Decreased self-face recognition: A new evidence of body image disturbances in anorexia nervosa

Abstract

ObjectiveBody image disturbances are core symptoms of Anorexia Nervosa (AN). This study investigated self-face recognition in cases of AN, and the influence of others factors associated with AN, such as massive weight loss.MethodFifteen anorexic female patients and 15 matched Healthy Controls (HC) performed a self-face recognition task. Participants viewed digital morphs between their own face and a gender-matched, unfamiliar other face presented in a random sequence (Fig. 1). For each stimulus, subjects were asked if they recognized their own face, and respond by selectively pressing a button on a computer. Participants’ self-face recognition failures, cognitive flexibility, body concerns and eating habits were assessed, respectively, with the Self-Face Recognition Questionnaire (SFRQ), the Trail Marking Task (TMT), the Body Shape Questionnaire (BSQ) and the Eating Disorder Inventory-2 (EDI-2).Fig. 1Examples of stimulus. For each subject, a photograph of an unfamiliar face was digitally morphed into a photograph of the subject's face in 10% increments.resultsAnorexic patients showed a significantly greater difficulty than healthy control in identifying their own face (P = 0.028, Fig. 2). No significant difference was observed between the two groups for TMT (all P > 0.1). However, analysis did not reveal significant correlations between behavioral data and the EDI-2 or BSQ (all P > 0.1). A correlation analysis revealed a significant, negative correlation with BMI (P < 0.001) and the SFRQ “self-face recognition” subscale (P = 0.015). Fig. 2Self response rates per stimulus ranked in increasing order of familiarity (other to self) in both groups.DiscussionWe observed a decrease in self-face recognition, correlated with BMI, suggesting this disturbance could be linked to massive weight loss. It thus supports the theory of a lack of ability to update body image by the central nervous system, underlying self-images distortion in AN patients.