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Consciousness and body image: lessons from phantom limbs, Capgras syndrome and pain asymbolia.

Words such as 'consciousness' and 'self' actually encompass a number of distinct phenomena that are loosely lumped together. The study of neurological syndromes allows us to explore the neural mechanisms that might underlie different aspects of self, such as body image and emotional responses to sensory stimuli, and perhaps even laughter and humour. Mapping the 'functional logic' of the many different attributes of human nature on to specific neural circuits in the brain offers the best hope of understanding how the activity of neurons gives rise to conscious experience. We consider three neurological syndromes (phantom limbs, Capgras delusion and pain asymbolia) to illustrate this idea.

Body Image↗

Studies of body image. IV. Figure drawings in normal and abnormal geriatric and nongeriatric groups.

Figure drawings were obtained from 72 normal adults, 48 adult psychiatric inpatients, 30 senior citizens, and 33 elderly inpatients in a mental hospital. Blind analyses were carried out for "emotional indicators" and other characteristics such as body image disturbance and intellectual impairment. Significant differences were found on almost all measures between the normal elderly and the normal adult. They were also found to discriminate between the normal adult group and the adult psychiatric patients. Very few differences were found between the normal elderly and elderly psychiatric patients, or between normal elderly and adult psychiatric patients. These results imply that norms based upon figure drawings of children or adults may not apply to the elderly and that, therefore, figure drawings may be a less useful diagnostic tool for elderly people than they are for children or adults.

Aged↗

[The body image of children of nursery school age].

Both from the view of the pediatrician (16) and the child analyst (3, 6, 9, 21), and recently, too, by behavioral biologists (15) the emotional aspects of illness and hospitalization have been treated with increasing differentiation. On the other hand there are only few studies regarding the cognitive aspects of the problem, i.e. the concepts children have of their bodies and of illness, which depend on the momentary level of their intellectual development. Children's ideas and fears arising from illness or hospitalization frequently can only be understood with the knowledge of the actual body-image. Therefore we have tried to investigate by interviews and drawings of three- to seven-year-old preschoolers their conceptions of the interior of the body and its function. The sources of these ideas were discussed and some suggestions were made how the results of the study could be used in hospital and kindergarten.

Age Factors↗

The patient in a halo brace: striving for normalcy in body image and self-concept.

This retroactive descriptive study identified specific psychologic concerns and needs of halo patients related to the halo experience. Thirty-eight subjects who had a halo brace applied in the previous 8 years completed the questionnaire. Responses were categorized and analyzed using nursing diagnoses. Results showed that distortion of body image, distortion of self-concept, grieving for losses, and striving for normalcy are among the phenomena experienced by halo patients.

Adaptation, Psychological↗

Body image in adulthood: a projective approach.

A sample of 210 persons varying by age (young adults, middle-aged, older adults), gender, and relationship status (single or involved) were administered the Holtzman Inkblot Technique (HIT) and Geriatric Draw-A-Person (G-DAP) to ascertain projectively assessed aspects of body image in adulthood. Results suggested that both the HIT and G-DAP were sensitive to the effects of age and gender, wherein young adults scored higher on both HIT Barrier and Penetration than both middle-aged or older adults. In addition, G-DAP scores favored young adults. HIT Penetration scores varied by both age and relationship status.

Adolescent↗

Body image distortion in anorexia and bulimia nervosa: the role of perceived and actual control.

It has been suggested that a desire for control is a central factor in eating disorders. There is, however, little evidence to support this clinical hypothesis. This experimental study examines the effects of actual and perceived control on a symptom of anorexia and bulimia nervosa-body image distortion. Using a learned helplessness paradigm, it was shown that eating-disordered and comparison women respond differently to manipulations of control. Anorexic and bulimic women appear to have a cognitive style of "mistaken pessimism," overestimating body size more when an easy task is perceived as difficult. In contrast, the comparison women are "mistaken optimists" overestimating less when they see a difficult task as being easy. The clinical implications are discussed and further research is proposed to extend these preliminary findings.

Adult↗

Twenty year experience in maxillocraniofacial surgery. An evaluation of early surgery on growth, function and body image.

We have analyzed 404 patients with a wide variety of maxillary and craniofacial deformities. These do not include head and neck cancer patients as generally defined. Satisfaction has been high as judged by the patients, surgeons and psychiatrists. The complication rate has been significant, approximately 30%, the most common being infection or loss of bone grafts. As experience accumulated, the concept of earlier operative intervention has emerged as an aid in unlocking growth potential, diminishing secondary deformity and improving the development of body image.

Blindness↗

[Aspect of body image in physically disabled youth].

The following study compares body awareness and body satisfaction of physically handicapped and normal adolescents. In addition the correlations between self image were investigated in the group of handicapped adolescents. The comparison showed handicapped youths to have more negative body image. The handycap-associated differences between the 2 groups were paralleled by equally significant gender-associated differences within the group of handicapped adolescents. The differences are similiar to ones described in the literature as typical for normal adolescents. No evidence was found of minimizing or disavowing the illness or of shame for the handicapped body. Instead, a strong wish for contact with healthy youths was evident. The results of the study underline the importance of body-associated psychotherapeutic intervention supplementing the many therapeutic measures of handicapped adolescence.

Adolescent↗

Altered body image: the psychosocial needs of patients.

The psychosocial consequences of a disfiguring condition are well recognized. However, severity does not predict distress, and conditions in which the disfiguration is relatively minor can be disturbing. While the appearance-related concerns of patients with so-called 'minor' conditions such as acne are gradually being reported, body image changes that occur as a result of other conditions and/or their treatment are often overlooked. This article describes an audit of the appearance-related concerns of patients with rheumatic disease and outlines ways in which community nurses might elicit their concerns and address their needs.

Activities of Daily Living↗

Body image.

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Body Image↗