Body Integrity Identity Disorder: Deranged Body Processing,Right Fronto-Parietal Dysfunction,and Phenomenological Experience of Body Incongruity

Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in “non-belonging” of body parts, and the subsequent desire to amputate, paralyse or disable a limb. Little is known about BIID; however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation. The present review systematically investigates which aspects of neurological processing of the body, and sense of self, may be compromised in BIID. We argue that the disorder most likely reflects dysregulation in multiple levels of body processing. That is, the disunity between self and the body could arguably come about through congenital and/or developmental disruption of body representations, which, together with altered multisensory integration, may preclude the experience of self-attribution and embodiment of affected body parts. Ulimately, there is a need for official diagnostic criteria to facilitate epidemiological characterisation of BIID, and for further research to systematically investigate which aspects of body representation and processing are truly compromised in the disorder.     

Introject and Identity: Structural-Interpersonal Analysis and Psychological Assessment of Multiple Personality Disorder

Revisions of the diagnostic nomenclature have contributed to renewed interest in multiple personality disorder (MPD). Identity and self-organization in MPD are assessed using a sophisticated structural-interpersonal measurement system, Structural Analysis of Social Behavior (SASB). Two important features of the SASB model applied to MPD are the assessments of interpersonal perceptions of childhood initiators of abuse and of the introject or self-organization of host and secondary personalities. SASB findings from a clinical series of six cases of MPD are analyzed to illustrate the use of this assessment technique. Host personalities and abused secondary personalities differed in their identity and self-organization. Host personalities evidenced internalization of abuse dynamics related to selfdestructive trends. Secondary personalities, despite having experienced abuse, did not manifest such dynamics. Implications for understanding personality processes in MPD and for further research are discussed.     

From Social to Political Identity: A Critical Examination of Social Identity Theory

Interest in the concept of identity has grown exponentially within both the humanities and social sciences, but the discussion of identity has had less impact than might be expected on the quantitative study of political behavior in general and on political psychology more specifically. One of the approaches that holds the most promise for political psychologists is social identity theory, as reflected in the thinking of Henri Tajfel, John Turner, and colleagues. Although the theory addresses the kinds of problems of interest to political psychologists, it has had limited impact on political psychology because of social identity theorists' disinclination to examine the sources of social identity in a real world complicated by history and culture. In this review, four key issues are examined that hinder the successful application of social identity theory to political phenomena. These key issues are the existence of identity choice, the subjective meaning of identities, gradations in identity strength, and the considerable stability of many social and political identities.     

躯体变形障碍与美容整形术前心理评估

躯体变形障碍是一种并不罕见的精神障碍,其临床表现的特殊性使大多数患者以普通求术者的身份出现在美容整形科医生面前。然而,关容整形手术非但不能解决患者的心理问题,更可能引发复杂的医疗纠纷。基于躯体变形障碍在美容整形科呈高发生率的特点,文章对美容整形术前心理评估的必要性和现状进行分析,并列举了有效的评估工具以提高心理评估的准确性。     

The Palestinian/Israeli Conflict: A Geopolitical Identity Disorder

In this paper, the author considers that the large-group dynamics in certain war-torn, hot spots throughout the world are symptoms of a “geopolitical identity disorder.” He extrapolates from the model of the severely traumatized psyche in dissociative identity disorder in which there is so much intolerable emotion, destructive aggression and conflict that different selves with different identities develop which are unable to recognize how interdependent and related they actually are. In the most extreme cases, one dissociated self tries to kill off “the other” in order to gain exclusive control of the body and make it comply with his or her wishes and vision. In actuality, however, such an attempt is a dissociated suicide plan with lethal implications. This model is applied to the Palestinian/Israeli situation where there is a deadly battle over the land. A clinical vignette is offered to illustrate these ideas and offer possibilities for help.     

From Drive to Affectivity: Contextualizing Psychological Life

It is the thesis of this article that the shift in psychoanalytic thinking from the primacy of drive to the primacy of affectivity moves psychoanalysis toward a phenomenological contextualism and a central focus on dynamic intersubjective systems. Unlike drives, which originate deep within the interior of a Cartesian isolated mind, affect—that is, subjective emotional experience—is something that from birth onward is regulated, or misregulated, within ongoing relational systems. Therefore, locating affect at the center automatically entails a radical contextualization of virtually all aspects of human psychological life.     

Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder: A Pilot Study

Body dysmorphic disorder (BDD) is a relatively common and severe disorder that typically onsets in adolescence, but often goes unrecognized. Despite BDD’s severity and early onset, treatment outcome research on adolescent BDD is scarce. Cognitive-behavioral therapy is the gold-standard psychosocial treatment for BDD in adults and has shown promise in adolescents. The current study examined the development and testing of a new CBT for adolescents with BDD. We tested feasibility, acceptability, and treatment outcome in a sample of 13 adolescents (mean age 15.23 years, range: 13–17) with primary BDD. Treatment was delivered in 12–22 weekly individual sessions. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-months follow-up. At posttreatment, BDD and related symptoms (e.g., insight, mood) were significantly improved. Scores on the Yale–Brown Obsessive Compulsive Scale for BDD indicated a 50% (intent-to-treat) and 68% (completer) improvement in BDD symptoms. Seventy-five percent of adolescents who started treatment and 100% of completers were considered treatment responders. Treatment gains were maintained at follow-up. High patient satisfaction ratings and patient feedback indicated that treatment was acceptable. This represents the largest study of a psychosocial treatment for adolescent BDD.     

Personal Identity and the Importance of One's Own Body: A Response to Derek Parfit

In this essay I take issue with Derek Parfit's reductionist account of personal identity.Parfit is concerned to respond to what he sees as flaws in the conception of the role of 'person' in self-interest theories. He attempts to show that the notion of a person as something over and above a totality of mental and physical states and events (in his words, a 'further fact'), is empty, and so, our ethical concerns must be based on something other than this. My objections centre around the claim that Parfit employs an impoverished conception of 'life'. Parfit misconceives the connection between 'I' and one's body, and, so, despite his rejection of a metaphysical conception of 'self', remains within the logic of Cartesianism. What Parfit and other reductionists call an 'impersonal' perspective, I shall call the third-person perspective: a perspective which one in general may take. Against Parfit I shall offer a more complex conception of 'self' through the concept of 'bodily perspective'. I emphasize the irreducible ambiguities of human embodiment in order to show the presuppositions and the limitations of Parfit's view. Of interest is the conception of time and the model of continuity that is appropriate to an embodied subject's life. I employ Paul Ricoeur's concept of 'human time' to argue that the reflective character of human experience demands a model of temporality and continuity that differs significantly from the one Parfit employs.     

Sex-Dimorphic Color Preference in Children with Gender Identity Disorder: A Comparison to Clinical and Community Controls

The present study was designed to assess sex-dimorphic color preferences in children with gender identity disorder (47 boys, 18 girls), clinical controls (65 boys, 35 girls), and community controls (65 boys, 35 girls). The mean age of the children was 7.63 years (range?=?3–12 years). Children were shown a hexagon-shaped display of 144 colors extracted from PowerPoint?. Each child was asked to choose his or her three favorite colors (Trials 1–3) by pointing to them, naming them, and then to provide a justification for each choice. From the entire array, children labeled a total of 11 different colors: black, blue, brown, gray, green, orange, pink, purple, red, white, and yellow. For three of the colors (blue, pink/purple, and red), there was evidence for normative sex differences in color preference, and, for the colors blue and pink/purple, the gender-referred children showed inverted patterns of color preference. For the color blue, luminance values showed that the gender-referred boys and control girls preferred lighter shades, whereas the gender-referred girls and control boys preferred darker shades. Qualitative analysis indicated that gender-specific justifications were uncommon, even for the sex-dimorphic colors. Gender-referred children showed inverted gender-stereotyped color preferences, which are likely related to their more general pattern of cross-gender identification. Principles of gender-differentiated development derived from gender-schema theory are used to explain the group differences in color preferences.     

Similarities Between the Psychological Profiles of Complex Regional Pain Syndrome and Conversion Disorder Patients

The psychological profile of 17 Complex Regional Pain Syndrome type I (CRPS) and 20 Conversion Disorder (CD) patients were compared, using the Minnesota Multiphasic Personality Inventory (MMPI) and standardized, semistructured psychological interviews. Both groups presented abnormally high somatization scores. Low anxiety scores in both groups indicate that somatization may have served as a defense mechanism to bind anxiety. Depression was apparent in both groups, indicating that psychological distress accompany these syndromes. About one third of the participants in both groups presented comorbid Axis I disorders, mostly depression and PTSD. CRPS patients have traditionally been looked upon as suffering from mainly organic symptoms, whereas CD patients have been labeled as psychiatric patients. These results may indicate the need to reexamine the traditional classifications in respect to disorders that involve body and mind.     

Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Randomized Controlled Trial

There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking).     

Social Psychological Benefits of Gay Games Participation: A Social Identity Theory Explanation

Abstract

Research examining sexual orientation in sport settings has been limited in scope and lacked theoretical frameworks. To extend this body of research, the current study was framed within social identity theory and examined the impact of Gay Games participation on: (a) social identity, self-esteem, and collective esteem; and (b) expected subsequent social change activities following the Games. One hundred and twenty-five lesbian and bisexual athletes competing in Gay Games V participated in this investigation. The athletes completed a demographic profile and an open-ended questionnaire that asked about their Gay Games experience as well as expected social change activities after the Games. A content analysis of the responses revealed themes consistent with social identity theory. Specifically, these individuals identified the role of the Gay Games on social categorization, personal and social identity, and self and collective esteem. Additionally, these women revealed that following the Gay Games they felt more likely to work towards social change by becoming more out, educating others, and working through political channels.     

Terrorism,Identity, and Public Order: A Perspective From Goffman

From Erving Goffman's (1971) dramaturgical perspective, terrorism is interpretable as an indicator of, threat to, and frame for understanding public order. Public order emerges wherever strangers commingle. It is a foundation for social order more generally. Dramaturgically, public order is underwritten by inferences about strangers' identities based on appearances writ large. Those inferences in turn are warranted by moral assumptions that actors are who they appear to be and that apparent actors will act in dutiful ways that sustain selves and their meanings in the situation and into the future. These assumptions are warranted by the trust that persons in a common space bestow on each other. Terrorism violates the trust, moral assumptions, and identity inferences. As such, it generates an identity transitivity that weakens public order and threatens the security of identities in public space. The issue is to share cultural assumptions of self as inviolable and of appearances as trustworthy to warrant public order.     

行动、叙事与认同:从阿伦特到利科

认同是人生在世的基本处境,涉及人生活的方方面面,但就其本质而言,它关涉到自我,是对我是谁的追问,因而是一个古老且持久的哲学问题。与此同时,人作为一种存在于世界之中的历史性的存在者,对我是谁加以追问的认同,内在地有一个共同体的公共维度。因此,认同问题呈现的是个人与共同体的相互构成。通常,关于认同的论述,无论是基于笛卡尔精神实体的非还原论,还是基于洛克记忆经验的还原论,都忽视了认同的公共维度,而陷入了某种程度上的本质主义。阿伦特通过私人领域与公共领域的划分,强调认同在本质上是一个谁而非什么的问题,认为人在公共领域的行动彰显了一个人的谁,这种对于一个谁的彰显通过叙事得以持存。认同正是在这种行动和叙事中,与发生过的事件达成和解,呈现一个持久、开放的公共形象。借此,利科阐述了一种叙事认同观念。     

Virtual Anatomy: From the Body in the Text to the Body on the Screen

This paper analyzes the transformations in anatomical representation introduced by the Visible Human Project, the first complete virtual anatomy object. By comparing the process of production of book based classical anatomy with that of the Visible Human Project, the paper identifies the medium specificity of anatomical knowledge, the extent to which its powers of demonstration and analysis are conditioned by the medium in which they take place. The paper argues that anatomy can be productively thought of as a kind of writing practice, in which material flesh is written into different media as traces. Because the production of such traces always involves the destruction of the body involved the paper also interrogates the biopolitical hierarchies involved in anatomical knowledge.