Ignite Creation Date:
2024-06-16 @ 11:49 AM
Last Modification Date:
2024-10-26 @ 3:31 PM
Study NCT ID:
NCT06437002
Status:
RECRUITING
Last Update Posted:
2024-05-31
First Post:
2024-05-20
Brief Title:
Exploring the Full Body Representation in Anorexia Nervosa and Bulimia Nervosa
Sponsor:
Istituto Auxologico Italiano
Organization:
Istituto Auxologico Italiano
Study Overview
Official Title:
Exploring the Full Body Representation in Anorexia Nervosa and Bulimia Nervosa
Status:
RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
FULLBR_ANBN
Brief Summary:
The ability to mentally recall a motor act without any overt movement is called motor imagery MI The movement simulation that occurs on a cognitive level can be seen as a way in which we express the mental representation of the body in action MI tasks can be used as a proxy for the exploration of the mental representations of the body Interestingly MI tasks differ in the degree of action monitoring required to resolve the task More in detail we can allocate MI tasks along a continuum that goes from more implicit MI tasks less action monitoring required for the resolution of the task to more explicit MI tasks more action monitoring required for the resolution of the task
Eating disorders such as anorexia nervosa AN and bulimia nervosa BN are both characterized by body image distortion and impairments ie overestimation of the perceived body however on a different state of the physical body on one hand we have a highly malnourished body on the other hand we might have a healthy-looking body or an overweight body As above mentioned MI tasks can be used as a proxy for the exploration of the mental representations of the body and people affected by AN and BN show impairment on their imagined body This means that people affected by AN and BN might respond differently when assessed for their MI abilities
We hypothesize that people affected by AN might show greater impairment in their motor imagery abilities because of the greater discrepancy between the physical body malnourished and the mental body representation in comparison to people affected by BN who usually have a health weight even an altered body representation Nevertheless we might expect the alteration of body representation not strictly linked to the physical body dimensions in the case of no difference between AN and BN This would be of relevance for the creation of rehabilitative programs
Eating disorders such as anorexia nervosa AN and bulimia nervosa BN are both characterized by body image distortion and impairments ie overestimation of the perceived body however on a different state of the physical body on one hand we have a highly malnourished body on the other hand we might have a healthy-looking body or an overweight body As above mentioned MI tasks can be used as a proxy for the exploration of the mental representations of the body and people affected by AN and BN show impairment on their imagined body This means that people affected by AN and BN might respond differently when assessed for their MI abilities
We hypothesize that people affected by AN might show greater impairment in their motor imagery abilities because of the greater discrepancy between the physical body malnourished and the mental body representation in comparison to people affected by BN who usually have a health weight even an altered body representation Nevertheless we might expect the alteration of body representation not strictly linked to the physical body dimensions in the case of no difference between AN and BN This would be of relevance for the creation of rehabilitative programs
Detailed Description:
The ability to mentally recall a motor act without any overt movement is called motor imagery MI The movement simulation that occurs on a cognitive level can be seen as a way in which we express the mental representation of the body in action MI tasks can be used as a proxy for the exploration of the mental representations of the body Interestingly MI tasks differ in the degree of action monitoring required to resolve the task More in detail we can allocate MI tasks along a continuum that goes from more implicit MI tasks less action monitoring required for the resolution of the task to more explicit MI tasks more action monitoring required for the resolution of the task
Eating disorders such as anorexia nervosa AN and bulimia nervosa BN are both characterized by body image distortion and impairments ie overestimation of the perceived body however on a different state of the physical body on one hand we have a highly malnourished body on the other hand we might have a healthy-looking body or an overweight body As above mentioned MI tasks can be used as a proxy for the exploration of the mental representations of the body and people affected by AN and BN show impairment on their imagined body This means that people affected by AN and BN might respond differently when assessed for their MI abilities
Recent studies explored MI through more explicit and more implicit MI tasks in people affected by eating disorders such as AN and BN For example when it comes to more implicit MI tasks Campione et al observed that people affected by AN and BN do not show a temporal advantage when mentally rotating pictured hands based on their own hands compared to other hand stimuli as opposed to controls Authors point out how people affected by eating disorders show an alteration of the MI process highlighting an alteration of body schema Authors grouped AN and BN patients in their analysis without considering the responses about the psychiatric condition Recently in a work by Scarpina et al authors observed how people affected by AN present altered MI processes independently from the level of awareness required since alterations emerged in the more implicit ie laterality judgment tasks and more explicit ie Mental Motor Chronometry MMC tasks tasks Such evidence points out an alteration of the imagery process in AN and confirms what was observed also by Campione et al for people suffering from AN Both studies focused their attention on hands only In the study of Urgesi et al when using the own-body transformation task requiring left-right judgments on a schematic human figure that may be facing toward front-facing or away from the observers back-facing authors observed a partial impairment t-score calculated as patients reaction times on accuracy ratios of people affected by BN in resolving such a more implicit MI task people with BN were impaired in providing laterality judgments on the front-facing human figure wherein participants had to perform a mental transformation of their own body to assume the perspective of the body stimulus Interestingly this study focused its attention on the full body mental representation but for a more implicit type of task only Purcell et al again grouped AN and BN participants and compared their performance to controls at a more implicit MI task which involves several body parts ie sensitive body parts abdomen buttocks thigh controls body parts shin forearm head Participants were asked to execute a movement or to imagine executing the same movement ie sizing a body part involving the body parts above-mentioned People affected by AN and BN required significantly more time to imagine tracing sensitive body parts compared to control body parts than healthy controls HCs Despite Purcell et al consider their task as more implicit in our opinion in this experiment a more explicit process of MI was assessed That is because participants were asked to execute a movement or to imagine executing the same movement this means that the degree of action monitoring grounding the task resolution highly increased because participants were made aware of using their MI skills to solve the task ie participants are openly asked to execute and imagine movements When it comes to the full body Guardia et al observe that people affected by AN overestimate their body size when asked to judge whether or not a door aperture is wide enough for them to pass through ie first-person perspective This does not happen for a third person present in the room with them This shows an overestimation of the mentally represented body in AN Lastly in the work of Meregalli et al authors compared acute AN not differentiated by the type restrictive or binge purging and control in a series of MI-based tasks results evidence that patients with AN displayed greater difficulty than control in explicitly imagining movements in mentally rotating human figures and in adopting a different egocentric visuospatial perspective No significant differences were observed in an MMC-based task and the mental rotation of 3D objects Overall these previous pieces of evidence may suggest altered MI processes in individuals affected by eating disorders such as AN and BN Interestingly literature reports stronger results for people affected by AN and BN when the resolution of more implicit MI-based tasks is considered while for more explicit ones ie MMC tasks results do not seem clear-cut
In previous studies patients were often grouped within a more generic eating disorder sample rather than considered by the diagnosis such as AN restrictive vs binge purging and BN and no comparison between the three was made AN restrictive vs AN binge purging vs BN However the psychopathology behind these disorders is very different More in detail AN is characterized by i restriction of energy intake relative to requirements leading to a significant low body weight in the context of the age sex developmental trajectory and physical health less than minimally normalexpected ii intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain and iii disturbed by ones body weight or shape self-worth influenced by body weight or shape or persistent lack of recognition of seriousness of low body weight Moreover we can distinguish between the restricting type ie During the last 3 months has not regularly engaged in binge-eating or purging and the binge-purging type ie During the last 3 months has regularly engaged in binge-eating or purging Differently when it comes to BN the condition is characterized by i recurrent episodes of binge eating as characterized by both eating within any 2-hour period an amount of food that is definitively larger than what most individuals would eat in a similar period of time under similar circumstances and a feeling that one cannot stop eating or control what or how much one is eating ii recurrent inappropriate compensatory behaviors in order to prevent weight gain such as self-induced vomiting misuse of laxatives diuretics or other medications fasting or excessive exercise iii the binge eating and inappropriate compensatory behaviors occur on average at least once a week for 3 months iv self-evaluation is unjustifiability influenced by body shape and weight v the disturbance does not occur exclusively during episodes of AN Moreover despite both AN and BN are characterized by body image distortion and impairments ie overestimation of the perceived body this occurs in response to a different state of the physical body ie highly malnourished body vs healthy-looking bodyoverweight body In regards to such clinical differences studies evaluating MI processes especially when different body parts are involved eg hands and the whole body as for previous studies should consider each condition per se AN restrictive AN binge-purging and BN
We hypothesize that people affected by AN might show greater impairment in their motor imagery abilities because of the greater discrepancy between the physical body malnourished and the mental body representation in comparison to people affected by BN who usually have a health weight even an altered body representation Nevertheless we might expect the alteration of body representation not strictly linked to the physical body dimensions in the case of no difference between AN and BN This would be of relevance for the creation of rehabilitative programs
Eating disorders such as anorexia nervosa AN and bulimia nervosa BN are both characterized by body image distortion and impairments ie overestimation of the perceived body however on a different state of the physical body on one hand we have a highly malnourished body on the other hand we might have a healthy-looking body or an overweight body As above mentioned MI tasks can be used as a proxy for the exploration of the mental representations of the body and people affected by AN and BN show impairment on their imagined body This means that people affected by AN and BN might respond differently when assessed for their MI abilities
Recent studies explored MI through more explicit and more implicit MI tasks in people affected by eating disorders such as AN and BN For example when it comes to more implicit MI tasks Campione et al observed that people affected by AN and BN do not show a temporal advantage when mentally rotating pictured hands based on their own hands compared to other hand stimuli as opposed to controls Authors point out how people affected by eating disorders show an alteration of the MI process highlighting an alteration of body schema Authors grouped AN and BN patients in their analysis without considering the responses about the psychiatric condition Recently in a work by Scarpina et al authors observed how people affected by AN present altered MI processes independently from the level of awareness required since alterations emerged in the more implicit ie laterality judgment tasks and more explicit ie Mental Motor Chronometry MMC tasks tasks Such evidence points out an alteration of the imagery process in AN and confirms what was observed also by Campione et al for people suffering from AN Both studies focused their attention on hands only In the study of Urgesi et al when using the own-body transformation task requiring left-right judgments on a schematic human figure that may be facing toward front-facing or away from the observers back-facing authors observed a partial impairment t-score calculated as patients reaction times on accuracy ratios of people affected by BN in resolving such a more implicit MI task people with BN were impaired in providing laterality judgments on the front-facing human figure wherein participants had to perform a mental transformation of their own body to assume the perspective of the body stimulus Interestingly this study focused its attention on the full body mental representation but for a more implicit type of task only Purcell et al again grouped AN and BN participants and compared their performance to controls at a more implicit MI task which involves several body parts ie sensitive body parts abdomen buttocks thigh controls body parts shin forearm head Participants were asked to execute a movement or to imagine executing the same movement ie sizing a body part involving the body parts above-mentioned People affected by AN and BN required significantly more time to imagine tracing sensitive body parts compared to control body parts than healthy controls HCs Despite Purcell et al consider their task as more implicit in our opinion in this experiment a more explicit process of MI was assessed That is because participants were asked to execute a movement or to imagine executing the same movement this means that the degree of action monitoring grounding the task resolution highly increased because participants were made aware of using their MI skills to solve the task ie participants are openly asked to execute and imagine movements When it comes to the full body Guardia et al observe that people affected by AN overestimate their body size when asked to judge whether or not a door aperture is wide enough for them to pass through ie first-person perspective This does not happen for a third person present in the room with them This shows an overestimation of the mentally represented body in AN Lastly in the work of Meregalli et al authors compared acute AN not differentiated by the type restrictive or binge purging and control in a series of MI-based tasks results evidence that patients with AN displayed greater difficulty than control in explicitly imagining movements in mentally rotating human figures and in adopting a different egocentric visuospatial perspective No significant differences were observed in an MMC-based task and the mental rotation of 3D objects Overall these previous pieces of evidence may suggest altered MI processes in individuals affected by eating disorders such as AN and BN Interestingly literature reports stronger results for people affected by AN and BN when the resolution of more implicit MI-based tasks is considered while for more explicit ones ie MMC tasks results do not seem clear-cut
In previous studies patients were often grouped within a more generic eating disorder sample rather than considered by the diagnosis such as AN restrictive vs binge purging and BN and no comparison between the three was made AN restrictive vs AN binge purging vs BN However the psychopathology behind these disorders is very different More in detail AN is characterized by i restriction of energy intake relative to requirements leading to a significant low body weight in the context of the age sex developmental trajectory and physical health less than minimally normalexpected ii intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain and iii disturbed by ones body weight or shape self-worth influenced by body weight or shape or persistent lack of recognition of seriousness of low body weight Moreover we can distinguish between the restricting type ie During the last 3 months has not regularly engaged in binge-eating or purging and the binge-purging type ie During the last 3 months has regularly engaged in binge-eating or purging Differently when it comes to BN the condition is characterized by i recurrent episodes of binge eating as characterized by both eating within any 2-hour period an amount of food that is definitively larger than what most individuals would eat in a similar period of time under similar circumstances and a feeling that one cannot stop eating or control what or how much one is eating ii recurrent inappropriate compensatory behaviors in order to prevent weight gain such as self-induced vomiting misuse of laxatives diuretics or other medications fasting or excessive exercise iii the binge eating and inappropriate compensatory behaviors occur on average at least once a week for 3 months iv self-evaluation is unjustifiability influenced by body shape and weight v the disturbance does not occur exclusively during episodes of AN Moreover despite both AN and BN are characterized by body image distortion and impairments ie overestimation of the perceived body this occurs in response to a different state of the physical body ie highly malnourished body vs healthy-looking bodyoverweight body In regards to such clinical differences studies evaluating MI processes especially when different body parts are involved eg hands and the whole body as for previous studies should consider each condition per se AN restrictive AN binge-purging and BN
We hypothesize that people affected by AN might show greater impairment in their motor imagery abilities because of the greater discrepancy between the physical body malnourished and the mental body representation in comparison to people affected by BN who usually have a health weight even an altered body representation Nevertheless we might expect the alteration of body representation not strictly linked to the physical body dimensions in the case of no difference between AN and BN This would be of relevance for the creation of rehabilitative programs
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None