Anticipation of body-scaled action is modified in anorexia nervosa

Fibromyalgia is a widespread chronic pain disease characterized by generalized musculoskeletal pain and fatigue. It substantially affects patients' relationship with their bodies and quality of life, but few studies have investigated the relationship between pain and body awareness in fibromyalgia. We examined exteroceptive and interoceptive aspects of body awareness in 30 women with fibromyalgia and 29 control participants. Exteroceptive body awareness was assessed by a body-scaled action-anticipation task in which participants estimated whether they could pass through apertures of different widths. Interoceptive sensitivity (IS) was assessed by a heartbeat detection task where participants counted their heartbeats during different time intervals. Interoceptive awareness was assessed by the Multidimensional Assessment of Interoceptive Awareness (MAIA). The “passability ratio” (the aperture size for a 50% positive response rate, divided by shoulder width), assessed by the body-scaled action-anticipation task, was higher for fibromyalgia participants, indicating disrupted exteroceptive awareness. Overestimating body size correlated positively with pain and its impact on functionality, but not with pain intensity. There was no difference in IS between groups. Fibromyalgia patients exhibited a higher tendency to note bodily sensations and decreased body confidence. In addition, the passability ratio and IS score correlated negatively across the whole sample, suggesting an inverse relationship between exteroceptive and interoceptive body awareness. There was a lower tendency to actively listen to the body for insight, with higher passability ratios across the whole sample. Based on our results and building on the fear-avoidance model, we outline a proposal that highlights possible interactions between exteroceptive and interoceptive body awareness and pain. Movement based contemplative practices that target sensory-motor integration and foster non-judgmental reconnection with bodily sensations are suggested to improve body confidence, functionality, and quality of life.

Section: Discussionmentioning

confidence: 99%

“…The body scale action task was performed following the protocol of Guardia et al (2010). Fifty-one apertures varying from 35 to 78 cm were projected onto a wall in random fashion (constant stimuli method, E-prime software).…”

Section: Methodsmentioning

confidence: 99%

Exteroceptive and Interoceptive Body-Self Awareness in Fibromyalgia Patients

Valenzuela-Moguillansky

Reyes‐Reyes

Gaete

2017

“…Both Guardia et al (2010, 2012) and Keizer et al (2011, 2013) used interesting methodologies to reach this goal. Their data, even if preliminary, suggest that both conscious (i.e., the choice of a door-like aperture matching the perceived size of the body) and unconscious (i.e., the adaptive postural changes required to enter a door-like aperture) egocentric body-related judgments are impaired in AN (Guardia et al, 2012; Keizer et al, 2013).…”

Section: Future Directionsmentioning

confidence: 99%

Out of my real body: cognitive neuroscience meets eating disorders

Riva

2014

Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models—the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory—identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies—body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric).

“…Indeed, AN looks like a struggle with deeper and low-level aspects of the self, involving more implicit and unconscious aspects of the bodily-self such as action-oriented body schema (Guardia et al, 2010, 2012; Nico et al, 2010; Keizer et al, 2013), interoception (Fassino et al, 2004; Pollatos et al, 2008; Herbert and Pollatos, 2012; Strigo et al, 2013), multisensory body perception (see Gaudio et al, 2014 for a review), multisensory integration (Eshkevari et al, 2012), influencing both the body image and AN behaviors. For example, Epstein et al (2001) found that patients in acute phase of AN showed poorer proprioceptive abilities compared to controls.…”

Section: Introductionmentioning

confidence: 99%

Interoception and Autonomic Correlates during Social Interactions. Implications for Anorexia

Ambrosecchia

Ardizzi

Russo³

et al. 2017

The aim of this study is to investigate the bodily-self in Restrictive Anorexia, focusing on two basic aspects related to the bodily self: autonomic strategies in social behavior, in which others' social desirability features, and social cues (e.g., gaze) are modulated, and interoception (i.e., the sensitivity to stimuli originating inside the body). Furthermore, since previous studies carried out on healthy individuals found that interoception seems to contribute to the autonomic regulation of social behavior, as measured by Respiratory Sinus Arrhythmia (RSA), we aimed to explore this link in anorexia patients, whose ability to perceive their bodily signal seems to be impaired. To this purpose, we compared a group of anorexia patients (ANg; restrictive type) with a group of Healthy Controls (HCg) for RSA responses during both a resting state and a social proxemics task, for their explicit judgments of comfort in social distances during a behavioral proxemics task, and for their Interoceptive Accuracy (IA). The results showed that ANg displayed significantly lower social disposition and a flattened autonomic reactivity during the proxemics task, irrespective of the presence of others' socially desirable features or social cues. Moreover, unlike HCg, the autonomic arousal of ANg did not guide behavioral judgments of social distances. Finally, IA was strictly related to social disposition in both groups, but with opposite trends in ANg. We conclude that autonomic imbalance and its altered relationship with interoception might have a crucial role in anorexia disturbances.