Dissociation and Body Image Instability in Eating Disorders

Abstract

Background: Body image disturbances are central to the psychopathology of eating disorders (ED). There is growing recognition that body image is not stable and can be influenced by a variety of factors, however it remains unclear whether perceptual deficits exist in ED individuals. Recent research suggests that experiences of dissociation may undermine the stability of body image and create a vulnerability to body image disturbances. Dissociation is commonly observed in ED and has been linked to body image disturbance. The present study aimed to investigate the relationships between experiences of dissociation, body image disturbance and perceptual body image instability in a group of ED individuals, dieters (DT), and non-dieting healthy controls (HC). Method: 20 individuals diagnosed with an ED, 20 DT, and 20 HC completed experimental and self-report measures of dissociation, body disturbance, body checking and body image instability. Perceptual body image instability was measured using the Rubber Hand Illusion (Botvnik & Cohen, 1998). Results: Findings suggest ED individuals experience higher levels of dissociation, body image disturbance and body checking than HC and DT groups. Contrary to hypotheses, body image instability did not significantly differ between groups. Positive relationships were found between psychological dissociation and body checking cognitions in ED (r(20)=0.52, p<0.01) and in DT (r(20)=0.54, p<0.01). Furthermore, exploratory mediation analysis revealed that body checking cognitions were a significant predictor of the relationship between psychological dissociation and body dissatisfaction (z=-3.28, p<0.01). Conclusions: Body image disturbance in ED is a complex multi-factorial psychopathology. The study did not confirm whether ED individuals experience higher perceptual body image instability than controls; instead findings suggest cognitive-emotional influences impact upon body disturbance in ED to a greater degree. Furthermore, results showed that cognitions surrounding body checking are a significant maintaining factor in the relationship between psychological dissociation and body dissatisfaction. For some individuals, body checking may serve as a method of grounding themselves when experiencing dissociation. Findings have implications for the assessment and treatment of body image in ED.

Date of Award	2014
Original language	English
Awarding Institution	King's College London
Supervisor	Kate Tchanturia (Supervisor) & Vicki Mountford (Supervisor)