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Separating two components of body image in anorexia nervosa using fMRI

Published online by Cambridge University Press:  17 November 2009

H. M. Mohr ,
J. Zimmermann ,
C. Röder ,
C. Lenz ,
G. Overbeck  and
R. Grabhorn
H. M. Mohr*
Affiliation:
Department of Biological Psychology, Institute of Psychology, Johann Wolfgang Goethe University, Frankfurt, Germany Brain Imaging Center Frankfurt, Germany Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Johann Wolfgang Goethe University, Frankfurt, Germany
J. Zimmermann*
Affiliation:
Department of Biological Psychology, Institute of Psychology, Johann Wolfgang Goethe University, Frankfurt, Germany Brain Imaging Center Frankfurt, Germany
C. Röder
Affiliation:
Department of Psychiatry, Erasmus University, Medical School, Rotterdam, The Netherlands
C. Lenz
Affiliation:
Brain Imaging Center Frankfurt, Germany Department of Psychiatry, Psychosomatics and Psychotherapy, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany
G. Overbeck
Affiliation:
Brain Imaging Center Frankfurt, Germany Department of Psychiatry, Psychosomatics and Psychotherapy, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany
R. Grabhorn
Affiliation:
Brain Imaging Center Frankfurt, Germany Department of Psychiatry, Psychosomatics and Psychotherapy, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany
*
*Address for correspondence: Dr Dipl. Psych. H. M. Mohr, Department of Biological Psychology, Institute of Psychology, Johann Wolfgang Goethe University, Mertonstrasse 17, 60054Frankfurt, Germany. (Email: [email protected])
*Address for correspondence: Dr Dipl. Psych. H. M. Mohr, Department of Biological Psychology, Institute of Psychology, Johann Wolfgang Goethe University, Mertonstrasse 17, 60054Frankfurt, Germany. (Email: [email protected])
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Abstract

Background

Body image distortion is a key symptom of anorexia nervosa. In behavioral research two components of body image have been defined: attitudes towards the body and body size experience. Neuroimaging studies concerning own body image distortions in anorexia nervosa have revealed an inconsistent pattern of results and are constrained by the fact that no direct distinction between the different parts of body image has been made.

Method

The present study therefore set out to investigate the neural correlates of two parts of the own body image using functional magnetic resonance imaging (fMRI): satisfaction rating and size estimation for distorted own body photographs in patients with anorexia nervosa and controls.

Results

Anorectic patients were less satisfied with their current body shape than controls. Patients further demonstrated stronger activation of the insula and lateral prefrontal cortex during the satisfaction rating of thin self-images. This indicates a stronger emotional involvement when patients are presented with distorted images close to their own ideal body size. Patients also overestimated their own body size. We were able to show complex differential modulations in activation of the precuneus during body size estimation in control and anorectic subjects. It could be speculated that a deficit in the retrieval of a multimodal coded body schema in precuneus/posterior parietal cortex is related to body size overestimation.

Conclusions

We were able to find specific behavioral responses and neural activation patterns for two parts of body image in anorexia nervosa and healthy controls. Thus, the present results underline the importance of developing research and therapeutic strategies that target the two different aspects of body image separately.

Keywords

Anorexia nervosabody imageeating disordersfunctional magnetic resonance imaging
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 9 , September 2010 , pp. 1519 - 1529
Copyright
Copyright © Cambridge University Press 2009

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