Abstract
BackgroundBody image distortion is a central symptom of Anorexia Nervosa (AN). Even if corporeal awareness is multisensory majority of AN studies mainly investigated visual misperception. We systematically reviewed AN studies that have investigated different nonvisual sensory inputs using an integrative multisensory approach to body perception. We also discussed the findings in the light of AN neuroimaging evidence.MethodsPubMed and PsycINFO were searched until March, 2014. To be included in the review, studies were mainly required to: investigate a sample of patients with current or past AN and a control group and use tasks that directly elicited one or more nonvisual sensory domains.ResultsThirteen studies were included. They studied a total of 223 people with current or past AN and 273 control subjects. Overall, results show impairment in tactile and proprioceptive domains of body perception in AN patients. Interoception and multisensory integration have been poorly explored directly in AN patients. A limitation of this review is the relatively small amount of literature available.ConclusionsOur results showed that AN patients had a multisensory impairment of body perception that goes beyond visual misperception and involves tactile and proprioceptive sensory components. Furthermore, impairment of tactile and proprioceptive components may be associated with parietal cortex alterations in AN patients. Interoception and multisensory integration have been weakly explored directly. Further research, using multisensory approaches as well as neuroimaging techniques, is needed to better define the complexity of body image distortion in AN.Key FindingsThe review suggests an altered capacity of AN patients in processing and integration of bodily signals: body parts are experienced as dissociated from their holistic and perceptive dimensions. Specifically, it is likely that not only perception but memory, and in particular sensorimotor/proprioceptive memory, probably shapes bodily experience in patients with AN.
Highlights
Anorexia Nervosa (AN) is the psychiatric disorder with the highest rate of mortality [1], the onset mainly occurring in adolescent girls and young women
AN patients at post-treatment evaluation showed an improvement of such proprioceptive abilities [30]. These results suggest an impairment of the proprioceptive component of body perception that may contribute to body image distortion in AN
Our review highlighted that nonvisual domains of body perception remain under investigated in AN, the results of our paper, even if preliminary, showed that AN patients had a multisensory impairment of body perception that involve tactile and proprioceptive sensory components, in addition to the well studied visual misperception
Summary
Anorexia Nervosa (AN) is the psychiatric disorder with the highest rate of mortality [1], the onset mainly occurring in adolescent girls and young women. Several studies have shown that body image distortion (BID) can be considered as a risk factor in the development of AN [4,5] and its persistence may be among the most important predictors for clinical severity of AN [6]. The affective component mainly comprises feelings that individuals develop towards their body’s appearance and satisfaction/dissatisfaction of one’s own body [13]. The cognitive component mainly comprises beliefs concerning body shape and appearance and the mental representation of one’s own body [13]. Overall, literature on those with AN emphasised that all three dimensions are affected, and that these patients show an overestimation of their body size, a greater body dissatisfaction, and greater self-ideal discrepancies [7]. We discussed the findings in the light of AN neuroimaging evidence
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