Identity and Eating Disorders (IDEA): A Questionnaire Evaluating Identity and Embodiment in Eating Disorder Patients

Abstract

Background: In this paper we tested the hypothesis that persons with eating disorders (EDs) are affected by disturbances of the way they experience their own body (embodiment) and shape their personal identity, assuming that the various kinds of anomalies of eating behavior are consequences thereof. Sampling and Methods: We developed and validated a new self-reported questionnaire named IDEA (IDentity and EAting disorders), which was administered to 147 ED patients and 187 healthy controls. Test-retest reliability, internal consistency, psychopathological correlates, and concurrent validity were evaluated. A factor analysis was performed to verify the distribution of items into subscales. Results: The questionnaire showed good test-retest reliability, and internal consistency. IDEA scores were specifically associated with ED psychopathology, and they did not show any correlation with sociodemographic and general clinical variables. Four factors were extracted, which were related to the following phenomena: ‘feeling oneself only through the gaze of the other and defining oneself only through the evaluation of the other’, ‘feeling oneself only through objective measures’, ‘feeling extraneous from one’s own body’, and ‘feeling oneself through starvation’. Conclusions: IDEA represents a multidimensional, brief, versatile, easy-to-perform instrument for clinical evaluation, assessing abnormalities in lived corporeality, and of personal identity, which appeared to be specifically associated with the core features of ED psychopathology. The main limitations of the study are the cross-sectional design. Also, it is impossible to ascertain whether the domains we assessed are specific traits of patients with EDs, or state-related features. To answer this question, a longitudinal study is needed.

Is Feeling Extraneous from One's Own Body a Core Vulnerability Feature in Eating Disorders?

“…Both these hypotheses are grounded in the existing literature. The assumption that these patients do not ‘feel' themselves - and especially their own body and emotions - is in accordance with most of the literature on the psychopathology of eating disorders and, especially, with the emphasis given in body and specific cognitive and emotional disturbances [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20] to enhancing the vulnerability to eating disorders. The concept that eating disorders stem from identity impairments is also firmly grounded in the theoretical literature [21,22,23,24,25].…”

“…In a previous study, we showed that in patients suffering from eating disorders, the lived body is no longer direct first-personal experiential evidence, but it is an entity that exists as viewed from an external perspective [18]. This view from without on one's body can be described in terms of the Sartrean concept of ‘the body for the other'.…”

“…This means that the other becomes the mirror in which one can perceive oneself [19]. To obtain this result, in a previous study [18], we validated the Identity and Eating Disorders questionnaire (IDEA) in an eating disorder and a healthy control population. The IDEA is a multidimensional, brief and easy-to-perform self-rating scale which explores and measures two main domains: abnormal experiences related to one's own body and difficulties in the definition of one's own identity.…”

The 14th century religious women Margery Kempe and Catherine of Siena can still teach us lessons about eating disorders today

“…Jean Paul Sartre extends this to distinguish between the lived body (body-subject) and the physical body (body-object) -when one becomes aware of the body-object being looked at by the other, it becomes the "lived body for others" [7]. Embodiment theory considers an individual's connection to, awareness of, and satisfaction with their own body.…”

“…Embodiment theory considers an individual's connection to, awareness of, and satisfaction with their own body. Disturbances to one's experience of embodiment are implicated in the eating disordered subject [7].…”