Executive functioning and spatial processing in anorexia nervosa: an experimental study and its significance for the allocentric lock theory

Lander, Ravid; Heled, Eyal; Gur, Eitan

doi:10.1007/s40519-019-00728-2

Cited by 16 publications

(13 citation statements)

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“…(Keizer et al, 2016). One possible neuroscientific framework for being able to explain these results is the Allocentric Lock Theory (ALT) (Riva, 2011(Riva, , 2012Riva et al, 2014;Malighetti et al, 2016;Lander et al, 2020). According to the ALT, patients with ED keep clinging to their distorted body image because they are unable to adequately update their "remembered" body (allocentric representation) with perceptual information from their "experienced" body (egocentric representation).…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Virtual Reality in Mental Healthcare: Effects of Full Body Illusions on Body Image Disturbance

Turbyne

Goedhart

Koning

et al. 2021

Front. Virtual Real.

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Background: Body image (BI) disturbances have been identified in both clinical and non-clinical populations. Virtual reality (VR) has recently been used as a tool for modulating BI disturbances through the use of eliciting a full body illusion (FBI). This meta-analysis is the first to collate evidence on the effectiveness of an FBI to reduce BI disturbances in both clinical and non-clinical populations.Methods: We performed a literature search in MEDLINE (PubMed), EMBASE, PsychINFO, and Web of Science with the keywords and synonyms for “virtual reality” and “body image” to identify published studies until September 2020. We included studies that (1) created an FBI with a modified body shape or size and (2) reported BI disturbance outcomes both before and directly after the FBI. FBI was defined as a head-mounted display (HMD)-based simulation of embodying a virtual body from an egocentric perspective in an immersive 3D computer-generated environment.Results: Of the 398 identified unique studies, 13 were included after reading full-texts. Four of these studies were eligible for a meta-analysis on BI distortion inducing a small virtual body FBI in healthy females. Significant post-intervention results were found for estimations of shoulder width, hip width, and abdomen width, with the largest reductions in size being the estimation of shoulder circumference (SMD = −1.3; 95% CI: −2.2 to −0.4; p = 0.004) and hip circumference (SMD = −1.0; 95% CI: −1.6 to −0.4; p = 0.004). Mixed results were found in non-aggregated studies from large virtual body FBIs in terms of both estimated body size and BI dissatisfaction and in small virtual body FBI in terms of BI dissatisfaction.Conclusions: The findings presented in this paper suggest that the participants' BIs were able to conform to both an increased as well as a reduced virtual body size. However, because of the paucity of research in this field, the extent of the clinical utility of FBIs still remains unclear. In light of these limitations, we provide implications for future research about the clinical utility of FBIs for modulating BI-related outcomes.

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Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Virtual Reality in Mental Healthcare: Effects of Full Body Illusions on Body Image Disturbance

Turbyne

Goedhart

Koning

et al. 2021

Front. Virtual Real.

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“…According to data available in the literature, we might speculate that this disconnection is reached at different times by different groups of patients, in a way that is strongly linked to their own psychopathology: schizophrenic patients did not only dissociate their identity, but also identified themselves with the apparitions in the mirror, contrary to healthy individuals [29]; depressed patients, on the contrary, experienced a lower number of apparitions, probably because of their deficits in emotional facial recognition and expression [31]. Here, due to body image distortion (directly stimulated by looking in the mirror) [6][7][8][9][10][11][12][13] and the tendency to experience dissociation of patients with AN [17][18][19][20][21], we might think that they reach the threshold for a disconnection of the two over mentioned facets of representation before HC. This hypothesis is just speculative, since it was not directly examined in the present study, and therefore, it is difficult to conclude whether different results might be due to differences in timing (e.g., onset of the first anomalous experience in MGT, which was found to be much reduced in schizophrenic patients [29]) or some other aspects (e.g., the prodromal role of body image distortion on dissociative detachment of bodily-self); hence, we would suggest to conduct future studies to specifically examine this question.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the ability to encode and use visual information from the environment is impaired. Consequently, the egocentric sensory inputs are not able to update the contents of the allocentric representation of the body, and so the person is locked into this distorted perception [ 10 , 11 ]. The distortion of body image in ED might also be linked to perceptual biases, such as the visual body image adaptation (due to a pre-existing, long-lasting adaptation to thin body shapes in ED) [ 12 ] or the so-called serial dependence (a phenomenon occurring when errors in perceptual judgements are consistent with the assimilation of features of a previously viewed stimulus with the current stimulus) [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Visual perception and dissociation during Mirror Gazing Test in patients with anorexia nervosa: a preliminary study

et al. 2020

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Purpose It has been widely shown that dissociative features might play a fundamental role in producing body image distortions in patients affected by eating disorders. Here, we hypothesize that the Mirror Gazing Test (MGT), a task consisting in mirror exposure in a condition of sensory deprivation, would elicit dissociative symptoms in a group of patients with anorexia nervosa (AN). Methods Fourteen patients with AN and fourteen healthy controls (HC) underwent a 10 min MGT and completed the Strange Face Questionnaire and a short version of the Clinician-Administered Dissociative States Scale, along with a psychological assessment for eating disorders psychopathology, anxiety and depression. Results AN patients reported a higher number of strange-face apparitions and dissociative sensations than HC during the MGT. Dissociative identity (compartmentalization of two or more identities) and depersonalization (detachment of bodilyself) were much higher in patients with AN than in HC. These findings were correlated with body dissatisfaction and disruption in interoceptive awareness. Conclusion Dissociation and body image dysfunction are strongly connected in the pathophysiology of anorexia nervosa. Future research should investigate the same aspects in other psychiatric conditions characterized by body image distortions, such as Body Dysmorphic Disorder. Level of evidence I, Experimental studies.

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“…The results tend to converge towards attainment of central coherence, which some authors link with clinical specificities, such as the morbid pursuit of thinness and body image distortions, or such as traits of autistic spectrum disorders or obsessive traits [9]. Additionally, recent data support the attainment of visuospatial abilities, regardless of a perceptual disorder [10]. More recently, the impact of emotional status (depression in particular) has complemented the current models and research perspectives [11].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cognitive impairment in a French sample of patients with restrictive anorexia nervosa: two distinct profiles emerged with differences in impaired functions and psychopathological symptoms

Cholet¹,

Rousselet

Donnio³

et al. 2020

Eat Weight Disord

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Purpose The cognitive profiles of patients suffering from anorexia nervosa (AN) are currently explored as potential facilitating and/or maintenance factors. Specific data in restrictive AN (AN-R) remain contradictory. This study focused on women with AN-R to evaluate their cognitive functions to develop a more specific cognitive remediation program. Methods Female patients older than 15 years who were suffering from AN-R were recruited in a specialized unit for eating disorder management. Female healthy control (HC) participants were recruited who were matched with AN patients on age. All participants completed a cognitive evaluation (premorbid intelligence quotient (IQ), planning, information processing speed, cognitive flexibility) and a clinical evaluation (impulsivity, anxiety, depression). Results A total of 122 participants were included. Patients suffering from AN-R had significant impairment in information processing speed and planning. Patients exhibited significantly better cognitive flexibility than did the HC group when adjustments were made for other cognitive functions and impulsivity. Two distinct subgroups of patients were identified. The first subgroup had more marked cognitive impairment and fewer psychopathological symptoms than did the second subgroup of patients and the HC group. Conclusion Our results highlight cognitive impairment in patients with AN who had normal premorbid IQ. Two distinct profiles emerge. In clinical practice, these results open up perspectives for the development of more specific cognitive remediation programs (one specific program for cold cognitions and another specific program targeting emotions and hot cognitions). These results warrant confirmation by larger studies with a more specific evaluation of the impact of emotional status.

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Executive functioning and spatial processing in anorexia nervosa: an experimental study and its significance for the allocentric lock theory

Cited by 16 publications

References 70 publications

Systematic Review and Meta-Analysis of Virtual Reality in Mental Healthcare: Effects of Full Body Illusions on Body Image Disturbance

Systematic Review and Meta-Analysis of Virtual Reality in Mental Healthcare: Effects of Full Body Illusions on Body Image Disturbance

Visual perception and dissociation during Mirror Gazing Test in patients with anorexia nervosa: a preliminary study

Evaluation of cognitive impairment in a French sample of patients with restrictive anorexia nervosa: two distinct profiles emerged with differences in impaired functions and psychopathological symptoms

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