Interoceptive sensitivity,body image dissatisfaction,and body awareness in healthy individuals

Relationships among interoceptive sensitivity (IS), body image dissatisfaction, body mass index (BMI), and self‐reported body awareness were investigated in a cross‐sectional study. Eighty‐two Norwegian high school students and 70 Hungarian undergraduate university students participated in the study. Subjects completed two questionnaires (Body Image Ideals Questionnaire – BIQ; Body Awareness Questionnaire – BAQ) followed by the assessment of interoceptive sensitivity using the Mental Tracking Method (MTM). An inverse, medium‐level relationship between body image dissatisfaction and IS was found in both the Norwegian and the Hungarian samples. The relationships between IS and self‐reported body awareness, and between body image dissatisfaction and BMI were uniformly non‐significant in both samples. Predictors of body image dissatisfaction were resting heart rate, gender, and IS in the regression analysis after controlling for BMI, age, and nationality. The negative relationship between IS and body image dissatisfaction described in patients with anorexia nervosa also exists in healthy individuals. There is no direct connection between IS and self‐reported body awareness.     

Body‐Weight Self‐Schema: Determinant of Mood and Behavior in Women With an Eating Disorder1

The schema approach to self‐concept was used to investigate the association between body‐weight self‐conception and self‐esteem, negative affect states, and disordered eating behavior in women with anorexia nervosa (n= 26) or bulimia nervosa (N= 53) using experience sampling methodology. We predicted that self‐esteem would be lower and unpleasant affect and disordered eating behaviors would be higher when the body‐weight self‐schema was activated in working memory compared to when non‐weight‐related self‐schemas were activated. Participants recorded the currently activated self‐schema, self‐esteem, affect, and behavior in response to an alarm‐watch signal 5 times daily for 5 days. Activation of the body‐weight self‐schema was associated with lower self‐esteem and higher negative affect, but not higher levels of disordered eating behavior. Low self‐esteem and negative affect, however, were associated with disordered eating behavior. Findings have important implications for treatment of eating disorders.     

Cultural Differences in the Self: From Philosophy to Psychology and Neuroscience

Different thinking styles in Westerners and Chinese (analytic vs. holistic) lead to disparities between the two cultures not only in perception and attention but also in high‐level social cognition such as self‐representation. Most Western philosophers discussed the self by focusing on personal self‐identity, whereas Chinese philosophers emphasized the relation between the self and others. Dissimilar philosophical thinking of the self is associated with distinct cognitive styles of self‐representation (i.e., the independent self in Westerners and the interdependent self in Chinese). Recent brain imaging studies found that Westerners employed the medial prefrontal cortex to represent only the individual self, whereas Chinese utilized the same brain area to represent both the self and close others, providing neural basis of cultural differences in self‐representation. We suggest that the cultural differences in thinking styles between Westerners and Chinese influence both psychological and neural structure of self‐representation.     

Self‐Awareness Part 2: Neuroanatomy and Importance of Inner Speech

The present review of literature surveys two main issues related to self‐referential processes: (1) Where in the brain are these processes located, and do they correlate with brain areas uniquely specialized in self‐processing? (2) What are the empirical and theoretical links between inner speech and self‐awareness? Although initial neuroimaging attempts tended to favor a right hemispheric view of self‐awareness, more recent work shows that the brain areas which support self‐related processes are located in both hemispheres and are not uniquely activated during self‐reflective tasks. Furthermore, self‐awareness at least partially relies on internal speech. An activation of Broca’s area (which is known to sustain inner speech) is observed in a significant number of brain‐imaging studies of self‐reflection. Loss of inner speech following brain damage produces self‐awareness deficits. Inner speech most likely can internally reproduce social mechanisms leading to self‐awareness. Also, the process of self‐reflection can be seen as being a problem‐solving task, and self‐talk as being a cognitive tool the individual uses to effectively work on the task. It is noted that although a large body of knowledge already exists on self‐awareness, little is known about individual differences in dispositional self‐focus and types of self‐attention (e.g., rumination versus self‐reflection).     

Body images of patients with anorexia nervosa, bulimia nervosa and female control subjects: a comparison with male ideals of female attractiveness

Body images of female patients with anorexia nervosa and bulimia nervosa were assessed against females without eating disorders and compared with male ideals of female attractiveness. A computer program was applied to examine body images of 62 patients with anorexia nervosa, 45 patients with bulimia nervosa, and 40 female and 39 male control subjects. Body size overestimation was most distinct in the two patient groups. Self-ideal discrepancy was highest in bulimia nervosa. Estimation of the society's ideal female body in all three female groups did not differ from men's perception of the most attractive female body. Congruence of ideals of female attractiveness in patients, female, and male control subjects and described differences between patients and female controls support the theory that body image disturbance is a problem of processing self-referential information regarding body image rather than a problem of processing body image related information per se.     

Neuroimaging studies in eating disorders

The understanding of the eating disorders (EDs) anorexia (AN) and bulimia nervosa (BN) has undergone remarkable advancements in the past decade. Most studies that have been done in AN show brain gray and white matter volume loss during the ill state that, at least in part, remit with recovery. Similar patterns occur for brain phospholipids assessed using magnet resonance spectroscopy (MRS). Imaging studies have been used to provide functional information regarding serotonin neuroreceptor dynamics, regional cerebral blood flow, or cerebral glucose metabolism. Such studies have implicated cingulate, frontal, temporal, and parietal regions in AN. Investigators have found that challenges such as food and body image distortions may activate some of these regions, raising the possibility that such studies may shed light on puzzling AN symptoms, such as body image distortions or extremes of appetitive behaviors. Emerging data suggest these disturbances persist after recovery from AN, suggesting the possibility that these are traits that may create a vulnerability to develop an ED. While fewer studies have been done in BN or binge eating disorder, there may be disturbances of serotonin metabolism in similar brain regions. Taken together, these findings give promise for future investigations with the hope of delineating brain pathways that contribute to the etiology of EDs     

Extraversion modulates functional connectivity hubs of resting‐state brain networks

Personality dimension extraversion describes individual differences in social behaviour and socio‐emotional functioning. The intrinsic functional connectivity patterns of the brain are reportedly associated with extraversion. However, whether or not extraversion is associated with functional hubs warrants clarification. Functional hubs are involved in the rapid integration of neural processing, and their dysfunction contributes to the development of neuropsychiatric disorders. In this study, we employed the functional connectivity density (FCD) method for the first time to distinguish the energy‐efficient hubs associated with extraversion. The resting‐state functional magnetic resonance imaging data of 71 healthy subjects were used in the analysis. Short‐range FCD was positively correlated with extraversion in the left cuneus, revealing a link between the local functional activity of this region and extraversion in risk‐taking. Long‐range FCD was negatively correlated with extraversion in the right superior frontal gyrus and the inferior frontal gyrus. Seed‐based resting‐state functional connectivity (RSFC) analyses revealed that a decreased long‐range FCD in individuals with high extraversion scores showed a low long‐range functional connectivity pattern between the medial and dorsolateral prefrontal cortex, middle temporal gyrus, and anterior cingulate cortex. This result suggests that decreased RSFC patterns are responsible for self‐esteem, self‐evaluation, and inhibitory behaviour system that account for the modulation and shaping of extraversion. Overall, our results emphasize specific brain hubs, and reveal long‐range functional connections in relation to extraversion, thereby providing a neurobiological basis of extraversion.     

The importance of body satisfaction to physical self‐concept and body mass index in Spanish adolescents

This research examines the association between measured body mass index (BMI) and the perception of BMI by young students. Moreover, this research tests the importance of BMI and self‐concept, in order to predict body dissatisfaction in high school students. The sample consisted of 2087 individuals from different high schools in Extremadura, Spain, both males (n = 1046) and females (n = 1041), ranging in age from 15 to 17 years old (M = 15.42; SD = 0.86). Initially, participants' BMIs were assessed through anthropometry. Later, all individuals were asked about their weight and height, and their self‐reported BMI was calculated. Participants also answered a questionnaire about their perception of self‐concept, as well as completed a test about body image perception using Stunkard images. Outcomes revealed that factors concerning self‐concept and perceived BMI explained body dissatisfaction. Finally, results are discussed with the aim of improving knowledge in body dissatisfaction context.     

A review of eating disorders research in Mexico

The objective of this paper is to summarize research findings on eating disorders and the current state of the field in Mexico. Papers published in indexed journals and graduate dissertations were retrieved, using “eating disorders,” “anorexia nervosa,” “bulimia nervosa,” “body image,” “binge eating,” “restrained eating,” “weight and shape concern,” and “dieting” as keywords. These were combined with the Boolean operator “AND” with “Mexico” and “Latin America.” Findings are presented for epidemiology, the validity of assessment instruments, comorbidity, and risk factors. A national representative survey found a prevalence of 1.8% for bulimia nervosa, and no cases of anorexia nervosa. However, the lack of studies with confirmatory clinical interview and other national or regional representative samples makes it difficult to reach conclusions about the actual prevalence. A number of instruments for the detection of eating disorders and disordered eating have been validated for the Mexican population. The comorbidity of eating disorders in Mexico includes drug and alcohol abuse, obesity, and borderline personality disorder. Risk factors found included body weight and cultural pressure to be thin. Future lines of research should include epidemiological studies with representative samples and diagnosis confirmation, longitudinal studies, and the exploration of protective and risk factors specific to this population.     

Measurement of body size and shape perception in eating‐disordered and control observers using body‐shape software

A disturbance in the perception of personal body size and shape is a key feature of both anorexia and bulimia nervosa, but it has proved difficult to quantify. Previous attempts have used methods like the distorting video technique (DVT), which alters an image by stretching the figure in either the X‐ or Y‐axis. This is a poor representation of the way fat is added to or lost from the body, and the pattern of distortion provides a host of cues to the degree to which the image has been altered. To overcome these problems we have used a specially designed software system that uses biometric data based on real body shapes, instead of simply stretching or compressing images of bodies. This technique also allows individual body parts to be altered separately, so we can determine whether a specific body part is overestimated relative to others. We can also calculate the apparent body mass index (BMI) of our modified pictures, using the perimeter‐area ratio (PAR). This allows us to compare an observer's actual BMI with that calculated for their estimated and ideal bodies. We tested 30 anorexic, 30 bulimic and 137 control observers. Our results show that all three observer groups tend to overestimate their body size, but not significantly so. Both the control and bulimic observers prefer an ideal body with a BMI of 20, which is at the lower end of the ‘normal’ BMI range. However, the anorexics ideal BMI is 15, which is on the border between the emaciated and underweight BMI categories.     

Implicit affectivity and rapid processing of affective body language: An fMRI study

Previous research has revealed affect‐congruity effects for the recognition of affects from faces. Little is known about the impact of affect on the perception of body language. The aim of the present study was to investigate the relationship of implicit (versus explicit) affectivity with the recognition of briefly presented affective body expressions. Implicit affectivity, which can be measured using indirect assessment methods, has been found to be more predictive of spontaneous physiological reactions than explicit (self‐reported) affect. Thirty‐four healthy women had to label the expression of body postures (angry, fearful, happy, or neutral) presented for 66 ms and masked by a neutral body posture in a forced‐choice format while undergoing functional magnetic resonance imaging (fMRI). Participants' implicit affectivity was assessed using the Implicit Positive and Negative Affect Test. Measures of explicit state and trait affectivity were also administered. Analysis of the fMRI data was focused on a subcortical network involved in the rapid perception of affective body expressions. Only implicit negative affect (but not explicit affect) was correlated with correct labeling performance for angry body posture. As expected, implicit negative affect was positively associated with activation of the subcortical network in response to fearful and angry expression (compared to neutral expression). Responses of the caudate nucleus to affective body expression were especially associated with its recognition. It appears that processes of rapid recognition of affects from body postures could be facilitated by an individual's implicit negative affect.     

Self‐focused cognitive emotion regulation style as associated with widespread diminished EEG fractal dimension

The cognitive regulation of emotions is important for human adaptation. Self‐focused emotion regulation (ER) strategies have been linked to the development and persistence of anxiety and depression. A vast array of research has provided valuable knowledge about the neural correlates of the use of specific self‐focused ER strategies; however, the resting neural correlates of cognitive ER styles, which reflect an individual's disposition to engage in different forms of ER in order to manage distress, are largely unknown. In this study, associations between theoretically negative ER style (self‐focused or not) and the complexity (fractal dimension, FD) of the resting EEG at frontal, central, parietal, and occipital regions were investigated in 58 healthy volunteers. The Cognitive Emotion Regulation Questionnaire was used as the self‐report measure of ER style. Results showed that a diminished FD over the scalp significantly correlated with self‐focused ER style scores, even after controlling for negative affect, which has been also considered to influence the use of ER strategies. The lower the EEG FD, the higher were the self‐focused ER style scores. Correlational analyses of specific self‐focused ER strategies showed that self‐blaming and rumination were negatively associated with diminished FD of the EEG, but catastrophizing and blaming others were not. No significant correlations were found for ER strategies more focused on situation or others. Results are discussed within the self‐organized criticality theory of brain dynamics: The diminished FD of the EEG may reflect a disposition to engage in self‐focused ER strategies as people prone to ruminate and self‐blame show a less complex resting EEG activity, which may make it more difficult for them to exit their negative emotional state.     

Body image, shape, and volumetric assessments using 3D whole body laser scanning and 2D digital photography in females with a diagnosed eating disorder: preliminary novel findings

We piloted three-dimensional (3D) body scanning in eating disorder (ED) patients. Assessments of 22 ED patients (including nine anorexia nervosa (AN) patients, 12 bulimia nervosa (BN) patients, and one patient with eating disorder not otherwise specified) and 22 matched controls are presented. Volunteers underwent visual screening, two-dimensional (2D) digital photography to assess perception and dissatisfaction (via computerized image distortion), and adjunctive 3D full-body scanning. Patients and controls perceived themselves as bigger than their true shape (except in the chest region for controls and anorexia patients). All participants wished to be smaller across all body regions. Patients had poorer veridical perception and greater dissatisfaction than controls. Perception was generally poorer and dissatisfaction greater in bulimia compared with anorexia patients. 3D-volume:2D-area relationships showed that anorexia cases had least tissue on the torso and most on the arms and legs relative to frontal area. The engagement of patients with the scanning process suggests a validation study is viable. This would enable mental constructs of body image to be aligned with segmental volume of body areas, overcoming limitations, and errors associated with 2D instruments restricted to frontal (coronal) shapes. These novel data could inform the design of clinical trials in adjunctive treatments for eating disorders.     

无意识活动与静息态脑能量消耗

静息态脑活动的研究关注个体在清醒、静卧、闭眼时脑的活动情况,大量实验证明静息状态下大脑仍进行着持续不断的信息加工活动,并且消耗大量能量。本文在阐述无意识活动特性以及总结静息态脑能量消耗研究的基础上,提出用无意识活动解释静息态脑能量消耗的观点,强调在研究无意识活动的心理意义的同时,还要研究无意识活动的神经机制及其生理表现。     

A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa

In the context of the lack of nosological clarity surrounding muscle dysmorphia, this paper aims to compare the symptomatic profile of muscle dysmorphia and anorexia nervosa in males whilst using measures sensitive to indexing male body image concerns. Twenty-one male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 15 male gym-using controls completed the Eating Disorder Examination-Questionnaire, the Muscle Dysmorphia Disorder Inventory, the Compulsive Exercise Test, and a measure of appearance-enhancing substance use. Men with muscle dysmorphia and anorexia nervosa demonstrated widespread symptomatic similarities spanning the domains of disturbed body image, disordered eating, and exercise behaviour, whilst differences were consistent with the opposing physiques pursued in each condition. Furthermore, correlational analyses revealed significant associations between scores on muscle dysmorphia and eating disorder measures. The present findings provide moderate support for the notion that muscle dysmorphia may be nosologically similar to anorexia nervosa.     

Meta‐Analysis of Anorexia Nervosa Counseling Outcome Studies From 1990 to 2015

This meta‐analysis of 92 anorexia nervosa counseling articles examined the effectiveness of counseling in reducing symptoms of anorexia nervosa at termination and the longest follow‐up assessments. Treatment‐as‐usual studies showed no effect to small effects at both posttest and follow‐up assessments, wait‐list studies showed small effects at posttest and medium effects at follow‐up, and single‐group uncontrolled studies showed medium to large effects at posttest and medium effects at follow‐up. Implications for research and practice are discussed.     

Applications of ERP and fMRI techniques to developmental science

Event‐related potentials (ERPs) and functional magnetic resonance imaging are both measures of functional brain activation that have been applied to developmental questions. However, the two measures are not identical and reflect different aspects of neuronal function at a physiological level. There is increasing interest in using these methods in combination because of the complementary information they provide about brain activation. ERPs provide more detailed information about the timing of neural activity, while fMRI provides more detailed information about its spatial location. Thus, their combined use may provide more detailed spatio‐temporal information than either method alone. In this paper, we review the basic principles of ERP and fMRI and present selected studies from our own work to illustrate their strengths for studies of development. In addition, we discuss the potential benefits and special challenges of the combined use of electrophysiological and functional MRI techniques.     

The effects of sport dance on brain connectivity and body intelligence

Dancing is characterised by physical movement in accordance with rhythm perception. Twelve sport dancers and 12 age- and sex-matched young adults who had no dance experience (control group) were recruited. Body intelligence and brain activity were assessed in both groups using the Body Intelligence Scale (BIS) and resting state functional magnetic resonance imaging. BIS scores of dancers were higher than those of control subjects. The dancer group showed increased functional connectivity from the precentral gyrus to the right cingulate gyrus, right occipital fusiform gyrus, right inferior frontal gyrus, right medial frontal gyrus, left inferior frontal gyrus, right parietal postcentral gyrus, and right frontal lobe compared with control subjects. Sport dancers had increased body intelligence sensitivity compared with matched controls. In addition, the characteristics of dance, including physical movement in accordance with rhythm perception, might be associated with increased brain activity in the somatosensory and rhythm perception networks.     

抑郁症的脑功能异常:来自静息态功能磁共振成像的证据

静息态功能磁共振成像是指在静息状态下测量的BOLD信号,即受试者安静地躺在扫描仪中,不给受试者任何特定的任务,受试者也不用做任何反应,此时受试者的大脑活动处于自发状态。通过使用该技术可以为抑郁症发作的临床现象提供神经影像学依据,以期为将来抑郁症的治疗提供生物标记。因此,本文综述了大量抑郁症患者在静息态脑功能方面的差异研究,发现了单、双相抑郁症,首、复发抑郁症,早发性、晚发性抑郁症,难治、非难治性抑郁症等不同类型的抑郁症在包括局部一致性(Re Ho)和低频振幅(ALFF)在内的功能分化以及包括功能连接密度(FCD)、功能同伦(VMHC)、复杂网络(Complex Network)和ROI功能连接在内的功能整合两大指标的改变。     

‘It's like there are two people in my head’: A phenomenological exploration of anorexia nervosa and its relationship to the self

This study explores the lived experience of anorexia nervosa from the perspective of those who use pro-recovery websites for eating disorders. Fourteen people participated in an online focus group or an e-interview. Data were analysed using interpretative phenomenological analysis. Participants described their disorder as a functional tool for avoiding and coping with negative emotions, changing their identity and obtaining control. A central theme was the experience of an ‘anorexic voice’ with both demonic and friendly qualities. This voice felt like an external entity that criticised individuals and sometimes dominated their sense of self, particularly as anorexia nervosa got worse. Applying dialogical theory suggests a new model of anorexia nervosa, where the anorexic voice is a self-critical position, which disagrees with and attempts to dominate the more rational self. It is suggested that to move on from anorexia nervosa, the individual needs to address his/her anorexic voice and develop a new dominant position that accepts and values his/her sense of self.