Cognitive and Affective Processes in Body Integrity Dysphoria (BID): A Pilot Study

Individuals suffering from Body Integrity Dysphoria (BID) have the longstanding desire for amputation (BID-A) or palsy (BID-P). Most findings on mental aspects of BID are based on self-reports from sufferers. The aim of this pilot study is to examine cognitive and affective processes beyond what is accessible by self-reports. Therefore, n = 5 BID-A, n = 3 BID-P-sufferers, n = 22 healthy controls and n = 8 patients with body dysmorphic disorder (a further group with a strong desire for body modification) were tested. Selective attention bias (eye-tracking), tendency towards false memory (DRM-paradigm) and lack of affective involvement in the unwanted body part (induction and destruction of a rubber-hand/foot-illusion) were examined. Descriptive comparison of the groups showed that BID-A-sufferers fixated amputation stumps faster and longer than any other group and showed a reduced fear response when the body illusion was destroyed. There was no indication of a higher tendency towards false memory in either BID-group. Due to the small sample size, these results cannot be generalized. However, findings showed that BID-symptoms and underlying processes can be accessed in more ways than through self-reports. Moreover, results indicate that BID-A-sufferers selective attention and affective involvement differ from people not desiring an amputation. Understanding these processes may help developing an etiological model, identifying subtypes, and deriving treatment approaches.