illusory experiences were quantified using a questionnaire; threat-evoked skin-conductance responses (SCRs) provided complementary indirect physiological evidence for the illusion. Ratings on the illusion questionnaire statement showed significant main effects of synchronous visuo-vestibular and synchronous visuo-tactile stimulations, suggesting that both of these pairs of bimodal correlations contribute to the ownership illusion. Interestingly, visuo-tactile synchrony dominated because synchronous visuo-tactile stimulation combined with asynchronous visuo-vestibular stimulation elicited a body ownership illusion of similar strength as when both bimodal combinations were synchronous. Moreover, both visuo-tactile and visuo-vestibular synchrony were associated with enhanced self-motion perception; self-motion sensations were even triggered when visuo-tactile synchrony was combined with visuo-vestibular asynchrony, suggesting that ownership enhanced the relevance of visual information as a self-motion cue. Finally, the SCR results suggest that synchronous stimulation of either modality pair led to a stronger illusion compared to the asynchronous conditions. Collectively, the results suggest that visuo-tactile temporal correlations have a stronger influence on body ownership than visuo-vestibular correlations and that ownership boosts self-motion perception. We present a Bayesian causal inference model that can explain how visuo-vestibular and visuo-tactile information are combined in multisensory own-body perception.

Interoceptive sensibility and body satisfaction in pregnant and non-pregnant women with and without children

Pregnancy is a time of great physical and psychological change. As well as prominent changes in the external appearance of the body, such as the baby bump, there are also substantial changes taking place within the body. Our awareness of, and attention towards, internal bodily signals (interoception) is thought to have a direct impact on how we feel about our bodies. Therefore, understanding how our experience of these interoceptive signals might change during pregnancy may have important implications for maternal wellbeing. This study examined body satisfaction and interoceptive sensibility (subjective experience of interoception) in pregnant and non-pregnant women with and without children. Feelings towards pregnancy-specific changes in body satisfaction and interoceptive sensibility were also examined in women in their first pregnancy (primigravida) and subsequent pregnancies (multigravida). It was found that pregnancy did not directly impact levels of body satisfaction, instead pregnant and non-pregnant women with children reported less satisfaction with their bodies compared to those without children. Primigravida women were more satisfied with the appearance of pregnancy specific bodily changes compared to multigravida women. Interestingly, these differences in body satisfaction in those with children (pregnant and non-pregnant) were mediated by the extent to which women trusted their bodies (measure of interoceptive sensibility). All other pregnancy related changes in interoceptive sensibility and body satisfaction were either non-significant or had small effect sizes. These results may suggest body trust as an important factor to support during the transition to parenthood in order to improve body satisfaction in mothers.

Mirror, mirror, on the wall: During pandemics, how can self-perception research in people with eating disorders happen at all?

BACKGROUND

'Classic' embodiment illusions (e.g., the feeling of owning another person's hand) involves a three-way interaction between visual, proprioceptive, and tactile stimuli. These illusions have been studied in eating disorder (ED) populations given the potential implications for better understanding and improving body image concerns. Recently, several studies have employed 'tactile-reduced' methods mainly relying on the integration of visual and proprioceptive information to induce embodiment illusions in non-ED populations. To date, there has been no substantial review of these tactile-reduced approaches to consider their potential research and clinical utility in ED populations.

METHOD

This review sought to examine and integrate studies across three areas. Firstly, those that employed tactile-reduced embodiment techniques in non-ED populations. Secondly, those that used classic embodiment techniques to compare whether ED and non-ED populations differ in their susceptibility to embodiment. Thirdly, studies that investigated whether experiencing classic or tactile-reduced embodiment techniques can improve image-related concerns.

RESULTS

For the first aim five studies were identified, all of which found that tactile-reduced methods consistently induced embodiment illusions in non-ED individuals. For the second aim, seven studies comparing ED and non-ED samples were found. ED patients were more susceptible to embodiment than non-ED samples in four studies, less susceptible in one study, and equally susceptible in two studies. Finally, for aim three, amongst the seven studies that used classic or tactile-reduced embodiment methods in ED populations, six reported improvements in self-perception (i.e., reduced body size overestimation, decreased body dissatisfaction and fear of gaining weight).

CONCLUSIONS

Along with the classic approach, tactile-reduced embodiment approaches have implications for ED research and clinical practice, particularly for situations when face-to-face contact with people are restricted. Suggestions are provided for future researchers who wish to ensure best practice for planning embodiment research involving classic and tactile-reduced approaches.

Exploring the development of high-level contributions to body representation using the rubber hand illusion and the monkey hand illusion

During development our body undergoes significant changes, yet we are able to maintain a coherent experience of our body and sense of self. Bodily experience is thought to comprise integration of multisensory signals (vision, touch, and proprioception) constrained by top-down knowledge of body appearance. Evidence from developmental studies suggests that low-level multisensory integration develops throughout childhood, reaching adult levels by 10 years of age. However, how high-level cognitive knowledge changes during childhood to constrain our multisensory body experience is unknown. This study describes four experiments examining high-level contributions to the bodily experience in children compared with adults using the rubber hand illusion and a monkey hand illusion. We found that children (5-17 years of age) exhibited more flexible body representations, showing stronger illusions for small and fantastical (monkey) fake hands compared with adults. Conversely, using a task indirectly capturing changes in hand size, we found that children and adults demonstrated statistically equivalent increases and decreases in hand size following illusions over large and small hands, respectively. Interestingly, at baseline children showed a bias in reporting larger hand size judgments that decreased with age. Finally, we did not find a relationship between individual differences in fantasy proneness and illusion strength for a fantastical (monkey) hand for children or adults, suggesting that developmental changes of top-down constraints are not purely driven by more diffuse boundaries between imagination and reality. These data suggest that high-level constraints acting on our multisensory body experience change during development, allowing children a more flexible bodily experience compared with adults.

Distortion of mental body representations

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.

The Self in the Mind's Eye: Revealing How We Truly See Ourselves Through Reverse Correlation

Is there a way to visually depict the image people "see" of themselves in their minds' eyes? And if so, what can these mental images tell us about ourselves? We used a computational reverse-correlation technique to explore individuals' mental "self-portraits" of their faces and body shapes in an unbiased, data-driven way (total N = 116 adults). Self-portraits were similar to individuals' real faces but, importantly, also contained clues to each person's self-reported personality traits, which were reliably detected by external observers. Furthermore, people with higher social self-esteem produced more true-to-life self-portraits. Unlike face portraits, body portraits had negligible relationships with individuals' actual body shape, but as with faces, they were influenced by people's beliefs and emotions. We show how psychological beliefs and attitudes about oneself bias the perceptual representation of one's appearance and provide a unique window into the internal mental self-representation-findings that have important implications for mental health and visual culture.

The effect of visually manipulating back size and morphology on back perception, body ownership, and attitudes towards self-capacity during a lifting task

Body re-sizing illusions can profoundly alter perception of our own body. We investigated whether creating the illusion of a muscled and fit-looking back (Strong) influenced perceived back size, body ownership, and attitudes towards self-capacity during a lifting task. Twenty-four healthy male volunteers performed a standardised lifting task while viewing real-time (delay < 20 ms) video of their own back through a head-mounted display under four different conditions (Normal size, Strong, Reshaped, Large; order randomised). The MIRAGE-mediated reality system was used to modify the shape, size, and morphology of the back. Participants were poor at recognizing the correct appearance of their back, for both implicit (perceived width of shoulders and hips) and explicit (questionnaire) measures of back size. Visual distortions of body shape (Reshaped condition) altered implicit back size measures. However, viewing a muscled back (Strong condition) did not result in a sense of agency or ownership and did not update implicit perception of the back. No conditions improved perceptions/attitudes of self-capacity (perceived back strength, perceived lifting confidence, and perceived back fitness). The results lend support for the importance of the embodiment of bodily changes to induce changes in perception. Further work is warranted to determine whether increased exposure to illusory changes would alter perceptions and attitudes towards self-capacity or whether different mechanisms are involved.

Embodiment in Virtual Reality Intensifies Emotional Responses to Virtual Stimuli

Modulating emotional responses to virtual stimuli is a fundamental goal of many immersive interactive applications. In this study, we leverage the illusion of illusory embodiment and show that owning a virtual body provides means to modulate emotional responses. In a single-factor repeated-measures experiment, we manipulated the degree of illusory embodiment and assessed the emotional responses to virtual stimuli. We presented emotional stimuli in the same environment as the virtual body. Participants experienced higher arousal, dominance, and more intense valence in the high embodiment condition compared to the low embodiment condition. The illusion of embodiment thus intensifies the emotional processing of the virtual environment. This result suggests that artificial bodies can increase the effectiveness of immersive applications psychotherapy, entertainment, computer-mediated social interactions, or health applications.

Towards a Comprehensive Understanding of Body Image: Integrating Positive Body Image, Embodiment and Self-Compassion

Body image (BI) disturbance is a relevant factor in the etiology and treatment of eating disorders (ED). Although progress has been made in recent decades in understanding BI and its relationship with ED, the efficacy of BI disturbance prevention and intervention programs is still limited. In order to reach deeper understanding of BI disturbance and clarify the interactions between some protective and risk factors related to this construct, we carried out a literature review on some specific BI-related factors that so far have been analyzed independently. We specifically examined positive and negative BI; embodiment and its role in the development of positive and negative BI; and self-compassion as a protective factor that promotes positive embodiment (vs. disembodiment) and protection against body shame. We conclude that integrating the available evidence on these factors into BI models may be used to enhance our understanding of BI and improve the efficacy of prevention and intervention programs to help fight negative BI (by reducing body shame and disembodiment) and promote positive BI (by increasing self-compassion and positive embodiment).

The Perceived Match Between Observed and Own Bodies, but Not Its Accuracy, Is Influenced by Movement Dynamics and Clothing Cues

Own-perceived body matching - the ability to match one's own body with an observed body - is a difficult task for both general and clinical populations. Thus far, however, own-perceived body matching has been investigated in situations that are incongruent with how we are used to experience and perceive our body in daily life. In the current study, we aimed to examine own-perceived body matching in a context that more closely resembles real life. More specifically, we investigated the effects of body movement dynamics and clothing cues on own-perceived body matching. We asked participants to match their own body with an externally perceived body that was a 3D-generated avatar based on participants' real bodies, fitted with a computer-generated dress. This perceived body was (1) either static (non-walking avatar) or dynamic (walking avatar), (2) either bigger, smaller, or the same size as participants' own body size, and (3) fitted with a dress with a size either bigger, smaller, or the same as participants' own dress size. Our results suggest that movement dynamics cues did not improve the accuracy of own-perceived body matching, but that confidence about dress fit was higher for dynamic avatars, and that the difference between dynamic and static avatars was dependent on participants' self-esteem. Furthermore, when participants were asked to rate the observed body in reference to how they wanted to represent themselves to others, dynamic avatars were rated lower than static avatars for the biggest-sized bodies only, possibly reflecting the influence of movement cues on amplifying socio-cultural stereotypes. Finally, while smaller body/dress sizes were systematically rated higher than bigger body/dress sizes for several self-report items, the interplay between body and dress size played an important role in participants' self-report as well. Thus, while our research suggests that movement and garment dynamics, allowing for realistic, concrete situations that are reminiscent of daily life, influence own-body perception, these cues did not lead to an improvement in accuracy. These findings provide important insights for research exploring (own-) body perception and bodily self-awareness, with practical (e.g., development of online avatars) and clinical (e.g., anorexia nervosa and body dysmorphic disorder) implications.

Use of a real-life practical context changes the relationship between implicit body representations and real body measurements

A mismatch exists between people's mental representations of their own body and their real body measurements, which may impact general well-being and health. We investigated whether this mismatch is reduced when contextualizing body size estimation in a real-life scenario. Using a reverse correlation paradigm, we constructed unbiased, data-driven visual depictions of participants' implicit body representations. Across three conditions-own abstract, ideal, and own concrete body-participants selected the body that looked most like their own, like the body they would like to have, or like the body they would use for online shopping. In the own concrete condition only, we found a significant correlation between perceived and real hip width, suggesting that the perceived/real body match only exists when body size estimation takes place in a practical context, although the negative correlation indicated inaccurate estimation. Further, participants who underestimated their body size or who had more negative attitudes towards their body weight showed a positive correlation between perceived and real body size in the own abstract condition. Finally, our results indicated that different body areas were implicated in the different conditions. These findings suggest that implicit body representations depend on situational and individual differences, which has clinical and practical implications.

Changing your body changes your eating attitudes: embodiment of a slim virtual avatar induces avoidance of high-calorie food

The virtual-reality full-body illusion paradigm has been suggested to not only trigger the illusory ownership of the avatar's body but also the attitudinal and behavioral components stereotypically associated to that kind of virtual body. In the present study, we investigated whether this was true for stereotypes related to body size: body satisfaction and eating control behavior. Healthy participants underwent the full-body illusion paradigm with an avatar having either a larger or a slimmer body than their own, and were assessed for implicit attitudes towards body image and food calorie content at baseline and after each full-body illusion session. Results showed that the illusion emerged regardless of the avatar's body size, whereas the perceived dimension of the own body size changed according to the avatar's body size (i.e., participants felt to be slimmer after embodying their slim avatar and larger after embodying their large avatar). Crucially, we found that implicit attitudes towards food, but not those towards one's own body, were modulated by the size of the virtual body. Compared to baseline, ownership of a slimmer avatar increased the avoidance of high-calorie food, whereas ownership of a larger avatar did not induce changes. Our findings suggest that the illusory feeling of being slimmer drives also the food-related stereotypes associated with that body size, increasing the regulation of eating behaviors.

Wearing same- and opposite-sex virtual bodies and seeing them caressed in intimate areas

Immersive virtual reality enables people to undergo the experience of owning an artificial body and vicariously feeling tactile stimuli delivered to it. However, it is currently unknown how such experiences are modified by the sexual congruency between the human and the artificial agent. In two studies, heterosexual men (Experiment 1) and women (Experiment 2) embodied same-sex and opposite-sex avatars and were asked to evaluate the experience (e.g., pleasantness, erogeneity) of being touched on social or intimate areas of their virtual body by a male or female avatar. Electrocardiogram and galvanic skin response were also recorded. Moreover, participants' implicit and explicit gender biases were examined via a gender-potency implicit association test and the Ambivalent Sexism Inventory. When embodying a same-sex avatar, men and women rated caresses on intimate areas from an avatar of the opposite sex as more pleasant and erogenous. Conversely, body swap-that is, wearing an opposite-sex avatar-enhanced participants' perceptions of pleasantness and erogeneity for caresses on intimate areas from a same-sex toucher. This effect was stronger in men than in women. Furthermore, physiological correlates of enhanced processing of arousing stimuli predicted behavioural outcomes during the body swap illusion. Wearing an opposite-sex avatar affects one's own body representations and may have important implications on people's attitudes and implicit reactivity to touch-mediated interactions. Men seem more susceptible to this type of body swap illusion. Our paradigm may induce profound changes of cross-sex perspective-taking and provide novel tools for promoting empathy and comprehension of sex-related diversity.

Virtual reality in the treatment of eating disorders

Over the last 25 years, virtual reality (VR) has offered innovative solutions for targeting different key symptoms of eating disorders: from craving to negative emotions, from attentional biases to body dissatisfaction. The present narrative review assesses the existing literature in these areas trying to identify their different levels of clinical evidence. Specifically, the review presents four clinical approaches based upon VR and their implications in the treatment of eating disorders: VR cue exposure, VR reference frame shifting, VR for correcting body distortions and attentional biases. In general, existing findings demonstrate the clinical value of VR. On one side, the present review suggests that two VR-based techniques-VR exposure and reference frame shifting-have a significant research support and provide a possible advantage over traditional cognitive-behavioural therapy (CBT) for bulimia nervosa and binge eating disorder. On the other side, two emerging VR applications-multisensory body illusions and the use of VR for the modification of attentional biases-even if supported by preliminary data still need further research.

AN-VR-BE. A Randomized Controlled Trial for Reducing Fear of Gaining Weight and Other Eating Disorder Symptoms in Anorexia Nervosa through Virtual Reality-Based Body Exposure

In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image.

The contribution of stimulating multiple body parts simultaneously to the illusion of owning an entire artificial body

The full-body ownership illusion exploits multisensory perception to induce a feeling of ownership of an entire artificial body. Although previous research has shown that synchronous visuotactile stimulation of a single body part is sufficient for illusory ownership of the whole body, the effect of combining multisensory stimulation across multiple body parts remains unknown. Therefore, 48 healthy adults participated in a full-body ownership illusion with conditions involving synchronous (illusion) or asynchronous (control) visuotactile stimulation to one, two, or three body parts simultaneously (2×3 design). We used questionnaires to isolate illusory ownership of five specific body parts (left arm, right arm, trunk, left leg, right leg) from the full-body ownership experience and sought to test not only for increased ownership in synchronous versus asynchronous conditions but also for potentially varying degrees of full-body ownership illusion intensity related to the number of body parts stimulated. Illusory full-body ownership and all five body-part ownership ratings were significantly higher following synchronous stimulation than asynchronous stimulation (p-values < .01). Since non-stimulated body parts also received significantly increased ownership ratings following synchronous stimulation, the results are consistent with an illusion that engages the entire body. Furthermore, we noted that ownership ratings for right body parts (which were often but not always stimulated in this experiment) were significantly higher than ownership ratings for left body parts (which were never stimulated). Regarding the effect of stimulating multiple body parts simultaneously on explicit full-body ownership ratings, there was no evidence of a significant main effect of the number of stimulations (p = .850) or any significant interaction with stimulation synchronicity (p = .160), as assessed by linear mixed modelling. Instead, median ratings indicated a moderate affirmation (+1) of an illusory full-body sensation in all three synchronous conditions, a finding mirrored by comparable full-body illusion onset times. In sum, illusory full-body ownership appears to be an 'all-or-nothing' phenomenon and depends upon the synchronicity of visuotactile stimulation, irrespective of the number of stimulated body parts.

The role of affective touch in whole-body embodiment remains equivocal

Previous studies have highlighted that affective touch delivered at slow velocities (1-10 cm/s) enhances body-part embodiment during multisensory illusions, yet its role towards whole-body embodiment is less established. Across two experiments, we investigated the role of affective touch towards subjective embodiment of a whole mannequin body within the full body illusion, amongst healthy females. Participants perceived affective touch to be more pleasant than non-affective touch, but this did not enhance subjective embodiment within the illusion and no interaction between synchrony (Experiment 1), or congruency (Experiment 2), and the velocity of touch was observed. Finally, the perceived pleasantness of touch was not modulated by subthreshold eating disorder psychopathology, as measured by means of a self-report questionnaire. Therefore, the present findings suggest that enhancement of embodiment due to affective touch may be body-part specific, and not generalise to greater ownership towards a whole body.

Extended Reality for the Clinical, Affective, and Social Neurosciences

Brain science research often involves the use of low-dimensional tools and stimuli that lack several of the potentially valuable features of everyday activities and interactions. Although this research has provided important information about cognitive, affective, and social processes for both clinical and nonclinical populations, there is growing interest in high-dimensional simulations that extend reality. These high-dimensional simulations involve dynamic stimuli presented serially or concurrently to permit the assessment and training of perceivers' integrative processes over time. Moreover, high-dimensional simulation platforms can contextually restrain interpretations of cues about a target's internal states. Extended reality environments extend assessment and training platforms that balance experimental control with emotionally engaging background narratives aimed at extending the affective experience and social interactions. Herein, we highlight the promise of extended reality platforms for greater ecological validity in the clinical, affective, and social neurosciences.

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery.

Perception of Our Own Body Influences Self-Concept and Self-Incoherence Impairs Episodic Memory

How does our body affect the way we think about our personality? We addressed this question by eliciting the perceptual illusion that pairs of friends swapped bodies with each other. We found that during the illusion, the participants rated their own personality characteristics more similarly to the way they previously rated their friend's personality, and this flexible adjustment of self-concept to the "new" bodily self was related to the strength of illusory ownership of the friend's body. Moreover, a subsequent memory test showed that personality traits rated during the friend-body-swap illusion were generally remembered worse than traits rated during the control conditions; importantly, however, this impairment of episodic recognition memory was reduced for the participants who considerably adjusted their self-concept during the illusory body swapping. These findings demonstrate that our beliefs about own personality are dynamically shaped by the perception of our body and that coherence between the bodily and conceptual self-representations is important for the normal encoding of episodic memories.

Measuring recognition of body changes over time: A human-computer interaction tool using dynamic morphing and body ownership illusion

Measuring body image is crucial at both personal and social levels. Previous studies have attempted to quantitatively measure body image but methods for measuring body change recognition over time have not yet been established. The present study proposes a novel human-computer interaction technique using dynamic morphing and body ownership illusion, and we conducted a user study to investigate how body ownership illusion and gender would affect to body change recognition. The results showed that a participant's body change recognition was weak when the body ownership illusion was strong. In addition, female participants were less sensitive than male participants. With our proposed technique, we demonstrated that we were able to quantitatively measure body change recognition and our empirical data indicated that body change recognition varied depending on body ownership illusion and gender, suggesting that our methodology could not only be used in future body image studies but also in eating disorder treatments.

Fluidity of gender identity induced by illusory body-sex change

Gender identity is a collection of thoughts and feelings about one’s own gender, which may or may not correspond to the sex assigned at birth. How this sense is linked to the perception of one’s own masculine or feminine body remains unclear. Here, in a series of three behavioral experiments conducted on a large group of control volunteers (N = 140), we show that a perceptual illusion of having the opposite-sex body is associated with a shift toward a more balanced identification with both genders and less gender-stereotypical beliefs about own personality characteristics, as indicated by subjective reports and implicit behavioral measures. These findings demonstrate that the ongoing perception of one’s own body affects the sense of one’s own gender in a dynamic, robust, and automatic manner.

Gulliver's virtual travels: active embodiment in extreme body sizes for modulating our body representations

It is noted that the perceptual experience of body and space can be modulated by changing the action capabilities or by manipulating the perceived body dimensions through a multisensory stimulation. This study adds to pre-existing literature by investigating the alterations in bodily experience following embodiment to both enlarged and shrunked bodies, while participants actively navigated in a virtual environment. A normal-sized body served as a reference condition. After each embodied navigation, participants estimated the height and width of three different body parts. Results revealed that the embodiment over shrunked body induced a significant reduction in participants' body image, while no changes were reported after the embodiment over the enlarged body. Findings were discussed in terms of previous literature exploring the constraints implicated in the ownership over different bodies.

Body-Related Attentional Bias among Men with High and Low Muscularity Dissatisfaction

Previous studies have found gender differences in body-related attentional bias (AB), with women showing AB towards weight-related body parts. However, few studies have assessed the relationship between body-related AB and muscularity dissatisfaction (MD) in men. This study aimed to assess the presence of muscle-related AB in men, using a combination of a virtual reality (VR) embodiment-based technique and eye-tracking (ET) technology. Twenty men with high MD and 20 with low MD, owned a virtual avatar that had the same silhouette and body mass index as the participant. To analyze the gaze data, muscle-related areas of interest (M-AOIs) and nonmuscle-related areas of interest (NM-AOIs) were defined. The complete fixation time and the number of fixations on each AOI were recorded. Mixed between (group)-within (AOI_condition) analyses of variance showed a statistically significant interaction between group and time (p < 0.05) in both AB measures. Follow-up analyses revealed an AB towards M-AOIs only in men with high MD. Overall, men with high MD spent more time looking and displayed a higher number of fixations on M-AOIs, specifically the chest and shoulders, compared to men with low MD. This study provides new information about the relationship between MD and body-related AB in men. Combining VR with ET technologies presents interesting opportunities in the study of body image in men.

Body-related attentional bias as mediator of the relationship between body mass index and body dissatisfaction

Body image disturbance, consisting of an affective (body dissatisfaction) and perceptual (body distortion) component, is not only found in eating disorders, but is also present in healthy individuals, affecting their psychological well-being and everyday life. A higher body mass index is associated with higher body dissatisfaction, whereas results in relation to body distortion are mixed. Furthermore, body dissatisfaction is associated with a weight-related attentional bias. This study aimed to investigate the mediating role of a weight-related attentional bias in the relationship between body mass index and body image disturbance. Forty-one college women took part in a virtual reality and eye tracking procedure, in which the illusion of owning a virtual avatar with their body measurements was induced. During this procedure, body-related attentional bias was measured and afterwards body image disturbance was assessed. Mediation analysis revealed that weight-related attentional bias mediated the relationship between body mass index and body dissatisfaction (but not distortion). These findings suggest that modifying weight-related attentional bias would be a useful treatment target for improving body dissatisfaction. In addition, virtual reality technology could serve as an innovative method for modifying attentional bias in an ecologically valid way. HIGHLIGHTS: This Virtual Reality and Eye-Tracking study expands our knowledge about the relation between body mass index, body-related attention and body image disturbances. The results suggest that attentional bias towards weight-related body parts mediates the relation between BMI and body dissatisfaction. On the contrary, the relation between BMI and body distortion was not significant.

Impact of Body Size Match to an Avatar on the Body Ownership Illusion and User's Subjective Experience

The current study sought to investigate the effects of matching body movement and body size between an avatar and a participant on the body ownership illusion (BOI), the body size illusion, the sense of presence, simulator sickness, and emotional responses within an immersive virtual reality (IVR). Forty participants experienced their life-sized virtual avatars from a first-person perspective using a full-body motion-capture system. The experiment used a 2 (Motion: Synchrony and Asynchrony) × 2 (Size: Matched and Unmatched) within-subject design. Each participant completed a self-reported questionnaire that evaluated BOI, body size illusion, presence, simulator sickness, and emotional valence. Results showed that matching participant's motion to that of an avatar increased the BOI and sense of presence, while reducing simulator sickness. Furthermore, participants reported more positive emotions when motion was synchronized to the virtual avatar. Most notably, synchronizing body movement between participants and avatars resulted in strong body size illusion even when the body size of an avatar was larger than the one of a participant. To the best of our knowledge, this is the first study to directly link synchronization of user motion and body size to a virtual avatar with user's subjective experience (BOI, body size illusion, sense of presence, simulator sickness, and valence) in IVR. Our findings suggest beneficial effects of synchronized body motion and matched body size between a user and avatar on user's subjective experience in IVR, which can possibly boost the effects of virtual reality applications in the fields of entertainment, psychotherapy, and education.

Characterizing Body Image Distortion and Bodily Self-Plasticity in Anorexia Nervosa via Visuo-Tactile Stimulation in Virtual Reality

We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body. Results show higher body dissatisfaction in AN, caused by the desire of a thinner body, and no body-size overestimation. Interpersonal multisensory stimulation (IMS) was then applied on the avatar reproducing participant’s perceived body, and on the two avatars which reproduced increases and losses of 15% of it, all presented with a first-person perspective (1PP). Embodiment was stronger after synchronous IMS in both groups, but did not reduce BID in participants with AN. Interestingly, anorexics reported more negative emotions after embodying the fattest avatar, which scaled with symptoms severity. Overall, our findings suggest that the cognitive-emotional, more than the perceptual component of BID is severely altered in AN and that perspective (1PP vs. 3PP) from which a body is evaluated may play a crucial role. Future research and clinical trials might take advantage of virtual reality to reduce the emotional distress related to body dissatisfaction.

Distinct neural response to visual perspective and body size in the extrastriate body area

Neuroimaging research has independently implicated the extrastriate body area (EBA) in distinguishing between different visual perspectives and morphologies of bodies within visual processing. However, the combined processing of these physical attributes towards neural EBA response remains unclear, and may be crucial in influencing higher-order, aesthetic evaluation of bodies. Indeed, EBA alterations amongst eating disorder patients have been associated with disturbances in body image, and disruption to EBA activity amongst healthy individuals has been shown to influence aesthetic evaluations made towards bodies. Therefore, the present study used images of slim and large female bodies viewed from egocentric and allocentric perspectives, to investigate neural EBA response amongst healthy females (N = 30). In addition, participants provided behavioural aesthetic and weight evaluations of all model stimuli. Results revealed an interaction, bilaterally, between visual perspective and body size towards EBA activity, with multi-voxel pattern analysis revealing distinct neural patterns between the four conditions. However, EBA activity did not relate to non-clinical eating disorder psychopathology. No direct relationship was found between EBA activity and behavioural evaluations of model stimuli; however, a whole brain analysis revealed that higher-order, prefrontal regions were associated with cognitive evaluations of large bodies. Taken together, our results suggest that the EBA is an integral core region in discriminating between multiple physical attributes of the body, which is likely to provide important information to higher-order brain regions which make aesthetic evaluations towards bodies.

Investigating the Components of Body Image Disturbance Within Eating Disorders

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.

The Effect of a Virtual-Reality Full-Body Illusion on Body Representation in Obesity

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.

Is This My Own Body? Changing the Perceptual and Affective Body Image Experience among College Students Using a New Virtual Reality Embodiment-Based Technique

Body image disturbances (BIDs) have been widely studied using virtual reality (VR) devices that induce a full body illusion (FBI) and allow manipulation of the individual’s perceptual and affective experiences of the body. This study aimed to assess whether the induction of the FBI over a virtual body would produce changes in body-related anxiety and BIDs using a new whole-body visuo-tactile stimulation procedure. Fifty non-clinical participants were randomly assigned to synchronous or asynchronous visuo-tactile groups. During the pre-assessment, all participants filled in BIDs and body-anxiety questionnaires. Then, they were embodied into two virtual bodies (VBs): firstly, with their real measurements, and secondly, with a larger-size body. Body image disturbances, body anxiety, fear of gaining weight, and FBI levels were assessed after exposure to each avatar. All participants in both conditions showed higher levels of BIDs and body anxiety after owning the larger-size VB than after owning the real-size VB (p < 0.05). The synchronous visuo-tactile group had higher scores, although the differences did not reach statistical significance. This study provides evidence of the usefulness of this new embodiment-based technique to induce changes in BIDs or body anxiety in a non-clinical sample, being suitable for use in future body image interventions.

Affective judgement of social touch on a hand associated with hand embodiment

Social touch constitutes a critical component of human interactions. A gentle tap on the hand, for instance, can sometimes create emotional bonding and reduce interpersonal distance in social interactions. Evidence of tactile empathy suggests that touch can be experienced through both physical sensation and observation, yet vicarious perception of observed touch on an object as a function of the object’s conceptual representation (e.g., Is this object identified as mine? Does this object feel like part of me?) remains less explored. Here we examined the affective judgement of social touch when the illusory sense of ownership over a dummy hand was manipulated through the rubber-hand illusion. When the same social touch was performed on either the real or the dummy hand, we found a similar sense of perceived pleasantness between the felt and observed touch, but only when the dummy hand was embodied; when it was not, the perceived pleasantness of the observed touch was lesser (an “embodiment effect”; Experiment 1). In addition, we found that the embodiment effect associated with the observed touch was insensitive to the way in which embodiment was manipulated (Experiment 2), and that this effect was specific to social but not neutral touch (Experiment 3). Taken together, our findings suggest a role of embodiment in the affective component of observed social touch and contribute to our understanding of tactile empathy for objects.

The effect of intranasal oxytocin on the perception of affective touch and multisensory integration in anorexia nervosa: protocol for a double-blind placebo-controlled crossover study

INTRODUCTION

Anorexia nervosa (AN) is an eating disorder characterised by restriction of energy intake, fears of gaining weight and related body image disturbances. The oxytocinergic system has been proposed as a pathophysiological candidate for AN. Oxytocin is a neuropeptide involved in bodily processes (eg, breast feeding) and in the onset of social behaviours (eg, bonding). Studies investigating the effect of intranasal oxytocin (IN-OT) in AN showed that it can improve attentional bias for high-calorie food and fat bodies stimuli, and related stress. However, less is known about the effect of IN-OT on bodily awareness and body image distortions, key features of the disorder linked to its development, prognosis and maintenance. Here, we aim to investigate the effect of IN-OT on the perception of affective, C-tactile-optimal touch, known to be impaired in AN and on multisensory integration processes underlying a body ownership illusion (ie, rubber hand illusion). For exploratory purposes, we will also investigate the effect of IN-OT on another interoceptive modality, namely cardiac awareness and its relationship with affective touch.

DESIGN, METHODS AND ANALYSIS

Forty women with AN and forty matched healthy controls will be recruited and tested in two separate sessions; self-administering IN-OT (40 IU) or placebo, intranasally, in a pseudo-randomised manner. The data from this double-blind, placebo-controlled, cross-over study will be analysed using linear mixed models that allow the use of both fixed (treatment levels) and random (subjects) effects in the same analysis. To address our main hypotheses, separate analyses will be run for the affective touch task, where the primary outcome dependent variable will be the pleasantness of the touch, and for the rubber hand illusion, where we will investigate multisensory integration quantified as subjective embodiment towards the rubber hand. In the latter, we will manipulate the synchronicity of touch and the size of the hand.

ETHICS AND DISSEMINATION

Ethics approval has been obtained by National Research Ethics Service NRES Committee London (Queen's Square Committee, ref number 14/LO/1593). The results will be disseminated through conference presentations and publication in peer-reviewed journals.

The Effect of Visual Capture Towards Subjective Embodiment Within the Full Body Illusion

Typically, multisensory illusion paradigms emphasise the importance of synchronous visuotactile integration to induce subjective embodiment towards another body. However, the extent to which embodiment is due to the 'visual capture' of congruent visuoproprioceptive information alone remains unclear. Thus, across two experiments (total N = 80), we investigated how mere visual observation of a mannequin body, viewed from a first-person perspective, influenced subjective embodiment independently from concomitant visuotactile integration. Moreover, we investigated whether slow, affective touch on participants' own, unseen body (without concomitant touch on the seen mannequin) disrupted visual capture effects to a greater degree than fast, non-affective touch. In total, 40% of participants experienced subjective embodiment towards the mannequin body following mere visual observation, and this effect was significantly higher than conditions which included touch to participants own, unseen body. The velocity of the touch that participants received (affective/non-affective) did not differ in modulating visual capture effects. Furthermore, the effects of visual capture and perceived pleasantness of touch was not modulated by subthreshold eating disorder psychopathology. Overall, this study suggests that congruent visuoproprioceptive cues can be sufficient to induce subjective embodiment of a whole body, in the absence of visuotactile integration and beyond mere confabulatory responses.