Contribution of bottom-up and top-down processes to perceptive body image disturbances in adolescent anorexia nervosa

• Applicant: Dr. Ida Wessing
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2018 to 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 409656150

• Final Report Year: 2023

Final Report Abstract

Anorexia nervosa (AN) is a difficult to treat eating disorder that frequently affects adolescent girls. Food restriction and weight loss are often motivated by a perception of the own body as “fat” despite a low body weight. This body image disturbance (BID) is a key symptom, as it predicts the development of an eating disorder and is associated with treatment outcome. One important open question is whether BID is predominantly caused by sociocultural and psychological factors (e.g. slender ideal, perfectionism), or whether disturbed perception, as a biological vulnerability, plays a major role. The present project addressed this question by investigating visual and tactile body perception and BID in adolescent patients with AN and age-, gender, and IQ-matched healthy control participants using detailed clinical characterizations, behavioral tests and parallel electro- and magnetoencephalography (EEG and MEG). The study results confirmed the existence and high clinical relevance of BID in adolescent girls with AN. Beyond uneasiness with their own body, AN patients misjudged their body as wider as it is in different body size estimation tasks. Basic visual and tactile perception were intact in our sample of AN patients. In the visual domain, behavioral and neurophysiological data indicated that the visual perception of body pictures is undisturbed in AN, but biased by cognitive-affective processes. In the tactile domain, the tactile perception threshold and neural differentiation of tactile stimuli were intact. Nevertheless, AN patients performed worse than healthy controls in tactile stimulus discrimination tasks. This suggests that adolescent AN patients might have difficulties with the conscious access to tactile information. Taken together, the project results provided clear indications that perceptive disturbances underlying BID in AN do not emerge in the visual domain, and directed attention to the tactile domain. This encourages further studies on the role of tactile perception for BID in AN and suggests that tactile perception should be addressed during BID therapy.

Publications

• Body schema distortion in adolescent anorexia nervosa before and after weight gain. Talk at the 18th International Congress of the European Society for Child and Adolescent Psychiatry, Vienna.
  Wessing, I., Dalhoff, A., Romero Frausto, H. & Romer, G.
  
• Grundlage der Körperbildstörung? Neurophysiologische Korrelate taktiler Wahrnehmung bei jugendlichen Patientinnen mit Anorexia Nervosa. Talk at the XXXVI. Congress of the German Society for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Mannheim.
  Romero Frausto, H., Dalhoff, A., Romer, G., Junghöfer, M. & Wessing, I.
  
• Perceptive Body Image Distortion in Adolescent Anorexia Nervosa: Changes After Treatment. Frontiers in Psychiatry, 10.
  Dalhoff, Anke W.; Romero, Frausto Hugo; Romer, Georg & Wessing, Ida
  
• Veränderungen der Körperschemastörung bei der jugendlichen Anorexia Nervosa im Behandlungsverlauf. Talk at the German Congress for Psychosomatic Medicine and Psychotherapy, Berlin.
  Dalhoff, A., Romero Frausto, H., Romer, G.& Wessing, I.
  
• Increased early motivational response to food in adolescent anorexia nervosa revealed by magnetoencephalography. Psychological Medicine, 52(16), 4009-4017.
  Romero, Frausto Hugo; Roesmann, Kati; Klinkenberg, Isabelle A. G.; Rehbein, Maimu A.; Föcker, Manuel; Romer, Georg; Junghoefer, Markus & Wessing, Ida
  
• Der gefühlte Körper – taktile Wahrnehmung und Körperbild bei jugendlichen Patientinnen mit Anorexia Nervosa. Talk at the XXXVII. Congress of the German Society for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Magdeburg
  Wessing, I.
  
• Influence of Identity Development on Weight Gain in Adolescent Anorexia Nervosa. Frontiers in Psychiatry, 13.
  Budde, Lynn I.; Wilms, Simon; Föcker, Manuel; Dalhoff, Anke; Müller, Joerg M. & Wessing, Ida
  
• Intervention zur Behandlung von Körperbildstörungen bei jugendlicher Anorexia Nervosa auf Basis der Konzentrativen Bewegungstherapie. Talk at the XXXVII. Congress of the German Society for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Magdeburg.
  Dalhoff, A. & Wessing, I.
  
• Körperbildstörung und visuelle Körpermaßschätzung bei jugendlichen mit Anorexia Nervosa: eine MEG Studie. Talk at the XXXVII. Congress of the German Society for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Magdeburg
  Romero Frausto, H.
  
• Körperpsychotherapeutische Gruppentherapie für jugendliche Patientinnen mit Anorexia nervosa. Die Psychotherapie, 68(3), 179-186.
  Graute, Lea Anna; Wessing, Ida & Dalhoff, Anke