Experimental investigation of disturbances in body image estimation in anorexia nervosa patients, and ballet and gymnastics pupils

Abstract

Three different methods were used to study perceptual disorders of body image in 36 anorexia nervosa patients and 35 age-matched ballet/gymnastics pupils: (1) a video distortion of width of head and whole body of the subject; (2) a modification of the Image Marking Procedure first described by Askevold (1975); and (3) the Body Image Screening Scale, a paper-pencil version (not in a scale of 1:1, but diminished) of (2) (Fichter & Meermann, 1981). Concerning the video task (1), both groups under investigation show underestimation of their own body dimensions (head, whole body “en face,” whole body “en profile”) and of a female dummy. Underestimation seems to be due to the method used. For the other techniques (2,3), we found the known overestimation of body dimensions in anorexia nervosa patients. But the ballet/gymnastics pupils show overestimation as well. Anorexia nervosa patients show significantly higher overestimation in both techniques only for the thighs, calves, and hips. In neither task 1 nor task 3 were there significant differences found between patients and pupils in estimating the size of a female dummy, confirming that our methods deliver information about body image disturbances and not about a more general perceptual disorder including external objects. The diagnostic and therapeutic implications of body image disturbances in anorexia nervosa are discussed.