Sexual and Food Preference in Apotemnophilia and Anorexia: Interactions between ‘Beliefs' and ‘Needs' Regulated by Two-Way Connections between Body Image and Limbic Structures

Ramachandran, Vilayanur S.; Brang, David; McGeoch, Paul D.; Rosar, William H.

doi:10.1068/p6350

Cited by 29 publications

(22 citation statements)

References 6 publications

(2 reference statements)

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“…Integrity Identity Disorder (BIID) (First, 2005), also described as xenomelia ("foreign limb syndrome") (McGeoch et al, 2011), a condition which currently captures the attention of the popular media (Ananthaswamy, 2015) and that of scientific representatives (Ramachandran et al, 2009) and medical ethics (Ryan, 2008) alike.…”

Section: Introductionmentioning

confidence: 99%

When less is more – Implicit preference for incomplete bodies in xenomelia

Macauda

Bekrater-Bodmann

Brugger

et al. 2017

Journal of Psychiatric Research

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Individuals with xenomelia identify with an amputated rather than with their physically complete, healthy body. They often mimic amputees and show a strong admiration of and sexual attraction towards them. Here we investigated for the first time empirically whether such unusual preference for amputated bodies is present also on an implicit level. Using the well-validated Implicit Association Test we show that individuals with xenomelia manifested a stronger implicit and explicit preference for amputated bodies than a normally-limbed control group and a group of involuntary amputees did. Interestingly, the two latter groups did not differ in their implicit and explicit preference for complete versus amputated bodies. These findings are an important step in understanding how deeply rooted attitudes about a socially normative body appearance may be influenced by a developmentally disordered experience of one's own bodily self. We conclude that this is the first behavioral evidence demonstrating a conflict of self-identification on an implicit level and this enriches current understandings of xenomelia as a primarily neurological disorder. AbstractIndividuals with xenomelia identify with an amputated rather than with their physically complete, healthy body. They often mimic amputees and show a strong admiration of and sexual attraction towards them. Here we investigated for the first time empirically whether such unusual preference for amputated bodies is present also on an implicit level. Using the wellvalidated Implicit Association Test we show that individuals with xenomelia manifested a stronger implicit and explicit preference for amputated bodies stronger than a normally-limbed control group and a group of involuntary amputees did. Interestingly, the two latter groups did not differ in their implicit and explicit preference for complete versus amputated bodies. These findings are an important step in understanding how deeply rooted attitudes about a socially normative body appearance may be influenced by a developmentally disordered experience of one's own bodily self. We conclude that this first behavioral evidence to demonstrate a conflict of self-identification on an implicit level and this enriches current understandings of xenomelia as a primarily neurological disorder.

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Section: Introductionmentioning

confidence: 99%

When less is more – Implicit preference for incomplete bodies in xenomelia

Macauda

Bekrater-Bodmann

Brugger

et al. 2017

Journal of Psychiatric Research

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“…This group also posted magnetoencephalography data on Nature Precedings [61] suggesting that the right SPL was not normally active in their sample of 4 subjects with BIID. Noting that a deficit in body representation in the right SPL would not explain these individuals’ sexual attraction to amputees, they further hypothesized that sexual aesthetic preference for certain body morphology is dictated in part by the shape of the cortical representation of body image, which acts on limbic connections to determine aesthetic visual preference for one’s own body type [62]. …”

Section: Etiological Hypothesesmentioning

confidence: 99%

Body Integrity Identity Disorder: The Persistent Desire to Acquire a Physical Disability

First¹,

Fisher²

2011

Psychopathology

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Background: Body integrity identity disorder (BIID) is a rare and unusual psychiatric condition characterized by a persistent desire to acquire a physical disability (e.g., amputation, paraplegia) since childhood that to date has not been formally described in the psychiatric nosology. Most BIID sufferers experience a chronic and dysphoric sense of inappropriateness regarding their being able-bodied, and many have been driven to actualize their desired disability through surreptitious surgical or other more dangerous methods. This review aims to characterize the history and phenomenology of this condition, to present its differential diagnosis, and to consider possible etiologies, treatment options, and ethical considerations. Sampling and Method: Review of the psychiatric and neurological literature. Results: A growing body of data suggests the existence of a discrete entity with onset by early adolescence and a negative impact on functioning. Parallel neurological conditions and preliminary experimental investigations suggest a possible neurobiological component in at least a portion of cases. While attempts at treatment have been described, no systematic evidence for efficacy has emerged. Discussion: BIID is a unique nosological entity with significant consequences for its sufferers and as such may warrant inclusion in some form in the forthcoming DSM-5 and ICD-11.

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“…The adjacency of the foot/leg representation and that of the genital organs in the postcentral gyrus may be more than a coincidence when it comes to explain the four-fold incidence of legs over arms in amputation desires and the stronger erotic connotations of disability desires with leg compared to arm amputees. 77 This homuncular vicinity is probably determined during foetal life, induced by the frequency of genital self-touch with the feet due to the typical position of the unborn child. 78 It is the physiological explanation for the fact that touch to the face, but never to the genital region, can elicit phantom sensations in hand amputees, whereas the converse is true for foot amputees.…”

Section: Towards a Social Neuroscience Of Disability Desiresmentioning

confidence: 99%

Limb amputation and other disability desires as a medical condition

Brugger

Christen

Jellestad

et al. 2016

The Lancet Psychiatry

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Some people have a profound dissatisfaction with what is considered an able-bodied state by most others. These individuals desire to be disabled, by conventional standards. In this Review, we integrate research findings about the desire for a major limb amputation or paralysis (xenomelia). Neuropsychological and neuroimaging explorations of xenomelia show functional and structural abnormalities in predominantly right hemisphere cortical circuits of higher-order bodily representation, including affective and sexual aspects of corporeal awareness. These neural underpinnings of xenomelia do not necessarily imply a neurological cause, and a full understanding of the condition requires consideration of the interface between neural and social contributions to the bodily self and the concept of disability. Irrespective of cause, disability desires are accompanied by a disabling bodily dysphoria, in many respects similar to gender dysphoria, and we suggest that they should be considered a mental disorder. SummaryThere are persons who suffer from a profound dissatisfaction with what is considered an ablebodied state by most others. They desire to be "dis-abled" by conventional standards. We integrate recent research findings on the desire for a major limb amputation or paralysis ("xenomelia"). Neuropsychological and neuroimaging explorations of xenomelia revealed functional and structural abnormalities in predominantly right hemisphere cortical circuits of higher-order bodily representation, including affective and sexual aspects of corporeal awareness. These neural underpinnings of xenomelia do not necessarily imply a neurological etiology, and a full understanding of the condition requires consideration of the interface between neural and social contributions to the bodily self and the concept of (dis)ability. Irrespective of etiology, disability desires are accompanied by a disabling bodily dysphoria, in many respects similar to gender dysphoria, and deserve to be considered a mental disorder.3 IntroductionThis review integrates recent research findings concerning a condition that is not yet recognized as a mental disorder, which is still in search of a generally accepted medical label and whose conceptual basis is still "under construction". The condition involves a person's dissatisfaction with an able-bodied state. It is referred to as "body integrity identity disorder" (BIID) in the psychiatric literature, "xenomelia" in neurologically oriented studies, and "transability" ("transableism") in approaches to disability from a primarily sociological perspective (table 1, appendix and figure 1, appendix, for the terminology). In this review we use the term "disability desires" to remain descriptive and avoid controversial concepts of identity and too narrow notions of focal brain damage. Although deafness, blindness or the status of a eunuch can be the target of disability desires, the focus of our review is on the desire for limb amputation or paraplegia. These forms of profound bodily modification are the...

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Sexual and Food Preference in Apotemnophilia and Anorexia: Interactions between ‘Beliefs' and ‘Needs' Regulated by Two-Way Connections between Body Image and Limbic Structures

Cited by 29 publications

References 6 publications

When less is more – Implicit preference for incomplete bodies in xenomelia

When less is more – Implicit preference for incomplete bodies in xenomelia

Body Integrity Identity Disorder: The Persistent Desire to Acquire a Physical Disability

Limb amputation and other disability desires as a medical condition

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