Beyond body image: what body schema and motor imagery can tell us about the way patients with anorexia nervosa experience their body

Abstract

Aim Recent evidence suggests that the body image disturbance often observed in patients with anorexia nervosa also extends to the body schema. According to the embodiment approach, the body schema is not only involved in motor execution, but also in tasks that only require a mental simulation of a movement such as motor imagery, mental rotation of bodies, and visuospatial perspective-taking. The aim of the present study was to assess the ability of patients with anorexia in mentally simulate movements.Methods The sample included 52 patients with acute anorexia and 62 healthy controls. All participants completed three tests of explicit motor imagery, a mental rotation test and a test of visuospatial perspective-taking. ResultsPatients with anorexia nervosa, with respect to controls, reported greater difficulties in imagining movements according to a first-person perspective, lower accuracy in motor imagery, selective impairment in the mental rotation of human figures, and reduced ability in assuming a different egocentric visuospatial perspective. ConclusionThese results are indicative of a specific alteration in motor imagery in patients with anorexia nervosa. Interestingly, patients' difficulties appear to be limited to those tasks which specifically rely on the body schema, while patients and controls performed similarly in the 3D objects mental rotation task.

Linguistic embodiment in typical and atypical anorexia nervosa: Evidence from an image‐word matching task

“…One cognitive mechanism that has been proposed for the impaired body image in AN is the presence of an abnormal updating process of body schema, where top‐down control plays a key role in updating body schema representations (Riva et al., 2014). Explicit motor imagery abilities are impaired in individuals with AN, indicating difficulties in body schema tasks and motor imagery (Meregalli et al., 2022). Morphological analyses have found a disruption in the integration of somatosensory and visuospatial information in individuals with AN even after weight recovery, indicating that a neural substrate may play a role in the development and maintenance of embodiment impairments and body processing (Favaro et al., 2012).…”

Body image disturbance, interoceptive sensibility and the body schema across female adulthood: a pre-registered study

“…As such, individuals with EDs perceive their body as larger than its actual size and simultaneously interact with their body as if it occupies a greater space during action ( Guardia et al, 2010 , 2012 ; Beckmann et al, 2021 ). To date links between BID and body schema have primarily been researched in the context of young women diagnosed with EDs ( Guardia et al, 2010 ; Keizer and Engel, 2021 ; Meregalli et al, 2022 ). However, the detrimental impacts of negative body image persist in women across the lifespan, extending beyond young adulthood ( Stice and Shaw, 2002 ; Kilpela et al, 2015 ).…”

“…This process, known as egocentric mental rotation ( Zacks et al, 2000 ; Kaltner et al, 2014 ), relies on one’s body schema as a foundational basis for the judgement. There is now mounting evidence that those with clinical BIDs (e.g., individuals with EDs) show a disturbance in the egocentric reference frame during body-based mental rotation ( Urgesi et al, 2011 ; Cipolletta et al, 2017 ; Meregalli et al, 2022 ). Studies assessing whole-body mental rotations in individuals with BIDs typically use variations of the Own Body Transformation task (OBT) ( Blanke et al, 2005 ; Gardner et al, 2012 ) which involve making speeded left- and right-hand judgments of full-bodied avatars in either front-facing or back-facing positions ( Urgesi et al, 2011 ; Cooper and Mohr, 2012 ; Cipolletta et al, 2017 ).…”

“…Studies assessing whole-body mental rotations in individuals with BIDs typically use variations of the Own Body Transformation task (OBT) (Blanke et al, 2005;Gardner et al, 2012) which involve making speeded left-and right-hand judgments of fullbodied avatars in either front-facing or back-facing positions (Urgesi et al, 2011;Cooper and Mohr, 2012;Cipolletta et al, 2017). Individuals with EDs demonstrate altered reaction times and accuracy in the OBT task compared to non-ED controls, indicating disturbances in egocentric processing in ED individuals (Urgesi et al, 2011;Cooper and Mohr, 2012;Serino et al, 2015;Cipolletta et al, 2017;Meregalli et al, 2022). However, the evidence remains equivocal regarding the relationship between BIDs, altered egocentric processing, and their effect on the body schema in individuals without EDs.…”

Body image disturbance, interoceptive sensibility and the body schema across female adulthood: A pre-registered study

“…Whereby individuals with eating disorders (EDs), both perceive their body to be larger than it is and concurrently imagine and interact with their body as if their body occupies a larger space (Beckmann et al, 2021;Guardia et al, 2010Guardia et al, , 2012. To date links between body image disturbance and body schema have primarily been researched in the context of young women diagnosed with EDs (Guardia et al, 2010;Keizer & Engel, 2021;Meregalli et al, 2022). However, the detrimental impacts of negative body image persist in women across the lifespan, extending beyond young adulthood (Kilpela et al, 2015;Stice & Shaw, 2002).…”