Di Lernia Daniele, Serino Silvia, Polli Nicoletta, Cacciatore Chiara, Persani Luca, Riva Giuseppe
Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Front Psychol. 2019 Jan 17;9:2488. doi: 10.3389/fpsyg.2018.02488. eCollection 2018.
Anorexia nervosa (AN) is a disorder characterized by alterations in body perception. Recent literature suggested that AN can also impair the processing of stimuli from inside the body (i.e., interoceptive) however, very few studies performed a complete interoceptive assessment exploring the evolution of the interoceptive dimensions before and after the subject's recovery. To address this gap in knowledge, this study presented the case of Diana, a 25 years old woman affected by AN. At hospital admission, Diana performed a complete interoceptive assessment for accuracy (IAc), metacognitive awareness (IAw), sensibility (IAs), and interoceptive buffer saturation (IBs) - a new index that behaviourally evaluated the amount of interoceptive processing. Measures were repeated at the end of an outpatients rehabilitative hospital program, after Diana's recovery. Results were confronted with a control ( = 4) of healthy female subjects. Analyses indicated severe deficits in accuracy, buffer saturation, and sensibility compared to control group. Conversely, metacognitive awareness was pathologically enhanced. After the rehabilitative hospital program, Diana's clinical condition was largely improved and this reflected back on the interoceptive patterns that appeared restored, with no difference in interoceptive accuracy and metacognition compared to the control group. In conclusion, results indicated a very specific dissociation between interoceptive axes in AN with pervasive deficits in perception and processing that were accompanied by a pathologically enhanced confidence in the wrong perceptions. This case study reported an interesting and unique clinical pattern with a severe dissociation between interoceptive perceptions that nonetheless appeared restored after the subject's recovery, highlighting the role of interoceptive assessment in the clinical evolution of AN.
神经性厌食症（AN）是一种以身体感知改变为特征的疾病。最近的文献表明，AN也会损害来自身体内部的刺激（即内感受）的处理，然而，很少有研究进行完整的内感受评估，以探索受试者康复前后内感受维度的变化。为了填补这一知识空白，本研究介绍了戴安娜的案例，她是一名25岁患有AN的女性。入院时，戴安娜进行了全面的内感受准确性评估（IAc）、元认知意识（IAw）、敏感性（IAs）和内感受缓冲饱和度（IBs）——这是一个行为上评估内感受处理量的新指标。在戴安娜康复后，在门诊康复医院项目结束时重复进行了测量。结果与4名健康女性受试者的对照组进行了对比。分析表明，与对照组相比，戴安娜在准确性、缓冲饱和度和敏感性方面存在严重缺陷。相反，元认知意识却病理性增强。经过康复医院项目后，戴安娜的临床状况有了很大改善，这也反映在内感受模式上，内感受模式似乎恢复了，与对照组相比，内感受准确性和元认知没有差异。总之，结果表明AN在内感受轴之间存在非常特殊的分离，感知和处理方面普遍存在缺陷，同时对错误感知存在病理性增强的信心。本案例研究报告了一种有趣且独特的临床模式，内感受感知之间存在严重分离，但在受试者康复后似乎恢复了，突出了内感受评估在AN临床演变中的作用。
