Body Evaluation and Body Ownership in Patients with Inflammatory Bowel Disease: the Role of Interoceptive Sensibility and Childhood Maltreatment.

OBJECTIVE: Inflammatory bowel diseases (IBD) are accompanied by symptoms that can vastly affect patients' representations of their bodies. The aim of this study was to investigate alterations in body evaluation and body ownership in IBD and their link to interoceptive sensibility, gastrointestinal-specific anxiety, and history of childhood maltreatment. METHODS: Body evaluation and ownership was assessed in 41 clinically remitted patients with IBD and 44 healthy controls (HC) using a topographical self-report method. Interoceptive sensibility, gastrointestinal-specific anxiety and a history of childhood maltreatment were assessed via self-report questionnaires. RESULTS: Patients reporting higher interoceptive sensibility perceived their bodies in a more positive manner. Higher gastrointestinal-specific anxiety was linked to a more negative body evaluation particularly of the abdomen in patients with IBD. Childhood maltreatment severity strengthened the positive association between interoceptive sensibility and body ownership only in those patients reporting higher trauma load. CONCLUSION: Altered body representations of areas associated with abdominal pain are linked to higher symptom-specific anxiety and lower levels of interoceptive sensibility in IBD. Particularly in patients with a history of childhood maltreatment, higher levels of interoceptive sensibility might have a beneficial effect on the patients' sense of body ownership.

One body, two faces: How double standards influence body evaluation in women with binge-eating disorder compared to mentally healthy women with higher weight and average weight.

OBJECTIVE: Research has found evidence that women with anorexia nervosa (AN) and bulimia nervosa (BN) apply different standards for themselves than for others when evaluating bodies, an aspect of a disturbed body image. This study investigates whether women with binge-eating disorder (BED) likewise show self-deprecating double standards (DS). METHODS: Women with BED (n = 40), women with higher weight (n = 40) and women with average weight (n = 40) viewed a presentation of different builds, including their individual ideal body, which were presented once with participants' own and once with an unknown woman's face. After each presentation, participants rated their emotional response regarding arousal and valence, and evaluated the body's attractiveness, body fat and muscle mass. DS were defined as the difference in ratings of the same body with one's own and the unknown face. RESULTS: Women with BED showed a higher degree of negative emotions in response to a thin and a high-weight build, rated lower levels of body attractiveness for an athletic build, and displayed more arousal for almost all builds presented with their own compared to with another face. While women with BED showed a higher burden on measures of eating pathology and body image than the other groups, DS were not more pronounced in women with BED. DISCUSSION: The findings contradict DS as a characteristic feature of BED, but underline "normative" DS for higher-weight/high-weight builds, reflecting weight stigmatization. Psychoeducation on these DS might complement cognitive-behavioral therapy in BED in order to reduce negative emotions. PUBLIC SIGNIFICANCE: A bias in body evaluation has been proven in women with anorexia and BN, but no research has examined this in women with BED. This study provides evidence of DS in body evaluation in women with BED, compares the extent of DS between women with BED, higher weight, and average weight, and investigates individual body ideals in women with BED and higher weight.

Double standards in body evaluation? The influence of identification with body stimuli on ratings of attractiveness, body fat, and muscle mass.

Although it is well documented that women evaluate their own body differently from other bodies, it remains unclear whether this discrepancy is based on double standards because of identity or on objective differences between these bodies. The aim of this study was therefore to test whether women apply double standards depending on a body's identity when evaluating the same bodies presented with different faces. Average-weight women (N = 104) rated body attractiveness, body fat, and muscle mass of thin, average-weight, overweight, athletic, and hypermuscular bodies with either another female's face or their own face. With their own face, subjects rated overweight bodies as more unattractive, higher in body fat and lower in muscle mass than with another female's face. However, for non-overweight bodies, body ratings did not differ depending on body identity. Based on the self-deprecating double standards for overweight bodies, a body-related identity bias might be considered in theoretical models of body image.Level of evidence Level V, descriptive study.

Double standards in body evaluation? How identifying with a body stimulus influences ratings in women with anorexia nervosa and bulimia nervosa.

OBJECTIVE: Women with eating disorders (ED) evaluate their own body more negatively than do women without ED. However, it is unclear whether this negative rating is due to objective bodily features or different standards for one's own body and others' bodies. Therefore, the purpose of this study was to examine whether women with ED apply double standards when rating bodies by disentangling the objective features of one's own body from the feelings of ownership. METHOD: We presented n = 34 women with anorexia nervosa, n = 31 women with bulimia nervosa, and n = 114 healthy controls with pictures of thin, average-weight, overweight, athletic, and hypermuscular bodies. Identity was manipulated by showing each body once with the participant's own face and once with the face of another woman. Participants were instructed to report their emotional state according to valence and arousal and to rate body attractiveness, body fat, and muscle mass. RESULTS: Women with anorexia nervosa and bulimia nervosa displayed greater self-deprecating double standards in body fat rating than did women without ED, as quantified by the difference between the ratings of the same body with one's own versus another woman's face. Double standards reflected in valence, arousal and attractiveness ratings were significantly more pronounced in women with anorexia nervosa than in women without ED. DISCUSSION: The double standards found may be due to an activation of dysfunctional self-related body schemata, which distort body evaluation depending on identity. Double standards related to body fat were characteristic for women with ED, but not for women without ED.

Giving a Body a Different Face-How Men and Women Evaluate Their Own Body vs. That of Others.

Eating disorders affect women more than men. Women reportedly dislike their body shape more and appreciate it less than do men. One factor influencing body image might be the application of different standards for oneself than for other people when evaluating bodies. To investigate this possibility, we determined whether the application of double standards is different between men and women. We presented 57 women and 54 men (aged 18-30 and of average weight) with pictures of their own bodies and pictures of average weight, overweight, and "ideal" bodies attached to the participants' own face and to another person's face. Participants were instructed to evaluate their emotional reaction to the pictures and then rate the various pictures on aspects of attractiveness, body fat, and muscle mass. The degree of the double standard was defined as the difference between ratings of what appeared to be one's own body and what appeared to be someone else's according to the presented face. The analyses revealed, firstly, that both genders applied self-deprecating double standards when viewing overweight and average-weight bodies. Women, but not men, also showed self-deprecating double standards when viewing the ideal body and their own body. By contrast, men applied fewer double standards when viewing the ideal body and self-enhancing double standards when viewing their own body. The study suggests that young, average-weight men are more or less satisfied with their own bodies, whereas young, average-weight women tend to apply a stricter standard for themselves than for others, thus devaluing their own bodies. This vulnerability to body image is hypothesized as contributing to the prevalence of eating disorders in women.

Experiential avoidance and cognitive fusion mediate the relationship between body evaluation and unhelpful body image coping strategies in individuals with visible differences.

Psychological flexibility, the capacity to be open to any internal stimuli and act in accordance with valued ends, has been identified as an explanatory variable in how people cope with body concerns. The role of psychological flexibility is unexplored in adults with an atypical appearance due to a health condition, injury, or medical treatment (collectively visible difference), who often encounter multiple day-to-day body image threats. Testing two core components of psychological flexibility, namely experiential avoidance (a desire to avoid or get rid of unpleasant internal experiences) and cognitive fusion (taking thoughts literally), can also provide a more precise theoretical model, with clearer implications for psychological intervention. This survey study investigated whether each psychological flexibility component mediated the relationship between body evaluation and two unhelpful body image coping strategies (behavioural avoidance and appearance-fixing behaviours) in 220 adults with various causes of visible difference. Controlling for demographic variables and subjective noticeability of visible difference, results suggest that cognitive fusion partially mediated the relationship for both body image coping strategies, and experiential avoidance partially mediated behavioural avoidance but not appearance-fixing behaviours. Cognitive fusion may be a particularly important cognitive process in the mechanisms underpinning unhelpful body image coping strategies in this population.

Which Body Would You Like to Have? The Impact of Embodied Perspective on Body Perception and Body Evaluation in Immersive Virtual Reality.

In this experiment, we aimed to measure the conscious internal representation of one's body appearance and allow the participants to compare this to their ideal body appearance and to their real body appearance. We created a virtual representation of the internal image participants had of their own body shape. We also created a virtual body corresponding to the internal representation they had of their ideal body shape, and we built another virtual body based on their real body measures. Participants saw the three different virtual bodies from an embodied first-person perspective and from a third-person perspective and had to evaluate the appearance of those virtual bodies. We observed that female participants evaluated their real body as more attractive when they saw it from a third-person perspective, and that their level of body dissatisfaction was lower after the experimental procedure. We believe that third-person perspective allowed female participants to perceive their real body shape without applying the negative prior beliefs usually associated to the "self", and that this resulted in a more positive evaluation of their body shape. We speculate that this method could be applied with patients suffering from eating disorders, by making their body perception more realistic and therefore improve their body satisfaction.

Evaluation of the own body in women with current and remitted borderline personality disorder: evidence for long-lasting effects of childhood sexual abuse.

BACKGROUND: Evaluation of one's own body highly depends on psychopathology. In contrast to healthy women, body evaluation is negative in women from several diagnostic groups. Particularly negative ratings have been reported in disorders related to childhood sexual abuse (CSA) including borderline personality disorder (BPD). However, it is unknown whether this negative evaluation persists beyond symptomatic remission, whether it depends on the topography of body areas (sexually connoted versus neutral areas), and whether it depends on CSA. OBJECTIVE: First, we aimed at a quantitative comparison of body evaluation across three diagnostic groups: current BPD (cBPD), remitted BPD (rBPD), and healthy controls (HC). Second, we aimed at clarifying the potentially moderating role of a history of CSA and of the sexual connotation of body areas. METHODS: The study included 68 women from the diagnostic groups of interest (cBPD, rBPD, and HC). These diagnoses were established with the International Personality Disorder Examination. The participants used the Survey of Body Areas to quantify the evaluation of the own body and the Childhood Trauma Questionnaire for assessing CSA. RESULTS: While the evaluation of the own body was generally negative in women from the cBPD group it was positive in those who had remitted from BPD. However, their positive scores were strictly confined to neutral body areas, whereas the evaluation of sexually connoted body areas was negative, resembling the respective evaluation in cBPD patients and contrasting the positive evaluation of sexually connoted areas in healthy women. The negative evaluation of sexually connoted areas in remitted women was significantly related to a history of CSA. CONCLUSIONS: Women with BPD may require a specifically designed intervention to achieve a positive evaluation of their entire body. The evaluation of sexually connoted body areas seems to remain an issue even after remission from the disorder has been achieved.

Antecedentes: La evaluación del cuerpo propio depende en gran parte de la psicopatología. En contraste con mujeres sanas, la evaluación del cuerpo es negativa en mujeres de diferentes grupos diagnósticos. Evaluaciones particularmente negativas han sido reportadas en trastornos relacionados al abuso sexual infantil (CSA por sus siglas en inglés), incluyendo el trastorno de personalidad límite (BPD por sus siglas en inglés). Sin embargo, no se conoce si esta evaluación negativa persiste al alcanzar la remisión sintomática, si es que depende de la topografía de las áreas del cuerpo (áreas con connotación sexual versus neutras), y si depende del antecedente de CSA.Objetivo: Primero, dirigimos una comparación cuantitativa de la evaluación corporal en tres grupos diagnósticos: BPD actual (cBPD), BPD en remisión (rBPD) y controles sanos (HC por sus siglas en inglés). En segundo lugar, intentamos clarificar el potencial rol moderador de una historia de CSA y de la connotación sexual de las áreas corporales.Métodos: El estudio incluyó 68 mujeres de los grupos diagnósticos de interés (cBPD, rBPD y HC). Estos diagnósticos fueron establecidos con el Examen Internacional de Trastornos de Personalidad. Las participantes completaron la Encuesta de Áreas Corporales para cuantificar la evaluación del cuerpo propio y el Cuestionario de Trauma Infantil para evaluar CSA.Resultados: Mientras la evaluación del cuerpo propio fue generalmente negativa en mujeres del grupo cBPD, fue positiva en aquellas con BPD en remisión. Sin embargo, sus puntajes positivos fueron estrictamente circunscritos a las áreas del cuerpo neutrales, mientras que la evaluación de las áreas del cuerpo con connotación sexual fue negativa, y símiles a la evaluación de las pacientes del grupo cBPD, y contrastando con la evaluación positiva de las áreas con connotación sexual de las mujeres sanas. La evaluación negativa de áreas del cuerpo con connotación sexual en las mujeres en remisión fue relacionada significativamente con una historia de CSA.Conclusiones: Las mujeres con BPD pueden requerir una intervención específicamente diseñada para alcanzar una evaluación positiva de su cuerpo completo. La evaluación de áreas del cuerpo con connotación sexual parece permanecer problemática incuso posterior a que la remisión del trastorno ha sido alcanzada.

Gender Differences in Body Evaluation: Do Men Show More Self-Serving Double Standards Than Women?

Generally speaking, compared to women, men are less dissatisfied with their own body and consider themselves to be better-looking and less overweight. So far, however, it is unclear whether these divergent body ratings arise from the application of double standards. With the present study, we examined whether men apply different standards to their own body than to other men's bodies and whether they differ from women in this regard. To this aim, we presented n = 104 women and n = 93 men with pictures of thin, average-weight, overweight, athletic and hypermuscular male and female bodies on a computer screen. To manipulate identification, we showed the bodies of the respective participant's gender once with the participant's own face and once with the face of another person. Identity cues, such as faces, might activate different body schemata, which influence body ratings and thus lead to the application of double standards. Participants were instructed to rate their emotional reaction to the bodies according to valence and arousal, and to rate the bodies with respect to attractiveness, body fat, and muscle mass. The application of double standards was determined by calculating the difference between the rating of a body presented with the participant's face and the rating of the same body presented with another person's face. Both women and men showed self-deprecating double standards in valence, body attractiveness, body fat and muscle mass for the overweight body. Men also revealed self-deprecating double standards for the thin, average-weight and hypermuscular bodies, but evaluated the athletic body as more attractive and with a higher positive feeling when it was presented with their own face. Women did not show any self-serving double standards and showed fewer self-deprecating double standards than men. The results indicate that men devalue non-ideal bodies and upvalue ideal bodies when they are self-related, whereas women more rate in a fair-minded manner. Thus, in contrast to women, an advantage for men may be that they are able to self-enhance in the case of desirable bodies. This ability to self-enhance regarding desirable features might be beneficial for men's self-worth and body satisfaction.

Diminishing covariation bias in women with a negative body evaluation and the potential roles of outcome aversiveness and interpretation of social feedback.

Women with a more negative body evaluation perceive that their body is associated with more negative social feedback. This covariation bias could reinforce negative body evaluation. We investigated whether covariation bias could be diminished and explored the potential roles of outcome aversiveness and interpretation of negative social feedback associated with one's body. Ninety-seven undergraduate women completed a computer task wherein photos of their body, a control woman's body, and a neutral object were followed by negative social feedback or nothing. When the relation between each category and the negative feedback was random, women with a more negative body evaluation perceived more negative feedback following their body. They also experienced negative feedback following their body and the control woman's body as more aversive. After a manipulation block, women with a more negative body evaluation no longer perceived more negative feedback for their body. These effects coincided with improvements in state body evaluation.

Covariation bias in women with a negative body evaluation: How is it expressed and can it be diminished?

BACKGROUND AND OBJECTIVES: Women with a negative body evaluation display covariation bias: They overestimate the relation between their own body and negative social feedback. This study aimed to develop a more fine-grained understanding of this covariation bias and to determine whether it could be diminished. METHODS: Seventy women completed a computer task wherein three categories of stimuli--pictures of their own body, a control woman's body, and a neutral object--were followed by (nonverbal) negative social feedback or nothing. Participants' estimates of the relation between each stimulus category and negative social feedback were assessed throughout the task. RESULTS: Before starting the task, women with a more negative state body evaluation expected their body to be followed by more negative social feedback (demonstrating a priori covariation bias). During the task, when the relation between stimulus category and negative social feedback was random, women with a more negative trait and state body evaluation perceived at the present moment (online covariation bias) and retrospectively (a posteriori covariation bias) that their body was followed by more negative social feedback. When contingencies were manipulated so that women's own body was rarely followed by negative social feedback, covariation bias was temporarily diminished; this coincided with improvements in state body evaluation. LIMITATIONS: The task did not incorporate neutral or positive social feedback and focused only on undergraduate women. CONCLUSIONS: Covariation bias exists preexperimentally and occurs when situational information is ambiguous. It is possible to (temporarily) diminish covariation bias. This might be a technique for improving body evaluation.

Seeing ghosts: negative body evaluation predicts overestimation of negative social feedback.

The current study investigated whether negative body evaluation predicts women's overestimation of negative social feedback related to their own body (i.e., covariation bias). Sixty-five female university students completed a computer task where photos of their own body, of a control woman's body, and of a neutral object, were followed by nonverbal social feedback (i.e., facial crowds with equal numbers of negative, positive, and neutral faces). Afterward, women estimated the percentage of negative, positive, and neutral social feedback that followed their own body, the control woman's body, and the neutral object. The findings provided evidence for a covariation bias: negative body evaluation predicted higher estimates of negative social feedback for women's own body, but not for the other stimuli. Additionally, the covariation bias was not explained by differences in how women interpreted the social feedback (the facial stimuli). Clinical implications of the covariation bias to body image are discussed.