Abstract
Background
Body size overestimation is a fundamental feature in anorexia nervosa (AN). There have been inconclusive findings about the extent to which this feature distinguishes psychopathology and some authors have argued that overestimation may be a function of lower body mass index (BMI).
Methods
We examine body size estimation accuracy and body dissatisfaction in 74 females with AN and 11 age-matched female controls using two well-established psychophysical procedures.
Results
Participants with AN overestimated their body size more and had greater body dissatisfaction than controls. Size accuracy was found to be independent of BMI and correlated with body dissatisfaction and drive for thinness in participants with AN.
Conclusions
We conclude that overestimation of body size in AN is related to the psychopathology associated with the disorder and is not due to any perceptual tendency for people with lower BMI to overestimate their body size. We discuss the implications of these findings for treatment of AN.
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References
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text rev. American Psychiatric Association, Washington, DC. http://0-dx.doi.org.skyline.ucdenver.edu/10.1176/appi.books.9781585622665
Stice E, Shaw HE (2002) Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosom Res 53:985–993. doi:10.1016/S0022-3999(02)00488-9
Cornelissen KK, Bester A, Cairns P, Tovée MJ, Cornelissen PL (2015) The influence of personal BMI on body size estimations and sensitivity to body size change in anorexia spectrum disorders. Body Image 13:75–85. doi:10.1016/j.bodyim.2015.01.001
Gardner RM (2011) What affects body size estimation? The role of eating disorder, obesity, weight loss, hunger, restrained eating, mood, depression, sexual abuse, menstrual cycle, media influences, and gender. Curr Psychiatry Rev 7:96–103. doi:10.2174/157340011796391193
Gardner RM, Brown DL (2014) Body size estimation in anorexia nervosa: a brief review of findings from 2003 through 2013. Psychiatry Res 219:407–410. doi:10.1016/j.psychres.2014.06.029
Cash TF, Deagle EA (1997) The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: a meta-analysis. Int J Eat Disord 22:107–125. doi:10.1002/(SICI)1098-108X(199709)22:2
Sepulveda AR, Botella J, Leon JU (2002) Body-image disturbance in eating disorders: a meta-analysis. Psychol Spain 6:83–95. http://0-search.proquest.com.skyline.ucdenver.edu/docview/620051273?
Gardner RM, Bokenkamp ED (1996) The role of sensory and nonsensory factors in body size estimations of eating disorder subjects. J Clin Psychol 52: 3–16. doi:10.1002/(SICI)1097-4679(199601)52:
Gustavson CR, Gustavson JC, Pumariega AJ et al (1990) Body-image distortion among male and female college and high school students, and eating-disordered patients. Percept Mot Skills 71:1003–1010. doi:10.2466/PMS.71.7.1003-1010
Klesges RC (1983) An analysis of body image distortions in a nonpatient population. Int J Eat Disord 2:35–41. doi:10.1002/1098-108X(198321)2:2
Penner L, Thompson JK, Coovert DL (1991) Size overestimation among anorexics: much ado about very little? J Abnormal Psychol 100:90–93. doi:10.1037/0021-843X.100.1.90
Roy M, Forest F (2007) Assessment of body image distortion in eating and weight disorders: the validation of a computer-based tool (Q-BID). Eat Weight Disord 12:1–11. doi:10.1007/BF03327766
Gardner RM, Brown DL (2010) Comparison of video distortion and figural drawing scale for measuring and predicting body image dissatisfaction and distortion. Personal Individ Differ 49:794–798. doi:10.1016/j.paid.2010.07.001
Jappe LM, Gardner RM (2009) Body-image perception and dissatisfaction throughout phases of the female menstrual cycle. Percept Mot Skills 108:74–80. doi:10.2466/PMS.108.1.74-80
Gardner RM, Boice R (2004) A computer program for measuring body size distortion and body dissatisfaction. Behav Res Methods Instrum Comput 36:89–95. doi:10.3758/BF03195553
Gardner RM (1996) Methodological issues in assessment of the perceptual component of body image disturbance. Br J Psychol 87:1–11. doi:10.1111/j.2044-8295.1996.tb02593.x
Garner DM (1991) Eating Disorder Inventory-2 manual. Psychological Assessment Resources, Odessa
Theil A, Paul T (2006) Test-retest reliability of the Eating Disorder Inventory 2. J Psychosomatic Res 61:567–569. doi:10.1016/j.jpsychores.2006.02.015
Nevonen L, Clinton D, Norring C (2006) Validating the EDI-2 in three Swedish female samples: eating disorders patients, psychiatric outpatients and normal controls. Nordic J Psychiatry 60:44–50. doi:10.1080/08039480500504537
March J (1997) Multidimensional anxiety scale for children. Multi-Health Systems Inc, Tonawanda
Baldwin JS, Dadds MR (2007) Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. J Am Acad Child Adol Psychiatry 46:252–260. doi:10.1097/01.chi.0000246065.93200.a1
March JS, Parker JD, Sullivan K, Stallings P, Conners CK (1997) The multidimensional anxiety scale for children (MASC): factor structure, reliability, and validity. J Am Acad Child Adol Psychiatry 36:554–565. doi:10.1097/00004583-199704000-00019
Rynn MA, Barber JP, Khalid-Khan S et al (2006) The psychometric properties of the MASC in a pediatric sample. Anxiety Disord 20:139–157. doi:10.1016/j.janxdis.2005.01.004
Gardner RM, Moncrieff C (1988) Body image distortion in anorexics as a non-sensory phenomenon: a signal detection approach. J Clin Psychol 44:101–107. doi:10.1002/1097-4679(198803)44:2
Smeets MAM, Smit F, Panhuysen GEM, Ingleby JD (1997) The influence of methodological differences on the outcome of body size estimation studies in anorexia nervosa. Br J Clin Psychol 36:263–277. doi:10.1111/j.2044-8260.1997.tb01412.x
Thompson JK, Gardner RM (2002) Measuring perceptual body image among adolescents and adults. In: Cash TF, Pruzinsky T (eds) Body image: a handbook of theory, research, and clinical practice. The Guilford Press, New York, pp. 135–141
Mussap AJ, McCabe MP, Ricciardelli LA (2008) Implications of accuracy, sensitivity, and variability of body size estimations to disordered eating. Body Image 5:80–90. doi:10.1016/j.bodyim.2007.07.003
Smeets MAM, Smit F, Panhuysen GEM, Ingleby JD (1997) Body perception index: benefits, pitfalls, ideas. J Psychosom Res 44:457–464. doi:10.1016/S0022-3999(97)00142-6
Jarry JL, Berardi K (2004) Characteristics and effectiveness of stand-alone body image treatments: a review of the empirical literature. Body Image 1:319–333. doi:10.1016/j.bodyim.2004.10.005
Jarry JL Ip K (2005) The effectiveness of stand-alone cognitive-behavioural therapy for body image: a meta-analysis. Body Image 2:317–331. doi:10.1016/j.bodyim.2005.10.001
Holm S (1979) A simple sequentially rejective multiple test procedure. Scand J Stat 6(2):65–70. http://www.jstor.org/stable/4615733
Acknowledgments
The analysis and interpretation of the findings of this research were supported in part by NIH/NCATS Colorado CTSI Grant Number UL TR000154 to Jane Gralla. The body image software used in this study is available from Rick Gardner, e-mail: rick.gardner@ucdenver.edu.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no actual or potential conflict of interest in relation to this article.
Ethical approval
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
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Hagman, J., Gardner, R.M., Brown, D.L. et al. Body size overestimation and its association with body mass index, body dissatisfaction, and drive for thinness in anorexia nervosa. Eat Weight Disord 20, 449–455 (2015). https://doi.org/10.1007/s40519-015-0193-0
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DOI: https://doi.org/10.1007/s40519-015-0193-0