Abstract
PurposeIt has been widely shown that dissociative features might play a fundamental role in producing body image distortions in patients affected by eating disorders. Here, we hypothesize that the Mirror Gazing Test (MGT), a task consisting in mirror exposure in a condition of sensory deprivation, would elicit dissociative symptoms in a group of patients with anorexia nervosa (AN).MethodsFourteen patients with AN and fourteen healthy controls (HC) underwent a 10 min MGT and completed the Strange Face Questionnaire and a short version of the Clinician-Administered Dissociative States Scale, along with a psychological assessment for eating disorders psychopathology, anxiety and depression.ResultsAN patients reported a higher number of strange-face apparitions and dissociative sensations than HC during the MGT. Dissociative identity (compartmentalization of two or more identities) and depersonalization (detachment of bodily-self) were much higher in patients with AN than in HC. These findings were correlated with body dissatisfaction and disruption in interoceptive awareness.ConclusionDissociation and body image dysfunction are strongly connected in the pathophysiology of anorexia nervosa. Future research should investigate the same aspects in other psychiatric conditions characterized by body image distortions, such as Body Dysmorphic Disorder.Level of evidenceI, Experimental studies.
Highlights
Body image is commonly defined as “the picture of our own body which we form in our mind” [1], as it appears when observed in a third-person perspective
The aim of the present study was to assess dissociative symptoms elicited by mirror exposure in a particular condition through the Mirror Gazing Test (MGT), in a group of patients with anorexia nervosa (AN) and a group of healthy controls (HC)
Novel aspects of this study are mainly two: first, dissociation was evaluated both through a specific task and specific questionnaires; second, the instrument used here to trigger dissociative features involved the presence of a mirror, which is known to elicit body image disruption in patients with AN
Summary
Body image is commonly defined as “the picture of our own body which we form in our mind” [1], as it appears when observed in a third-person perspective It can be considered a multidimensional construct, implying both bottom-up (visual and proprioceptive information) and top–down facets (such as memory, mood states, affects, attitudes and beliefs concerning appearance). Patients with ED, tend to present stronger negative affect than HC during the course of a mirror exposure [7,8,9] Following this framework, the Allocentric Lock Theory tried to explain the body image disruption seen in patients with ED: ED might be explained as being locked on a negative body image (e.g., my body is fat). The activity of the anterior insula, which may represent motivational tendencies, but is part of the fear and emotional network, has been found to be diminished in anorexic patients [16]
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