Article

Body integrity identity disorder.

Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
PLoS ONE (Impact Factor: 3.53). 04/2012; 7(4):e34702. DOI: 10.1371/journal.pone.0034702
Source: PubMed

ABSTRACT Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID.
Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared.
Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification.
The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

Full-text

Available from: Damiaan Denys, Jun 10, 2015
2 Followers
 · 
269 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article discusses the acquisition of a physical impairment/disability through voluntary body modification, or transability. From the perspectives of critical genealogy and feminist intersectional analysis, the article considers the ability and cis*/trans* axes in order to question the boundaries between trans and transabled experience and examines two assumptions impeding the conceptualization of their placement on the same continuum: 1) trans studies assumes an able-bodied trans identity and able-bodied trans subject of analysis; and 2) disability studies assumes a cis* disabled identity. The perception of transsexuality and transability as mutually exclusive phenomena results from a nonintersectional analysis of transsexuality as an issue of sex/gender, but not of ability, and of transability as an issue of ability, but not of sex/gender. Difficulty recognizing continuities between these phenomena thus stems from an ableist interpretation of sex/gender and a cis(gender)normative* interpretation of ability. This article aims to: 1) enrich intersectional analysis in trans and disability studies and transability scholarship; 2) complicate disability studies, in which disabilities are often presumed to be “involuntary,” and encourage the decentering of a cis* subject; 3) encourage trans studies to decenter an able-bodied subject; and 4) advocate for increased dialogue and the creation of alliances between trans and disability studies and movements.
    Hypatia A Journal of Feminist Philosophy 09/2014; 30(1). DOI:10.1111/hypa.12113 · 0.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: In BIID a disorder of body identity, concerned subjects desire an amputation of a healthy limb. So far, no psychiatric comorbidity was found in the few studies on BIID-subjects. Patients and Methods: This study explored clinical symptoms, personality characteristics, interpersonal aspects and coping strategies in 15 BIID persons. Psychometric testing on the topics (1) clinical symptoms, (2) personality and interpersonal aspects, (3) coping strategies, (4) attitudes towards the bodywere used and statistically evaluated with the T-test for one sample. Results: Some psychopathologies such as depression, anxiety and obsessive-compulsive disorders (OCD) could be excluded although an increased tendency of depressiveness was found. BIID subjects showed specific personality and interpersonal characteristics: high agreeableness, autonomy, autarky and restrained behaviour towards others. Stress and conflicts are managed by selfcontrol and self-affirmation. Their subjective physical attractiveness was low. Conclusion: BIID persons do not exhibit psychopathological characteristics (such as anxiety, depression or OCD), but do showspecifics in personality, relationships and copingmechanisms. In the future, further personality traits and personality
    Fortschritte der Neurologie · Psychiatrie 05/2014; 82:250-260. DOI:10.1055/s-0034-1366245 · 0.76 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Today, the anthropomorphism of the tools and the development of neural interfaces require reconsidering the concept of human-tools interaction in the framework of human augmentation. This review analyzes the plastic process that the brain undergoes when it comes into contact with augmenting artificial sensors and effectors and, on the other hand, the changes that the use of external augmenting devices produces in the brain. Hitherto, few studies investigated the neural correlates of augmentation, but clues on it can be borrowed from logically-related paradigms: sensorimotor training, cognitive enhancement, cross-modal plasticity, sensorimotor functional substitution, use and embodiment of tools. Augmentation modifies function and structure of a number of areas, i.e. primary sensory cortices shape their receptive fields to become sensitive to novel inputs. Motor areas adapt the neuroprosthesis representation firing-rate to refine kinematics. As for normal motor outputs, the learning process recruits motor and premotor cortices and the acquisition of proficiency decreases attentional recruitment, focuses the activity on sensorimotor areas and increases the basal ganglia drive on the cortex. Augmentation deeply relies on the frontoparietal network. In particular, premotor cortex is involved in learning the control of an external effector and owns the tool motor representation, while the intraparietal sulcus extracts its visual features. In these areas, multisensory integration neurons enlarge their receptive fields to embody supernumerary limbs. For operating an anthropomorphic neuroprosthesis, the mirror system is required to understand the meaning of the action, the cerebellum for the formation of its internal model and the insula for its interoception. In conclusion, anthropomorphic sensorized devices can provide the critical sensory afferences to evolve the exploitation of tools through their embodiment, reshaping the body representation and the sense of the self.
    Frontiers in Systems Neuroscience 06/2014; 8(109). DOI:10.3389/fnsys.2014.00109