Depictive and metric body size estimation in anorexia nervosa and bulimia nervosa: A systematic review and meta-analysis

Mölbert, Simone Claire; Klein, Lukas; Thaler, Anne; Mohler, Betty J.; Brozzo, Chiara; Martus, Peter; Karnath, Hans‐Otto; Zipfel, Stephan; Giel, Katrin Elisabeth

doi:10.1016/j.cpr.2017.08.005

Cited by 131 publications

(139 citation statements)

References 83 publications

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“…It might be understood in the sense that general anxiety symptoms are too broad to capture the more specific fears of patients with AN (fear of gaining weight, fear to eat) and hence may not detect adequately body‐related anxiety of patients with AN. Reflecting the results on our own recent work (Junne et al, ; Mölbert, Thaler, et al, ; Mölbert, Klein, et al, ), the here presented results underline the importance of cognitive–emotional body image perceptions for treatment outcomes in patients with AN.…”

Section: Discussionsupporting

confidence: 85%

The importance of body image disturbances for the outcome of outpatient psychotherapy in patients with anorexia nervosa: Results of the ANTOP‐study

Junne¹,

Wild

Resmark³

et al. 2018

Euro Eating Disorders Rev

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This study investigates the role of body image self-appraisal in predicting the outcomes of outpatient psychotherapy in patients with anorexia nervosa (AN). Multiple linear regression analyses and a path-analysis model were applied to test the study hypotheses that body image at baseline predicts treatment outcomes of outpatient psychotherapy in patients with AN at follow-up measurement. The analyses were conducted as secondary analyses in a subgroup (n = 148) of the anorexia nervosa treatment of outpatient-cohort (ANTOP-study) (N = 242) of patients with AN. The results show that Negative Evaluation of the Body at baseline predicts perceived stress during psychotherapy, which in turn predicts depressive symptoms at the end of therapy which in turn predicts the outcomes body mass index and EDI-2 sum score at 12 months follow-up. The results underline the importance of body image disturbance in the course of AN and call for body image as a central target of psychotherapeutic interventions in patients with AN.

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Section: Discussionsupporting

confidence: 85%

The importance of body image disturbances for the outcome of outpatient psychotherapy in patients with anorexia nervosa: Results of the ANTOP‐study

Junne¹,

Wild

Resmark³

et al. 2018

Euro Eating Disorders Rev

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“…Our results are consistent with Pitron et al's model of body representation [33]. This 'serial coconstruction' model enhances previous conceptual models of body representation in clinical conditions by presenting body schema and body image as two distinct yet interacting concepts whereby body schema modifies body image [25,28]. Responses to the illusion were rapid and resulted in changes to a range of sensory-perceptual and cognitive experiences.…”

Section: Discussionsupporting

confidence: 90%

Changing hand appearance using visual illusions modulates body perception disturbance and pain in longstanding Complex Regional Pain Syndrome: A randomised trial

Lewis

Newport

Taylor

et al. 2020

Preprint

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Effective treatment of longstanding Complex Regional Pain Syndrome (CRPS) is a challenge, as causal mechanisms remain elusive. People with CRPS frequently report distorted subjective perceptions of their affected limb. Evidence of pain reduction when the affected limb is visually altered in size, suggests that visual illusions used to target central processing could restore coherence of this disrupted limb representation. We hypothesised that using virtual reality that alters hand image to match the patients desired hand appearance, would improve body perception disturbance and pain. Also, repeated exposure would maintain any therapeutic effect. A blinded randomised controlled trial of 45 participants with refractory upper-limb CRPS and body perception disturbance (BPD) viewed a digital image of their affected hand for one minute. The image was digitally altered according to the patients description of how they desired their hand to look in the experimental group and unaltered in the control group. BPD and pain were measured pre and post-intervention. A subgroup was followed up two weeks after a course of repeated interventions. BPD (p=0.036, effect size (ES)=0.6) and pain intensity (p = 0.047, ES=0.5) reduced in 23 participants after single exposure compared to controls (n=22). At follow-up the subgroup (experimental n= 21; control n=18) showed sustained pain reduction only (p=0.037 ES=0.7), with an overall 1.2 decrease on an 11-point scale. Visually changing the CRPS hand to a desired appearance modulates BPD and pain suggesting therapeutic potential for those with refractory CRPS. Future detailed studies to optimise this therapeutic effect are required. Clinical Trial Registration ID #ISRCTN64093359.

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“…We did not include measures of perceptual aspects (e.g., distortions) of body image which have been reviewed elsewhere for their significance in AN and BN (Molbert et al, ); we emphasize, however, that (a) the distinction between perceptual and attitudinal components of body image is well established and that (b) attitudinal aspects more strongly distinguish EDs from control groups and discriminate AN and BN than do perceptual disturbances. We also did not include other potentially relevant clinical variables such as, for example, body checking and avoidance behaviors which have been found to be salient across ED diagnoses (Calugi, El Ghoch, & Dalle Grave, ; Lavender et al, ; Mountford et al, ; Reas, Grilo, Masheb, & Wilson, ) and thought to play roles in the maintenance of EDs (Fairburn, ).…”

Section: Discussionmentioning

confidence: 99%

Examining the distinctiveness of body image concerns in patients with anorexia nervosa and bulimia nervosa

Grilo

Crosby

Machado

2019

Intl J Eating Disorders

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Objective This study examined the distinctiveness of specific constructs of body‐image disturbance in patients with anorexia nervosa (AN) and bulimia nervosa (BN). We compared weight/shape dissatisfaction, weight/shape overvaluation, weight/shape preoccupation, and fear of weight gain in patients with AN and BN and examined how each specific body‐image construct relates to clinical measures within and between AN and BN. Method A clinical sample of 490 treatment‐seeking patients diagnosed with DSM‐5 AN (N = 310) or BN (N = 180) by clinicians using structured interviews in Portugal completed the Eating Disorder Examination‐Questionnaire to assess body image and eating‐disorder (ED) psychopathology. Results Both within and between AN and BN, the four body‐image constructs varied in their strengths of association among themselves, with ED psychopathology, and body mass index (BMI). Analyses revealed considerable variability in variance accounted for in clinical measures by body‐image constructs. Body‐image constructs predicted significant, albeit small, variance in BMI within BN (dissatisfaction, preoccupation significant) but not within AN. Body‐image constructs predicted significant, albeit small, variance in the frequencies of binge eating and purging in AN (with preoccupation significant for both and fear for purging) but not within BN. Body‐image constructs predicted significant variance in ED psychopathology (large amounts of variance for Eating Concern and Restraint) within both AN and BN (with overvaluation, preoccupation, and fear significant). Conclusion Clinical manifestations of body‐image disturbances are complex and show important differences across AN and BN. Understanding distinctions and differential salience of different body‐image constructs across different EDs can inform refinement of specific case conceptualization.

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Depictive and metric body size estimation in anorexia nervosa and bulimia nervosa: A systematic review and meta-analysis

Cited by 131 publications

References 83 publications

The importance of body image disturbances for the outcome of outpatient psychotherapy in patients with anorexia nervosa: Results of the ANTOP‐study

The importance of body image disturbances for the outcome of outpatient psychotherapy in patients with anorexia nervosa: Results of the ANTOP‐study

Changing hand appearance using visual illusions modulates body perception disturbance and pain in longstanding Complex Regional Pain Syndrome: A randomised trial

Examining the distinctiveness of body image concerns in patients with anorexia nervosa and bulimia nervosa

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