Page 88 - JCBP-2-4

Journal of Clinical and
Basic Psychosomatics Adverse life events and body image

Finally, linear regression analysis revealed that pre-13 symptoms usually attempt to change/criticize the ideal
interpersonal ALEs predicted both visual and non-visual image of a thin body. Therapeutic interventions should
BID. The model was also suitable for predicting the levels focus on identifying patients who have experienced
of perfectionism and impulsivity in the ED group. BID interpersonal ALEs during childhood. This will facilitate
is considered an independent factor for predicting low the application of appropriate interventions based on
body weight in patients with anorexia nervosa or fasting reestablishing a secure attachment through a therapeutic
in patients with bulimia nervosa. This study suggests relationship, thereby enabling patients to reconstruct a
36
that BID is dependent on interpersonal ALEs during positive body image. 13,32
middle childhood. In general, interpersonal ALEs have
been associated with the cognitive aspects of body image 4.2. Limitations
in patients with ED. 3,7,33 Possible mediators include post- Regarding the study limitations, the small number
traumatic stress disorder and binge eating. Impulsivity of participants in each subgroup should be noted,
5,15
and perfectionism are fundamental psychopathological particularly in the RMDD group. This is because the
dimensions of individuals with ED that can be used as sample was collected during the COVID-19 pandemic.
prognostic factors for assessing disease progression. 36,37 In addition, the ED sample was heterogeneous because
The experience of interpersonal trauma during childhood it included patients with active disease and patients who
may lead to starvation and body control as a means to had recovered, the trauma assessment was retrospective
manage negative emotions, likely due to unrecognized without the possibility of establishing cause–effect
feelings such as shame. If this mechanism fails or if the relationships, and the assessment was observational
33
patient exhibits high impulsivity, binge eating may assist in and non-experimental. Although retrospective trauma
the management of negative emotions. assessment may have recall bias, only a few false
The results of this study revealed that there may be a positives have been reported in other studies, and the
transfer of negative self-perceptions and emotions onto questionnaires were administered anonymously, which
40
the body when evaluating body shape. Therefore, the may encourage honest responses. Finally, due to the
evaluation of BID should be replaced with a cognitive– small sample size, a more robust statistical analysis could
affective one. This change is considered necessary because not be performed.
individuals with ED do not experience a change in body 5. Conclusion
perception; instead, they engage in a negative evaluation of
their bodies. 32,33,38 On closing our eyes, we experience internal or external
sensory experiences that may be pleasant or unpleasant.
4.1. Strengths and clinical implications Consequently, the negative perception of BID experienced

The methodology used in this study could be easily by patients with ED is arguably attributed to unresolved
replicated. It categorizes the perceptual component of body emotions rather than social pressure. 30,32,33
image into visual and non-visual images, making it easier The results of this study suggest that impulsivity
to understand body image. The visual image could respond and perfectionism act as non-specific risk factors
to a social bias influence, whereas the non-visual image for ED development and that experiencing a pre-
could respond to an emotional bias. This may help promote 13 interpersonal ALE could be a risk factor for the
specific interventions for patients with ED who have development of BID, impulsivity, and perfectionism
recognized ALEs to achieve a better outcome, such as the in adulthood. On the contrary, BID in patients with
narrative approach or multiple access psychotherapy, where ED appears to have a non-visual component that is
the therapist adapts the strategy according to the patient’s likely related to negative internal emotions resulting
report. ED-trained clinicians performed the diagnostic from childhood ALEs. In addition, individuals with
32
evaluation using the DSM5 diagnostic guidelines. The childhood ALEs may seek to control their bodies due
22
assessment included a control group of healthy participants to the presence of unacknowledged emotions. Thus,
and a study group of patients with affective pathology. This to identify interpersonal risk situations, body image
approach differs from conventional studies that typically should not be considered as an independent factor
focus only on the ED population. In addition, a dimensional but as a dimension that can be modified through early
perspective was used to comprehensively examine the intervention strategies during childhood.
common aspects across all treatable EDs. 39
Acknowledgments
Our findings suggest that BID is not primarily based
on social influence. Preventive interventions to reduce ED None.

Volume 2 Issue 4 (2024) 8 doi: 10.36922/jcbp.4662