Is the desire for amputation related to disturbed emotion processing? A multiple case study analysis in BIID

Bottini, Gabriella; Brugger, Peter; Sedda, Anna

doi:10.1080/13554794.2014.902969

Cited by 24 publications

(16 citation statements)

References 42 publications

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“…Through limbic projections on the cerebellum, this structure is an important region in neuroanatomical models of mood-disorders [51]. One study formally assessed emotional processing in BIID [52]. Seven individuals with BIID were tested in facial emotion recognition and emotional responses to disgusting images and, in general, showed no emotional impairment [52].…”

Section: Discussionmentioning

confidence: 99%

“…One study formally assessed emotional processing in BIID [52]. Seven individuals with BIID were tested in facial emotion recognition and emotional responses to disgusting images and, in general, showed no emotional impairment [52]. Functional imaging data are needed to test whether over-activity of the emotional brain circuitry, including the cerebellum, is present in BIID as a result of life-long depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

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The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

et al. 2016

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BackgroundBody Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for a neuro-anatomical basis is sparse.MethodsWe collected T1-weighted structural magnetic resonance imaging scans on a 3T scanner in eight individuals with BIID and 24 matched healthy controls, and analyzed the data using voxel-based morphometry.ResultsThe results showed reduced grey matter volume in the left dorsal and ventral premotor cortices and larger grey matter volume in the cerebellum (lobule VIIa) in individuals with BIID compared to controls.ConclusionThe premotor cortex and cerebellum are thought to be crucial for the experience of body-ownership and the integration of multisensory information. Our results suggest that BIID is associated with structural brain anomalies and might result from a dysfunction in the integration of multisensory information, leading to the feeling of disunity between the mental and physical body shape.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

et al. 2016

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“…When arriving in Milan selected participants have also been administered with a semi-structured interview modeled after the SCID-II preliminary questionnaire (First, Gibbon, Spitzer, Williams, & Benjamin, 1994). This interview contains questions concerning family (i.e., whether parents and relatives know about the disease), psychotherapy treatment, mood disorders, obsessions concerning the desire and sexual fantasies (the same instrument was previously used by our group in Bottini, Brugger, & Sedda, 2014).…”

Section: 1subjectsmentioning

confidence: 99%

Body ownership: When feeling and knowing diverge

Romano

Sedda

Brugger

et al. 2015

Consciousness and Cognition

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Individuals with the peculiar disturbance of 'overcompleteness' experience an intense desire to amputate one of their healthy limbs, describing a sense of disownership for it (Body Integrity Identity Disorder -BIID). This condition is similar to somatoparaphrenia, the acquired delusion that one's own limb belongs to someone else. In ten individuals with BIID, we measured skin conductance response to noxious stimuli, delivered to the accepted and non-accepted limb, touching the body part or simulating the contact (stimuli approach the body without contacting it), hypothesizing that these individuals have responses like somatoparaphrenic patients, who previously showed reduced pain anticipation, when the threat was directed to the disowned limb. We found reduced anticipatory response to stimuli approaching, but not contacting, the unwanted limb. Conversely, stimuli contacting the non-accepted body-part, induced stronger SCR than those contacting the healthy parts, suggesting that feeling of ownership is critically related to a proper processing of incoming threats. AbstractPersons with peculiar disturbance of 'overcompleteness' experience an intense desire to amputate

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“…Finally, this is the first study, to our knowledge, that has tested amputation-and paralysis-variant BIID participants involving behavioral measurements. All of the behavioral studies on BIID, to date, have been in those who desire amputation (5,7,8,100). A few questionnaire-based investigations of BIID have included paralysis-variant participants (4,6,101) and only one neuroimaging study included paralysis-variant participants (n = 2) in addition to amputation-desire participants (n = 6; 12).…”

Section: Discussionmentioning

confidence: 99%

An Investigation of Lower Limb Representations Underlying Vision, Touch, and Proprioception in Body Integrity Identity Disorder

et al. 2020

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Individuals with Body Integrity Identity Disorder (BIID) have a (non-psychotic) longstanding desire to amputate or paralyze one or more fully-functioning limbs, often the legs. This desire presumably arises from experiencing a mismatch between one's perceived mental image of the body and the physical structural and/or functional boundaries of the body itself. While neuroimaging studies suggest a disturbed body representation network in individuals with BIID, few behavioral studies have looked at the manifestation of this disrupted lower limb representations in this population. Specifically, people with BIID feel like they are overcomplete in their current body. Perhaps sensory input, processed normally on and about the limb, cannot communicate with a higher-order model of the leg in the brain (which might be underdeveloped). We asked individuals who desire paralysis or amputation of the lower legs (and a group of age-and sex-matched controls) to make explicit and implicit judgments about the size and shape of their legs while relying on vision, touch, and proprioception. We hypothesized that BIID participants would misestimate the size of their affected leg(s) more than the same leg of controls. Using a multiple single-case analysis, we found no global differences in lower limb representations between BIID participants and controls. Thus, while people with BIID feel that part of the body is foreign, they can still make normal sensory-guided implicit and explicit judgments about the limb. Moreover, these results suggest that BIID is not a body image disorder, per se, and that an examination of leg representation does not uncover the disturbed bodily experience that individuals with BIID have.

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Is the desire for amputation related to disturbed emotion processing? A multiple case study analysis in BIID

Cited by 24 publications

References 42 publications

The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

Body ownership: When feeling and knowing diverge

An Investigation of Lower Limb Representations Underlying Vision, Touch, and Proprioception in Body Integrity Identity Disorder

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