Body Integrity Identity Disorder: Deranged Body Processing,Right Fronto-Parietal Dysfunction,and Phenomenological Experience of Body Incongruity |
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Authors: | Melita J Giummarra John L Bradshaw Michael E R Nicholls Leonie M Hilti Peter Brugger |
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Institution: | (1) Experimental Neuropsychology Research Unit, School of Psychology and Psychiatry, Monash University, Wellington Road, Clayton, VIC, 3800, Australia;(2) School of Psychology, Flinders University, Bedford Park, SA, Australia;(3) Neuropsychology Unit, Department of Neurology, University Hospital, Zurich, Switzerland;(4) Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland |
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Abstract: | 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. |
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