Body-Related Emotions in Posttraumatic Stress Disorder Following Childhood Sexual Abuse.

Traumatic experiences are associated with emotions such as anxiety, shame, guilt, disgust, and anger. For patients who have experienced child sexual abuse, these emotions might be triggered by perceptions of their own body. The aim of this study was to investigate the extent of the association of the body to traumatic experiences and to discern the emotions linked to trauma-associated body areas. Ninety-seven female participants were assigned to four groups: post-traumatic stress disorder following child sexual abuse with co-occurring borderline personality disorder, post-traumatic stress disorder following child sexual abuse without co-occurring borderline personality disorder, borderline personality disorder without post-traumatic stress disorder, and healthy controls. Participants rated 26 body areas regarding their association with trauma and 7 emotions. Emotions were assessed by questionnaires. Results suggest that specific areas of the body are associated with trauma and linked to highly aversive emotions. In post-traumatic stress disorder patients, the areas associated with highly negative emotions were the pubic region and inner thighs. Thus, the patient's body may act as a trigger for traumatic memories.

Body image and noticeable self-inflicted scars.

Scars from burn injuries have a negative influence on body image. Patients with borderline symptoms with nonsuicidal self-injuries (NSSIs), which often result in scars, report body image disturbances. We study whether the origin and characteristics of scars are associated with body image. Altogether, 125 female participants (n = 65 with NSSI) filled in multidimensional body image questionnaires. The participants with NSSI reported a significantly more negative body image on most subscales compared with the participants with scars of other origins. This result remained significant after partialling out scar characteristics from regression equations. On a scale assessing body image after injuries, a significant correlation with origin of scars was found after additionally partialling out body mass index and borderline symptoms. These results indicate that self-inflicted scars may adversely affect body image. Addressing NSSI, which is relevant in a multitude of disorders, early in treatment might help to reduce the extent of scarification and therefore reduce the disturbance of body image.

Body image in patients with posttraumatic stress disorder after childhood sexual abuse and co-occurring eating disorder.

BACKGROUND: Body image is a multidimensional construct with cognitive-affective, behavioral and perceptive components. Survivors of childhood sexual abuse report a disturbance of the cognitive-affective component of their body image but not of the perceptive component. It has not yet been examined whether and how the behavioral component is affected. Also, it is still unknown whether the disturbances might be due to the influence of co-occurring eating disorders. SAMPLING AND METHODS: The cognitive-affective and behavioral components of the body image of 84 female participants with posttraumatic stress disorder (PTSD) after childhood sexual abuse (31 with a co-occurring eating disorder) and 53 healthy participants were assessed via the Dresden Body Image Inventory (Dresdner Körperbildfragebogen-35, DKB-35) and the Body Image Avoidance Questionnaire (BIAQ). RESULTS: PTSD patients reported significantly higher negative scores on all DKB-35 subscales (p < 0.001) and the BIAQ (p = 0.002; p < 0.001). Results remained consistent after accounting for the influence of co-occurring eating disorders (p = 0.021; p = 0.001; p < 0.001). CONCLUSIONS: Results show for the first time that the behavioral component of the body image is impaired in female patients with PTSD in addition to the cognitive-affective component. This is not solely due to a comorbid eating disorder. The effect of established treatments on the body image of PTSD patients should be evaluated and new treatment modules should be developed and tested, if necessary.

Standardized mirror confrontation: Body-related emotions, cognitions and level of dissociation in patients with Posttraumatic Stress Disorder after childhood sexual abuse.

BACKGROUND: A criterion for Posttraumatic Stress Disorder (PTSD) is the avoidance of trauma-associated stimuli that trigger emotional suffering. First studies on body image of patients with PTSD after childhood sexual abuse (CSA) support the hypothesis that awareness of the own body triggers emotional suffering. METHODS: Body-related emotions, cognitions and level of dissociation of n = 17 patients meeting DSM-IV criteria for PTSD and n = 29 healthy controls (HCs) during a standardized mirror confrontation while wearing a standard bikini were assessed. RESULTS: It was shown that expecting to be and while being confronted with one's own body, patients with PTSD showed significantly stronger negative emotionality and cognitions as well as higher dissociative states as compared to HCs. CONCLUSIONS: Findings suggest that in patients with PTSD after CSA, one's own body might function as a stimulus that leads to aversive emotional responses, negative cognitions and dissociative states. The elaboration of treatment for PTSD should consider these body-related aspects, e.g., by investigating the effects of body exposure.

Body self-evaluation and physical scars in patients with borderline personality disorder: an observational study.

BACKGROUND: Data from general psychology suggest that body self-evaluation is linked to self-esteem and social emotions. Although these emotions are fragile in individuals with borderline personality disorder (BPD), body self-evaluation is clearly understudied in BPD research. METHODS: A total of 200 women took part in the study: 80 female BPD patients, and 47 healthy and 73 clinical controls including post-traumatic stress disorder (PTSD) after childhood sexual abuse (CSA). Diagnoses were established through standardised interviews conducted by experienced psychologists. The participants used the Survey of Body Areas to indicate which areas of their own bodies they liked or disliked and to mark the locations of physical scars. RESULTS: Compared to healthy controls, both BPD patients and patients with PTSD after CSA had a predominantly negative body self-evaluation (Cohen's d = 1.42 and 1.38, respectively). As indicated by multilevel analyses, scars were related to a negative evaluation of the affected areas in BPD patients, but not in the control groups. Subgroup analyses revealed that the negative body self-evaluation applies to both BPD patients with and without PTSD or reported CSA. CONCLUSIONS: BPD patients show a negative body self-evaluation which is associated with the presence of scars but not with CSA.

Body image disturbance in patients with borderline personality disorder: impact of eating disorders and perceived childhood sexual abuse.

Body image disturbances occur in women with borderline personality disorder (BPD). Systematic research on these characteristics in well-defined BPD groups is lacking. It is unknown, if the disturbances are related to eating disorders and childhood sexual abuse (CSA), which frequently co-occur in patients with BPD. In the present study, cognitive-affective and behavioral components of body image for 89 female patients with BPD (49 with lifetime eating disorders) and 41 healthy participants were assessed via Body Image Avoidance Questionnaire (BIAQ) and Multidimensional Body-Self Relations Questionnaire (MBSRQ). Within the BPD group, 43 patients reported a history of CSA. Compared to healthy controls, BPD patients reported significantly more negative scores in the BIAQ and the MBSRQ. Both a history of CSA and a comorbid eating disorder were independently associated with an even more negative body image. Results suggest a disturbance of cognitive-affective and behavioral components of body image in female BPD patients.