Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano Milan, Italy ; Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy.
Front Hum Neurosci. 2014 May 6;8:236. doi: 10.3389/fnhum.2014.00236. eCollection 2014.
Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models-the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory-identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies-body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric).
临床心理学开始将饮食失调（ED）解释为认知、社会情感和人际因素相互作用的结果。特别是两个有影响力的模型——修正后的认知-人际维持模型和跨诊断认知行为理论——确定了可能的关键易感和维持因素。这些模型，尽管非常有影响力并能够为治疗提供明确的建议，但仍不能回答几个关键问题：为什么不是所有具有强迫特质、焦虑回避或自我评估功能失调模式的人都会发展为 ED？身体体验在这些疾病的发病机制中扮演什么角色？在本文中，我们提出，要找到有意义的答案，需要将这些模型与认知神经科学的最新成果结合起来。首先，我们的身体表象不仅仅是映射外部空间的一种方式，而是我们用来生成意义、组织经验和塑造社会认同的主要工具。特别是，我们将论证我们的身体体验是通过整合六个不同的身体表象来进化的，这些表象具有特定的病理学特征——身体图式（幻肢）、空间身体（单侧半球忽视）、主动身体（异体手综合征）、个人身体（自动体视现象）、客观化身体（异物妄想）和身体意象（身体变形障碍）。其次，这些表象包括图式（非自我中心）或知觉（自我中心）内容，它们通过从长时记忆中检索到的内容与从感知中获得的当前自我中心内容之间的对齐，在个体的工作记忆中相互作用。从这个角度来看，ED 可能是个体更新存储在自传体记忆中的负面身体表象（非自我中心）的能力受损的结果，这种更新需要实时的感觉运动和本体感觉数据（自我中心）。
