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Abstract
Many who suffer from eating disorders claim that they see themselves as "fat". Despite decades of research into the phenomenon, behavioural evidence has failed to confirm that eating disorders involve visual misperception of own-body size. I illustrate the importance of this phenomenon for our understanding of perceptual processing, outline the challenges involved in experimentally confirming it, and provide solutions to those challenges.
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Affiliation(s)
- Stephen Gadsby
- Department of Philosophy, 445418University of Antwerp, Antwerp, Belgium
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2
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Brooks KR, Stevenson RJ, Stephen ID. Over or Under? Mental Representations and the Paradox of Body Size Estimation. Front Psychol 2021; 12:706313. [PMID: 34413814 PMCID: PMC8369339 DOI: 10.3389/fpsyg.2021.706313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/30/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Kevin R Brooks
- Body Image & Ingestion Group (BIIG), Faculty of Medicine, Health & Human Sciences, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia.,Perception in Action Research Centre (PARC), Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Richard J Stevenson
- Body Image & Ingestion Group (BIIG), Faculty of Medicine, Health & Human Sciences, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia.,Perception in Action Research Centre (PARC), Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Ian D Stephen
- Body Image & Ingestion Group (BIIG), Faculty of Medicine, Health & Human Sciences, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia.,Perception in Action Research Centre (PARC), Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
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3
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Behrens SC, Meneguzzo P, Favaro A, Teufel M, Skoda EM, Lindner M, Walder L, Quiros Ramirez A, Zipfel S, Mohler B, Black M, Giel KE. Weight bias and linguistic body representation in anorexia nervosa: Findings from the BodyTalk project. Eur Eat Disord Rev 2020; 29:204-215. [PMID: 33252835 DOI: 10.1002/erv.2812] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/17/2020] [Accepted: 11/01/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study provides a comprehensive assessment of own body representation and linguistic representation of bodies in general in women with typical and atypical anorexia nervosa (AN). METHODS In a series of desktop experiments, participants rated a set of adjectives according to their match with a series of computer generated bodies varying in body mass index, and generated prototypic body shapes for the same set of adjectives. We analysed how body mass index of the bodies was associated with positive or negative valence of the adjectives in the different groups. Further, body image and own body perception were assessed. RESULTS In a German-Italian sample comprising 39 women with AN, 20 women with atypical AN and 40 age matched control participants, we observed effects indicative of weight stigmatization, but no significant differences between the groups. Generally, positive adjectives were associated with lean bodies, whereas negative adjectives were associated with obese bodies. DISCUSSION Our observations suggest that patients with both typical and atypical AN affectively and visually represent body descriptions not differently from healthy women. We conclude that overvaluation of low body weight and fear of weight gain cannot be explained by generally distorted perception or cognition, but require individual consideration.
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Affiliation(s)
- Simone Claire Behrens
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Marion Lindner
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR University-Hospital Essen, Essen, Germany
| | - Lukas Walder
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Alejandra Quiros Ramirez
- Max Planck Institute for Intelligent Systems, Tübingen, Germany.,Psychology Department, University of Konstanz, Konstanz, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Betty Mohler
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Michael Black
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
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4
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Alexi J, Dommisse K, Cleary D, Palermo R, Kloth N, Bell J. An Assessment of Computer-Generated Stimuli for Use in Studies of Body Size Estimation and Bias. Front Psychol 2019; 10:2390. [PMID: 31695661 PMCID: PMC6817789 DOI: 10.3389/fpsyg.2019.02390] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/07/2019] [Indexed: 12/20/2022] Open
Abstract
Inaccurate body size judgments are associated with body image disturbances, a clinical feature of many eating disorders. Accordingly, body-related stimuli have become increasingly important in the study of estimation inaccuracies and body image disturbances. Technological advancements in the last decade have led to an increased use of computer-generated (CG) body stimuli in body image research. However, recent face perception research has suggested that CG face stimuli are not recognized as readily and may not fully tap facial processing mechanisms. The current study assessed the effectiveness of using CG stimuli in an established body size estimation task (the “bodyline” task). Specifically, we examined whether employing CG body stimuli alters body size judgments and associated estimation biases. One hundred and six 17- to 25-year-old females completed the CG bodyline task, which involved estimating the size of full-length CG body stimuli along a visual analogue scale. Our results show that perception of body size for CG stimuli was non-linear. Participants struggled to discriminate between extreme bodies sizes and overestimated the size change between near to average bodies. Furthermore, one of our measured size estimation biases was larger for CG stimuli. Our collective findings suggest using caution when employing CG stimuli in experimental research on body perception.
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Affiliation(s)
- Joanna Alexi
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Kendra Dommisse
- School of Psychological Science, University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Dominique Cleary
- School of Psychological Science, University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Romina Palermo
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Nadine Kloth
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Jason Bell
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
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5
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Corno G, Serino S, Cipresso P, Baños RM, Riva G. Assessing the Relationship Between Attitudinal and Perceptual Component of Body Image Disturbance Using Virtual Reality. Cyberpsychol Behav Soc Netw 2019; 21:679-686. [PMID: 30421995 DOI: 10.1089/cyber.2018.0340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Body image disturbance (BID) affects quality of life even in the absence of clinically diagnosable eating pathology, and numerous studies have shown its crucial role in the emergence and maintenance of eating disorders. This study aimed at exploring attitudinal and perceptual components of BID using a novel virtual reality (VR)-based paradigm. A community sample of women (N = 27) recreated in VR their perceived body in both an allocentric (third-person view) and egocentric (first-person view) perspective. Specifically, women were able to choose between a wide range of three-dimensional bodies spanning body mass index 12.5-42.5 kg/m2. Attitudinal indexes of BID (body dissatisfaction, body uneasiness, and body image avoidance) were assessed through questionnaires. Attitudinal components predicted the perceptual BID only in the allocentric perspective. Specifically, overestimation was predicted by body image avoidance, while underestimation was predicted by body uneasiness. Furthermore, a common predictor of underestimation and overestimation was body dissatisfaction. In line with the allocentric lock hypothesis, the current results seem to confirm the presence of two different mechanisms underlying BID: one related to real-time perception-driven inputs (egocentric frame) and one related to abstract knowledge, beliefs, and attitudes related to a person's body (allocentric frame). These findings contribute to a better understanding of the nature and mechanisms underlying BID and provide additional evidence about the suitability of using VR for exploring and assessing body image-related components and disturbances.
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Affiliation(s)
- Giulia Corno
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy
| | - Silvia Serino
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy .,2 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
| | - Pietro Cipresso
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy .,2 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
| | - Rosa M Baños
- 3 Departamento Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de Valencia , Valencia, Spain .,4 CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health , Madrid, Spain
| | - Giuseppe Riva
- 1 Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano , Milan, Italy .,2 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
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6
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Groves V, Cornelissen P, McCarty K, Mohamed S, Maalin N, Tovée MJ, Cornelissen K. How Does Variation in the Body Composition of Both Stimuli and Participant Modulate Self-Estimates of Men's Body Size? Front Psychiatry 2019; 10:720. [PMID: 31649565 PMCID: PMC6794946 DOI: 10.3389/fpsyt.2019.00720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/09/2019] [Indexed: 12/21/2022] Open
Abstract
When measured in units of body mass index (BMI), how much variation in men's self-estimates of body size is caused by i) variation in participants' body composition and ii) variation in the apparent muscle mass and muscle tone of the stimuli being judged? To address this, we generated nine sets of male CGI bodies representing low, mid, and high muscle mass rendered at low, mid, and high muscle tone, from 18.75 to 40 BMIhse units. BMIhse units in this study are estimates of BMI derived from calibration equations predicting BMI from waist and hip circumference, age, sex, height, and ethnicity in the Health Survey for England databases. Forty-five healthy adult men estimated their body size using a yes-no paradigm for each combination of muscle mass/tone. We also measured participants' body composition with Harpenden callipers and their body concerns with psychometric questionnaires. We show that stimulus variation in apparent muscle mass/tone can introduce differences up to ∼2.5 BMIhse units in men's self-estimates of body size. Moreover, men with the same actual BMI, but different body composition, showed up to ∼5-7 BMIhse unit differences in self-estimates of body size. In the face of such large errors, we advocate that such judgments in men should be made instead by simultaneously manipulating both the adiposity and the muscle mass of stimuli which are appropriately calibrated for body composition, so that the participant can match the body size and shape they believe themselves to have to the stimulus they see.
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Affiliation(s)
- Vicki Groves
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Piers Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Sophie Mohamed
- School of Psychology, University of Lincoln, Lincoln, United Kingdom
| | - Nadia Maalin
- School of Psychology, University of Lincoln, Lincoln, United Kingdom
| | | | - Katri Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
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7
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Dalhoff AW, Romero Frausto H, Romer G, Wessing I. Perceptive Body Image Distortion in Adolescent Anorexia Nervosa: Changes After Treatment. Front Psychiatry 2019; 10:748. [PMID: 31681048 PMCID: PMC6803517 DOI: 10.3389/fpsyt.2019.00748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/18/2019] [Indexed: 11/13/2022] Open
Abstract
One key symptom of anorexia nervosa (AN) is body image distortion (BID). For example, AN patients who are asked to perform body size estimation tasks tend to overestimate their body size; this is thought to indicate a distortion of the perceptive component of body image. Although BID is an important treatment objective, only few treatment approaches explicitly target body image, and even fewer target the perceptive component. Moreover, very little is known about how patients' perceptive body image changes after treatment and related weight gain. Consequently, we investigated changes of the perceptive BID in adolescent AN patients at the beginning (T1) and the end (T2) of inpatient treatment using a body size estimation task. A total of 38 AN patients performed the test for Body Image Distortion in Children and Adolescents (BID-CA) within the first 2 weeks of inpatient treatment and at the end of treatment. The results were compared to 48 healthy control (HC) participants performing the same task once. At T1, AN patients overestimated their body size more than HC, i.e., a total overestimation of 33% in AN patients vs. 11% in HC. At T2, AN patients overestimated their arm size to the same degree that they did at TI, but overestimations for the thigh and waist were reduced, and their overestimations for the waist no longer differed from the HC group. Thus, after treatment, AN patients were partly able to more realistically estimate their body size. Several factors may have influenced the observed changes in body size estimation, including task repetition, deliberate adjustment, growing into their preexisting perceptive body image through weight gain, as well as targeted and non-specific psychotherapeutic treatments. In conclusion, the perceptive BID in adolescent AN patients is persistent but also modifiable. Although diverse factors presumably play a role in changing BID, these findings suggest that AN patients may benefit from targeted treatment of BID.
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Affiliation(s)
- Anke W Dalhoff
- Department of Child and Adolescent Psychiatry, University Hospital, Münster, Germany
| | - Hugo Romero Frausto
- Department of Child and Adolescent Psychiatry, University Hospital, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University Hospital, Münster, Germany
| | - Ida Wessing
- Department of Child and Adolescent Psychiatry, University Hospital, Münster, Germany.,Institute for Biomagnetism and Biosignalanalysis, University Hospital, Münster, Germany
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8
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Abstract
The conscious representation of our physical appearance is important for many aspects of everyday life. Here, we asked whether different visual experiences of our bodies influence body width estimates. In Experiment 1, width estimates of three body parts (foot, hips, and shoulders) without any visual access were compared to estimates with visual feedback available in a mirror or from a first-person perspective. In the no visual access and mirror condition, participants additionally estimated their head width. There was no influence of viewing condition on body part width estimates. Consistent with previous research, all body part widths were overestimated with greater overestimation of hip and head width. In Experiment 2, participants estimated the size of unfamiliar noncorporeal objects to test whether this overestimation was partially due to the metric body size estimation method or our experimental conditions. Object width was overestimated with visual feedback in a mirror available as compared to when directly looking at the object, but only for objects placed at shoulder and head height. We conclude that at least some of the overestimation of body part width seems to be body specific and occurs regardless of the visual information provided about the own body.
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Affiliation(s)
- Anne Thaler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Michael N. Geuss
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Betty J. Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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9
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Purcell JB, Winter SR, Breslin CM, White NC, Lowe MR, Branch Coslett H. Implicit Mental Motor Imagery Task Demonstrates a Distortion of the Body Schema in Patients With Eating Disorders. J Int Neuropsychol Soc 2018; 24:715-23. [PMID: 29909800 DOI: 10.1017/S1355617718000371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES A rich body of literature has established the role of body image distortion and dissatisfaction in the development and maintenance of eating disorders. However, many of the currently used techniques require explicit comparison of the person's body to an external stimulus. As the body schema is a largely unconscious construct, explicit comparison tasks may reflect a proxy, rather than the body schema itself. METHODS Here we use an implicit mental motor imagery (MMI) task to interrogate the body schema in healthy control participants (N=40) and participants at a residential eating disorder treatment center (N=42). By comparing the time it takes to imagine making a movement along a part of the body to the time it takes to actually make the same movement, we were able to assess participants' mental image of their body (i.e., body schema). RESULTS We found that participants with eating disorders, but not healthy controls, exhibited distortions of the body schema such that they believed their abdomen, buttocks, and thighs to be larger than they really are. Additionally, the MMI task used here provided information above and beyond traditional self-report measures (i.e., Body Shape Questionnaire). Together the MMI task and traditional measures provide the most information. CONCLUSIONS Findings using the novel MMI task are in line with the literature; participants with eating disorders consider themselves to be larger than they truly are. Taken together, results of this study suggest that MMI tasks provide complementary information to traditional self-report measures. (JINS, 2018, 24, 715-723).
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10
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Mölbert SC, Thaler A, Mohler BJ, Streuber S, Romero J, Black MJ, Zipfel S, Karnath HO, Giel KE. Assessing body image in anorexia nervosa using biometric self-avatars in virtual reality: Attitudinal components rather than visual body size estimation are distorted. Psychol Med 2018; 48:642-653. [PMID: 28745268 PMCID: PMC5964466 DOI: 10.1017/s0033291717002008] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN. METHODS We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants' weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity. RESULTS Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1. CONCLUSIONS Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.
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Affiliation(s)
- S. C. Mölbert
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - A. Thaler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - B. J. Mohler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
| | - S. Streuber
- École Polytechnique Fédérale de Lausanne, Brain
Mind Institute, Lausanne,
Switzerland
| | - J. Romero
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - M. J. Black
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - S. Zipfel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
| | - H.-O. Karnath
- Division of Neuropsychology,
Center of Neurology, Hertie-Institute for Clinical Brain Research, University
of Tübingen, Tübingen, Germany
| | - K. E. Giel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
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11
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Mölbert SC, Thaler A, Streuber S, Black MJ, Karnath HO, Zipfel S, Mohler B, Giel KE. Investigating Body Image Disturbance in Anorexia Nervosa Using Novel Biometric Figure Rating Scales: A Pilot Study. Eur Eat Disord Rev 2018; 25:607-612. [PMID: 29057601 DOI: 10.1002/erv.2559] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/05/2017] [Accepted: 09/14/2017] [Indexed: 11/08/2022]
Abstract
This study uses novel biometric figure rating scales (FRS) spanning body mass index (BMI) 13.8 to 32.2 kg/m2 and BMI 18 to 42 kg/m2 . The aims of the study were (i) to compare FRS body weight dissatisfaction and perceptual distortion of women with anorexia nervosa (AN) to a community sample; (ii) how FRS parameters are associated with questionnaire body dissatisfaction, eating disorder symptoms and appearance comparison habits; and (iii) whether the weight spectrum of the FRS matters. Women with AN (n = 24) and a community sample of women (n = 104) selected their current and ideal body on the FRS and completed additional questionnaires. Women with AN accurately picked the body that aligned best with their actual weight in both FRS. Controls underestimated their BMI in the FRS 14-32 and were accurate in the FRS 18-42. In both FRS, women with AN desired a body close to their actual BMI and controls desired a thinner body. Our observations suggest that body image disturbance in AN is unlikely to be characterized by a visual perceptual disturbance, but rather by an idealization of underweight in conjunction with high body dissatisfaction. The weight spectrum of FRS can influence the accuracy of BMI estimation. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Simone C Mölbert
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Anne Thaler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | | | - Michael J Black
- Max Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Betty Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
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12
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Steinsbekk S, Klöckner CA, Fildes A, Kristoffersen P, Rognsås SL, Wichstrøm L. Body Size Estimation from Early to Middle Childhood: Stability of Underestimation, BMI, and Gender Effects. Front Psychol 2017; 8:2038. [PMID: 29209262 PMCID: PMC5702321 DOI: 10.3389/fpsyg.2017.02038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/07/2017] [Indexed: 12/26/2022] Open
Abstract
Individuals who are overweight are more likely to underestimate their body size than those who are normal weight, and overweight underestimators are less likely to engage in weight loss efforts. Underestimation of body size might represent a barrier to prevention and treatment of overweight; thus insight in how underestimation of body size develops and tracks through the childhood years is needed. The aim of the present study was therefore to examine stability in children's underestimation of body size, exploring predictors of underestimation over time. The prospective path from underestimation to BMI was also tested. In a Norwegian cohort of 6 year olds, followed up at ages 8 and 10 (analysis sample: n = 793) body size estimation was captured by the Children's Body Image Scale, height and weight were measured and BMI calculated. Overall, children were more likely to underestimate than overestimate their body size. Individual stability in underestimation was modest, but significant. Higher BMI predicted future underestimation, even when previous underestimation was adjusted for, but there was no evidence for the opposite direction of influence. Boys were more likely than girls to underestimate their body size at ages 8 and 10 (age 8: 38.0% vs. 24.1%; Age 10: 57.9% vs. 30.8%) and showed a steeper increase in underestimation with age compared to girls. In conclusion, the majority of 6, 8, and 10-year olds correctly estimate their body size (prevalence ranging from 40 to 70% depending on age and gender), although a substantial portion perceived themselves to be thinner than they actually were. Higher BMI forecasted future underestimation, but underestimation did not increase the risk for excessive weight gain in middle childhood.
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Affiliation(s)
- Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian A. Klöckner
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Alison Fildes
- Institute of Psychological Sciences, University of Leeds, Leeds, United Kingdom
| | - Pernille Kristoffersen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stine L. Rognsås
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Human Development, NTNU Social Research, Trondheim, Norway
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13
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Øverås M, Kapstad H, Brunborg C, Landrø NI, Rø Ø. Is overestimation of body size associated with neuropsychological weaknesses in anorexia nervosa? Eur Eat Disord Rev 2017; 25:129-134. [PMID: 28217881 DOI: 10.1002/erv.2500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 10/21/2016] [Accepted: 11/25/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent research indicates some evidence of neuropsychological weaknesses in visuospatial memory, central coherence and set-shifting in adults with anorexia nervosa (AN). The growing interest in neuropsychological functioning of patients with AN is based upon the assumption that neuropsychological weaknesses contribute to the clinical features of the illness. However, due to a paucity of research on the connection between neuropsychological difficulties and the clinical features of AN, this link remains hypothetical. The main objective of this study was to explore the association between specific areas of neuropsychological functioning and body size estimation in patients with AN and healthy controls. METHODS The sample consisted of 36 women diagnosed with AN and 34 healthy female controls. Participants were administered the continuous visual memory test and the recall trials of Rey Complex Figure Test to assess visual memory. Central coherence was assessed using the copy trial of Rey Complex Figure Test, and the Wisconsin Card Sorting Test was used to assess set-shifting. Body size estimation was assessed with a computerized morphing programme. RESULTS The analyses showed no significant correlations between any of the neuropsychological measures and body size estimation. CONCLUSION The results suggest that there is no association between these areas of neuropsychological difficulties and body size estimation among patients with AN. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Maria Øverås
- Regional Department for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Hilde Kapstad
- Regional Department for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Øverås M, Kapstad H, Brunborg C, Landrø NI, Lask B. Memory versus perception of body size in patients with anorexia nervosa and healthy controls. Eur Eat Disord Rev 2014; 22:109-15. [PMID: 24590562 DOI: 10.1002/erv.2276] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 11/22/2013] [Accepted: 12/02/2013] [Indexed: 11/08/2022]
Abstract
The objective of this study was to compare body size estimation based on memory versus perception, in patients with anorexia nervosa (AN) and healthy controls, adjusting for possible confounders. Seventy-one women (AN: 37, controls: 35), aged 14-29 years, were assessed with a computerized body size estimation morphing program. Information was gathered on depression, anxiety, time since last meal, weight and height. Results showed that patients overestimated their body size significantly more than controls, both in the memory and perception condition. Further, patients overestimated their body size significantly more when estimation was based on perception than memory. When controlling for anxiety, the difference between patients and controls no longer reached significance. None of the other confounders contributed significantly to the model. The results suggest that anxiety plays a role in overestimation of body size in AN. This finding might inform treatment, suggesting that more focus should be aimed at the underlying anxiety.
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Affiliation(s)
- Maria Øverås
- Regional Unit for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Ullevål, Oslo, Norway
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