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Hamamoto Y, Oba K, Ishibashi R, Ding Y, Nouchi R, Sugiura M. Reduced body-image disturbance by body-image interventions is associated with neural-response changes in visual and social processing regions: a preliminary study. Front Psychiatry 2024; 15:1337776. [PMID: 38510808 PMCID: PMC10951070 DOI: 10.3389/fpsyt.2024.1337776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Body-image disturbance is a major factor in the development of eating disorders, especially among young women. There are two main components: perceptual disturbance, characterized by a discrepancy between perceived and actual body size, and affective disturbance, characterized by a discrepancy between perceived and ideal body size. Interventions targeting body-image disturbance ask individuals to describe their own body without using negative expressions when either viewing it in a mirror or imagining it. Despite the importance of reducing body-image disturbance, its neural mechanisms remain unclear. Here we investigated the changes in neural responses before and after an intervention. We hypothesized that neural responses correlated with the degree of body-image disturbance would also be related to its reduction, i.e., a reduction in perceptual and affective disturbances would be related to changes in attentional and socio-cognitive processing, respectively. Methods Twenty-eight young adult women without known psychiatric disorders underwent a single 40-min intervention. Participants completed tasks before and after the intervention, in which they estimated their perceived and ideal body sizes using distorted silhouette images to measure body-image disturbance. We analyzed the behavioral and neural responses of participants during the tasks. Results The intervention did not significantly reduce body-image disturbance. Analysis of individual differences showed distinct changes in neural responses for each type of disturbance. A decrease in perceptual disturbance was associated with bodily visuospatial processing: increased activation in the left superior parietal lobule, bilateral occipital gyri, and right cuneus. Reduced affective disturbance was associated with socio-cognitive processing; decreased activation in the right temporoparietal junction, and increased functional connectivity between the left extrastriate body area and the right precuneus. Discussion We identified distinct neural mechanisms (bodily visuospatial and socio-cognitive processing) associated with the reduction in each component of body-image disturbance. Our results imply that different neural mechanisms are related to reduced perceptual disturbance and the expression thereof, whereas similar neural mechanisms are related to the reduction and expression of affective disturbance. Considering the small sample size of this study, our results should be regarded as preliminary.
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Affiliation(s)
- Yumi Hamamoto
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kentaro Oba
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryo Ishibashi
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yi Ding
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- School of Medicine, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Motoaki Sugiura
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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Brooks J, Walker DC, Murray K. What can my body do for me? Guided body-functionality mirror gazing task improved college women's body appreciation and body functionality orientation. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37207308 DOI: 10.1080/07448481.2023.2209195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/30/2023] [Accepted: 04/23/2023] [Indexed: 05/21/2023]
Abstract
Objective: Focusing on body functionality - what the body can do - may benefit women's body image. This pilot study examined the effects of focusing on body functionality appreciation during an audio-guided mirror gazing task (F-MGT). Participants: 101 college women, M(SD)AGE = 19.49(1.31), were alternately assigned to F-MGT or a comparison with no guidance on how to examine the body, directed attention mirror gazing task (DA-MGT). Methods: Participants self-reported pre- and post-MGT body appreciation, state appearance satisfaction, and orientation to and satisfaction with physical functionality. Results: Group interactions were significant for body appreciation and functionality orientation. DA-MGT decreased body appreciation from pre- to post-MGT; F-MGT did not change. There were no significant interactions in post-MGT state appearance satisfaction or functionality satisfaction, though state appearance satisfaction increased significantly in F-MGT. Conclusions: Integrating body functionality may buffer against harmful effects of mirror gazing. Given F-MGT's brevity, additional work must assess its potential as an intervention technique.
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Affiliation(s)
- Julia Brooks
- Union College Psychology Department, Union College, Schenectady, New York, USA
| | - D Catherine Walker
- Union College Psychology Department, Union College, Schenectady, New York, USA
| | - Kristen Murray
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
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Sánchez CG, Ferrer SD, Cuellar JAA, Martín JLM, Ruiz SR. I Look at my whole body and i feel better: attentional bias, emotional and psychophysiological response by pure exposure treatment in women with obesity. Psychother Res 2022; 32:748-762. [PMID: 34983319 DOI: 10.1080/10503307.2021.2021310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Obesity is one of the most important health problems nowadays. In addition to the direct physical consequences, it is also a risk factor in the development of psychological (Eating disorders, body dissatisfaction, depression, anxiety, etc.) and social problems. Among there, body dissatisfaction is key for development and maintenance of such problems. OBJECTIVE to deepen the effectiveness of the body exposure treatment, both in its pure form and guided modality in subjective, psychological and attentional levels in people with body dissatisfaction and obesity. METHODS Evaluations were carried out in a total of 16 women with obesity and body dissatisfaction at the beginning and end of 6 treatment sessions of pure exposure in front of the mirror. The changes experienced at the subjective level (questionnaires and subjective discomfort during the sessions) and psychophysiological (eye-tracking and heart rate) were analyzed. RESULTS Pure exposure treatment reduces negative thoughts and emotions towards the body itself, as well as the experienced discomfort towards the most conflictive parts. Selective attention to those parts of the body classified as uglier by the participants (especially the rear view of the body) show a decrease in physiological reactivity. CONCLUSIONS Pure exposure treatment seems to be effective in reducing subjective and psychological symptoms associated with body dissatisfaction in people with obesity, this technique could be considered a good choice for the treatment of body dissatisfaction. This step is essential to guarantee the long-term therapeutic success of any other treatment (nutritional or/and physical activity) in the future.
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Affiliation(s)
- Cristina González Sánchez
- Faculty of Psychology, Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain
| | - Sandra Díaz Ferrer
- Faculty of Psychology, Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain
| | | | - José Luis Mata Martín
- Faculty of Psychology, Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain
| | - Sonia Rodríguez Ruiz
- Faculty of Psychology, Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain
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Knejzlíková T, Světlák M, Malatincová T, Roman R, Chládek J, Najmanová J, Theiner P, Linhartová P, Kašpárek T. Electrodermal Response to Mirror Exposure in Relation to Subjective Emotional Responses, Emotional Competences and Affectivity in Adolescent Girls With Restrictive Anorexia and Healthy Controls. Front Psychol 2021; 12:673597. [PMID: 34566754 PMCID: PMC8461306 DOI: 10.3389/fpsyg.2021.673597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 08/18/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Body image disturbances and the attendant negative emotions are two of the major clinical symptoms of eating disorders. The objective of the present experimental study was to shed more light on the degree of association or dissociation between the physiological and emotional response to mirror exposure in patients with restrictive mental anorexia, and on the relationships between the physiological response and characteristics connected with emotional processing. Materials and Methods: Thirty adolescent girls with the restrictive type of anorexia and thirty matched healthy controls underwent bilateral measurement of skin conductance (SC) during rest, neutral stimulus exposure, and mirror exposure, and completed a set of measures focused on emotion regulation competencies, affectivity, and eating disorder pathology. Results: Compared to healthy controls, girls with restrictive anorexia rated mirror exposure as a subjectively more distressful experience. Differences in skin conductance response (SCR) were not significant; however, variance in SCR was substantially greater in the group of anorexia patients as compared to healthy controls. The overall skin conductance level (SCL) was lower in anorexia patients. Increase in SCR during mirror exposure, as opposed to exposure to neutral stimuli, was positively related to the tendency to experience negative emotions, interoceptive sensitivity, body dissatisfaction and suppression, but not to other symptoms of eating pathology or emotional awareness. A post hoc analysis suggested that physiological reactivity might be associated with interoceptive sensitivity to mirror exposure especially in anorectic patients. Conclusion: The study seems to demonstrate some degree of dissociation between psychophysiological reactivity and subjective response to body exposure in patients with restrictive anorexia. Factors affecting differences in psychophysiological responsiveness to body exposure in anorectic patients require further exploration.
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Affiliation(s)
- Terézia Knejzlíková
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Miroslav Světlák
- Institute of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tatiana Malatincová
- Institute of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Robert Roman
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jan Chládek
- Institute of Scientific Instruments of the CAS, Brno, Czechia
| | - Jana Najmanová
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Pavel Theiner
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Pavla Linhartová
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tomáš Kašpárek
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
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Scheer C, Kubowitsch S, Dendorfer S, Jansen P. Happy Enough to Relax? How Positive and Negative Emotions Activate Different Muscular Regions in the Back - an Explorative Study. Front Psychol 2021; 12:511746. [PMID: 34135791 PMCID: PMC8201496 DOI: 10.3389/fpsyg.2021.511746] [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: 01/28/2020] [Accepted: 05/04/2021] [Indexed: 11/23/2022] Open
Abstract
Embodiment theories have proposed a reciprocal relationship between emotional state and bodily reactions. Besides large body postures, recent studies have found emotions to affect rather subtle bodily expressions, such as slumped or upright sitting posture. This study investigated back muscle activity as an indication of an effect of positive and negative emotions on the sitting position. The electromyography (EMG) activity of six back muscles was recorded in 31 healthy subjects during exposure to positive and negative affective pictures. A resting period was used as a control condition. Increased muscle activity patterns in the back were found during the exposure to negative emotional stimuli, which was mainly measured in the lumbar and thorax regions. The positive emotion condition caused no elevated activity. The findings show that negative emotions lead to increased differential muscle activity in the back and thus corroborate those of previous research that emotion affects subtle bodily expressions.
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Affiliation(s)
- Clara Scheer
- Institute of Sport Science, Faculty of Humanities, University of Regensburg, Regensburg, Germany
| | - Simone Kubowitsch
- Laboratory for Biomechanics, Ostbayrische Technische Hoschschule Regensburg, Regensburg, Germany
| | - Sebastian Dendorfer
- Laboratory for Biomechanics, Ostbayrische Technische Hoschschule Regensburg, Regensburg, Germany
| | - Petra Jansen
- Institute of Sport Science, Faculty of Humanities, University of Regensburg, Regensburg, Germany
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Stonawski V, Sasse L, Moll G, Kratz O, Horndasch S. Computer Based Body Exposure in Adolescents With Anorexia Nervosa: A Study Protocol. Front Psychiatry 2021; 12:769239. [PMID: 35140637 PMCID: PMC8818868 DOI: 10.3389/fpsyt.2021.769239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Body dissatisfaction is a core feature of eating disorders (EDs) and plays an essential role in the development and maintenance of anorexia nervosa (AN). In the current study, a computer based body exposure intervention is conducted and evaluated regarding short-term effects on body dissatisfaction, psychopathology, viewing patterns, and stress reactivity. Within a randomized controlled trial (RCT) female adolescents and young women with AN are either receiving the intervention or treatment as usual (TAU). Furthermore, in a transdiagnostic approach, a highly body-dissatisfied group of clinical control participants obtaining the intervention will be surveyed to identify AN-specific processes. The standardized four-session body exposure intervention using photographs of the own body is adapted from a manualized body image treatment program for computer use. Psychopathology (body dissatisfaction, body image avoidance, body checking, depression, anxiety) is assessed via standardized questionnaires before and after the intervention. During each session, attentional biases regarding one's own body are measured via eye tracking, stress levels are measured via subjective ratings, heart rate variability, as well as salivary cortisol and alpha amylase. Between- and within-subject effects will be assessed. The pilot study aims to identify short-term effects of the intervention on body dissatisfaction and attentional bias, as well as to investigate the potential underlying mechanism of physiological habituation.
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Affiliation(s)
- Valeska Stonawski
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Lena Sasse
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Gunther Moll
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Stefanie Horndasch
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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Baur J, Krohmer K, Naumann E, Tuschen-Caffier B, Svaldi J. Vocal arousal: a physiological correlate of body distress in women with overweight and obesity. Eat Weight Disord 2020; 25:1161-1169. [PMID: 31338792 DOI: 10.1007/s40519-019-00744-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/01/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Numerous studies highlight the relevance of body image in the development and maintenance of overweight and obesity mostly using self-reported data. Given the importance of physiological assessment methods, the present study aimed at investigating vocally encoded emotional arousal as a correlate of body distress in women with overweight and obesity. METHODS Cognitions of women with overweight and obesity (OW; n = 22) as well as normal weight controls (NW; n = 22) were assessed by means of a thought-sampling procedure during a mirror exposure and a control condition. Fundamental frequency (f0) as a marker of vocally encoded emotional arousal as well as verbalized body-related cognitions were analyzed during this experimental task. RESULTS A stronger increase in f0 between the control and the mirror exposure condition was found in OW compared to NW. Furthermore, there were significant positive correlations between vocally encoded emotional arousal and various measures of body image. CONCLUSION The findings support the utility of vocally encoded emotional arousal as an objective physiological correlate of the evaluative dimension of body image in women with overweight and obesity. LEVEL OF EVIDENCE Level I, experimental study.
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Affiliation(s)
- Julia Baur
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Schleichstraße 4, 72076, Tübingen, Germany
| | - Kerstin Krohmer
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Schleichstraße 4, 72076, Tübingen, Germany
| | - Eva Naumann
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Schleichstraße 4, 72076, Tübingen, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Engelbergerstraße 41, 79106, Freiburg, Germany
| | - Jennifer Svaldi
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Schleichstraße 4, 72076, Tübingen, Germany.
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8
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Baur J, Krohmer K, Tuschen-Caffier B, Svaldi J. Cognitive-Emotional Involvement During Mirror Exposure Is Not Accompanied by Physiological Activation in Binge Eating Disorder. Front Psychiatry 2019; 10:745. [PMID: 31803074 PMCID: PMC6877718 DOI: 10.3389/fpsyt.2019.00745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/17/2019] [Indexed: 12/29/2022] Open
Abstract
Body image interventions have been shown to reduce self-reported cognitive-emotional facets of body image disturbance in binge eating disorder (BED). However, more objective assessment methods are required to evaluate the effects of these interventions. Therefore, the present study aimed at investigating the usefulness of vocally encoded emotional arousal as physiological correlate of body dissatisfaction during mirror exposure in women with BED. Women with BED (n = 60) and weight-matched controls (CG; n = 60) participated in an experimental thought-sampling procedure including a mirror exposure and a control condition in a repeated-measures design. Fundamental frequency as a vocal correlate of emotional arousal as well as negative, neutral, and positive body-related cognitions during both conditions were analyzed. In line with our hypotheses, the BED group verbalized more negative, and less positive and neutral body-related cognitions during the mirror exposure condition compared to the CG. Contrary to our hypotheses, though, there was a stronger increase in physiological arousal between the control and the mirror exposure condition in the CG relative to the BED group. Furthermore, a significant negative correlation between fundamental frequency and the severity of cognitive-emotional body image disturbances emerged. The findings indicate a cognitive-emotional over-involvement with physical appearance during mirror exposure in women with BED compared to weight-matched controls in the absence of a corresponding physiological pattern. Results are discussed in terms of an impaired ability of women with BED to show adequate physiological responses to body-related stress. In addition, methodological recommendations for future research are presented.
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Affiliation(s)
- Julia Baur
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Kerstin Krohmer
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Jennifer Svaldi
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Tuebingen, Germany
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9
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Mirror exposure therapy for body image disturbances and eating disorders: A review. Clin Psychol Rev 2018; 65:163-174. [DOI: 10.1016/j.cpr.2018.08.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/25/2018] [Accepted: 08/27/2018] [Indexed: 12/21/2022]
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10
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Moreno-Domínguez S, Servián-Franco F, Reyes del Paso GA, Cepeda-Benito A. Images of Thin and Plus-Size Models Produce Opposite Effects on Women’s Body Image, Body Dissatisfaction, and Anxiety. SEX ROLES 2018. [DOI: 10.1007/s11199-018-0951-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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11
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Miragall M, Etchemendy E, Cebolla A, Rodríguez V, Medrano C, Baños RM. Expand your body when you look at yourself: The role of the posture in a mirror exposure task. PLoS One 2018; 13:e0194686. [PMID: 29570729 PMCID: PMC5865731 DOI: 10.1371/journal.pone.0194686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/07/2018] [Indexed: 11/28/2022] Open
Abstract
Mirror exposure (ME) is one of the main components of the treatment of patients with eating disorders symptomatology and it has shown its effectiveness in improving several outcomes (e.g., body dissatisfaction). However, the study as to what body posture should be adopted to maximize its effectiveness has been neglected. From embodied cognition and emotion theories, the adoption of an expansive (vs. contractive) body posture has been associated with positive changes in cognitive and emotional responses. The objective of this study was to analyze the effect of adopting an expansive (vs. contractive) posture before an ME task on body-related emotions and cognitions, as well as to analyze the possible moderator and mediator variables of these relationships. The sample was composed of 68 women (age: M = 21.74, SD = 3.12) with high scores on body dissatisfaction. Participants were randomly assigned to the expansive or contractive condition, where the openness of the arms/legs and the back position were manipulated. Posture was monitored by an electronic device and participants filled out several self-reported measures. ANCOVAs, moderation, mediation, and moderated mediated analyses were performed. Results showed that women in the expansive condition showed higher positive emotions after the ME. Moreover, exploratory analyses showed that adopting an expansive posture improved positive emotions, leading to improvements in negative emotions, body image satisfaction, and appraisal of the person’s own body. Psychological interventions should explore the value of holding an expansive posture before the ME in women with body dissatisfaction.
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Affiliation(s)
- Marta Miragall
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | | | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | | | - Carlos Medrano
- EduQTech, EUPT, University of Zaragoza, Teruel, Spain.,Aragon Institute for Health Research (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Rosa María Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Carlos III, Madrid, Spain
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12
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Schäflein E, Sattel H, Schmidt U, Sack M. The enemy in the mirror: self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder. Eur J Psychotraumatol 2018; 9:1472991. [PMID: 29938011 PMCID: PMC6008582 DOI: 10.1080/20008198.2018.1472991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/17/2018] [Indexed: 12/25/2022] Open
Abstract
Background: Patients suffering from dissociative disorders (DD) are characterized by an avoidance of aversive stimuli. Clinical experience has shown that DD patients typically avoid the confrontation with their own faces in a mirror (CFM). Objective: To investigate potential CFM-associated self-reported and psychophysiological stress reactions of DD patients, which most likely inform on the still unknown pathophysiology of dysfunctional self-perception in DD. Method: Eighteen DD patients and 18 healthy controls (HCs) underwent CFM. They were assessed for CFM-induced subjective self-reported stress, acute dissociative symptoms and sympathetic and parasympathetic drive using impedance cardiography. Results: DD patients experienced more subjective stress and acute dissociation than HCs upon CFM. Their psychological stress response did not activate the sympathetic and parasympathetic nervous system. Conclusions: In DD patients, CFM constitutes serious self-reported stress and is associated with a blunted autonomic reactivity. Therapeutic approaches promoting self-perception and self-compassion, in particular by using CFM, might serve as goal-oriented diagnostic and therapeutic tools in DD.
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Affiliation(s)
- Eva Schäflein
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ulrike Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Centre of Göttingen, RG Stressmodulation of Neurodegeneration, Göttingen, Germany
| | - Martin Sack
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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13
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Díaz-Ferrer S, Rodríguez-Ruiz S, Ortega-Roldán B, Mata-Martín JL, Carmen Fernández-Santaella M. Psychophysiological Changes during Pure vs Guided Mirror Exposure Therapies in Women with High Body Dissatisfaction: What Are They Learning about Their Bodies? EUROPEAN EATING DISORDERS REVIEW 2017; 25:562-569. [PMID: 28944527 DOI: 10.1002/erv.2546] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/05/2017] [Accepted: 08/14/2017] [Indexed: 11/11/2022]
Abstract
This study aimed to examine the psychophysiological changes resulting from two mirror exposure treatments that are effective at reducing body dissatisfaction. Thirty-five university women with body dissatisfaction and subclinical eating disorders were randomly assigned to one of two groups: pure (n = 17) or guided exposure (n = 18). The participants received six sessions of treatment. Their thoughts, feelings and avoidance behaviours were assessed after each session. Their subjective discomfort, heart rate and skin conductance were assessed within the sessions. Both groups showed improvement in cognitive-affective and avoidance behaviour symptoms. Nevertheless, the pure exposure group showed faster habituation of subjective discomfort and a greater physiological response than the guided exposure group. These findings suggest that both procedures are effective interventions for improving body image disturbances, although psychophysiological changes observed within session suggest that each technique would act through different processes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Sandra Díaz-Ferrer
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Spain
| | - Sonia Rodríguez-Ruiz
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Spain
| | - Blanca Ortega-Roldán
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Spain
| | - José Luis Mata-Martín
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Spain
| | - M Carmen Fernández-Santaella
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Spain
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