Cognitive Neuropsychiatry | Full Exam Notes | Utrecht University | A+ Study Guide

BID in ANOREXIA
- AN diagnosis: (A) limited food intake (B) Fear gaining weight (C) Disturbed perception/experience of body
- Body perception: see/feel/think about own body  current treatment CBT (cognition/affect)  not perception
(know/feel)
- AN = multisensory disorder  more severe than assumed
- Body representation: abstract collection of body perceptionsintegratesuses sensory inputblueprint of
body/size conscious & unconscious main function to use & move body + protect from harm not an image
o Body cognitions: emotions/attitudes/semantics
o Body perception: visual/tactile/feeling
o Body action: planning/execute motor action
- Homunculus: somatosensory/motor representation on brain rescaled using body representation
- Body awareness: body in spacelocation/coordination based on size
- AN: disturbed body size stored in brain’s body representation affects multiple senses & modalities
o Tactile Size perception: caliper overestimated in AN different receptor density and sensitivity more
sensitive but less specificimpact tactile processing receptors relay info to brain size model of object is
projected onto size in distorted body representation feel bigger
o Body Scaled Action: move body through door/crowds rotate at 40%  brain uses overestimated body size
representation (which is larger) experience self as larger
- Treatment: use perceptual distortions to improve/treat AN (RHI) synchronous = ownership  estimate hand width
pre/post RHI  change occurs in both conditions  entire VR body overestimation normalizes and remains at FU 
altered perception in body size is flexible and remains stable over time even emotional body parts & asynchronous
 not linked to body ownership  not treatment
- Intervention: hoop training choose fits body coach through size smaller over time direct evidence forced to
actually experience body size (think/talk/see/move/feel) = multisensory visual size estimation + tactile size estimation
+ action planning
Study 01: study full scope of body representation in 4 domains of BID (attitudes/visual/tactile/affordance perception) 
visual size estimation (VSE); Tactile Size Estimation (TSE); Hoop Task (HT)  HC, AN, Remitted
- Incorrect notion of body size = body image disturbance  develop/maintain ED + complicates recovery remitted
- No standard treatment targeting BID in AN  bodily experience persists after treatment possible trait factor (stable
pattern thoughts/emotions over long period)
- AN: stronger negative attitudes VSE: difference across groups AN/Remitted/HC TET: no difference across groups
(unclear)  HT: AN overestimated more than Remitted
- Confirms BID in remitted AN in visual perception and affordance perception but not in body attitudes
- Multiple sensory domains in BID can improve efficiency of conventional treatments
Study 02: full body illusion (FBI) for emotional body parts  AN showed less overestimation after FBI for circumference on
emotional/non-emotional parts also asynchronous & at FU disturbed body size experience in AN is flexible and can be
changed
- AN treatment does not target multisensory disturbance body representation: experience body & size incl. body
image (perceptual representation) + body schema (motor action)
- Overestimate tactile/haptic perception/integration of visual & proprioceptive info/ body scaled action/ interoceptive
awareness, sensitivity  cross-modal integration of sensory signals is disturbed
- Seeing touch on fake body while being touched on actual body = integrates 2 separate streams
- Initial overestimation in RHI normalizes after multisensory body illusion make size estimation on most recent visual
input  discrepancy between knowing & feeling their size (e.g, body experience) unaffected structural body
- Pre-FBI: AN misestimated width/circumference Post-FBI: decreased misestimation FU: size estimates normalized
change from pre-to-FU was largest in AN FBI alters body size perception positively affects persistent body size
disturbance in AN possible to change embodiment does not result in fake body being added to body
representation
- AN have weaker central coherence to HC (poor global processing) more detailed focused to specific body parts 
visual processing bias (overestimates body size) by blocking visual input: body estimates normalize (shift to other
senses) illusion is not related to improved body size but experimental setting is NB.
Aetiologias of Dissociative Disorders (DID)
- Dissociation: outer body/unreality/memory lapse  amnesia (forget) / absorption (focus) / derealization or
depersonalization (word/self not real)  frequency & intensity = clinical threshold
- Dissociative Amnesia: cannot recall info during trauma
- Dissociative Fugue: unplanned trips  cannot recall past  new characteristics  cannot recall the fugue state
- Reason for dissociation: sleep deprivation/trauma protection/coping high emotion intensity escape  depends on
severity & duration of abuse  more affected in critical periods
- Dissociative Identity Disorder (DID): how valid is identity fragmentation  vulnerabilities: suggestibility/ fantasy-
proneness  treatment lengthy & ineffective