Department of Mental Health, USLCENTRO, Florence, Italy.
Department of Health Sciences, University of Florence, Florence, Italy.
Early Interv Psychiatry. 2024 Nov;18(11):901-911. doi: 10.1111/eip.13527. Epub 2024 Apr 13.
Psychotic-like anomalous self-experiences (ASEs) are core and early features of schizophrenia spectrum disorders, which have been recently also postulated to underlie embodiment disturbance in feeding and eating disorders (FEDs). The present study was aimed at investigating the interplay between ASEs and specific psychopathology in FED.
Ninety persons with Anorexia Nervosa and 41 with Bulimia Nervosa were evaluated with the inventory of psychotic-like anomalous self-experiences (IPASE), identity and eating disorders (IDEA), body uneasiness test (BUT), and eating disorder examination questionnaire (EDE-Q). The same assessment was performed for 92 subjects recruited from the general population. Structural equation modelling was employed to test the role of embodiment/identity disorders in mediating the relationship between ASEs and ED psychopathology.
Patients with FED displayed high scores on IPASE, comparable with people with schizophrenia spectrum disorders. A significant correlation was also demonstrated between IPASE, BUT and EDE-Q. All IPASE domains were strongly related to feeling extraneous from one's own body by IDEA. All IPASE domains demonstrated a high relationship with BUT Depersonalization scale. A strong correlation was also reported between total scores of IPASE and IDEA. The mediation model confirmed that ASEs impact on FED symptomatology through the mediation of both embodiment/identity disorders and body image.
Anomalous interoceptive processes may represent the first step of a maladaptive process-impairing embodiment, selfhood, and identity in FED. Assessment of ASEs might be a valid tool to identify an early-shared vulnerability of severe disorders characterized by embodiment alterations.
类精神病样异常自我体验（ASEs）是精神分裂症谱系障碍的核心和早期特征，最近也有人假设它们是进食和饮食障碍（FED）中身体感觉障碍的基础。本研究旨在调查 FED 中 ASEs 与特定精神病理学之间的相互作用。
评估 90 名厌食症患者和 41 名贪食症患者的类精神病样异常自我体验量表（IPASE）、身份和饮食障碍量表（IDEA）、身体不适测试（BUT）和饮食障碍检查问卷（EDE-Q）。对从普通人群中招募的 92 名受试者进行了相同的评估。结构方程模型用于测试身体/身份障碍在介导 ASEs 和 ED 精神病理学之间关系中的作用。
FED 患者的 IPASE 评分较高，与精神分裂症谱系障碍患者相当。IPASE、BUT 和 EDE-Q 之间也存在显著相关性。IPASE 的所有领域都与 IDEA 中对自身身体的陌生感密切相关。IPASE 的所有领域都与 BUT 人格解体量表高度相关。IPASE 总分与 IDEA 也有很强的相关性。中介模型证实，ASEs 通过身体/身份障碍和身体意象的中介作用对 FED 症状产生影响。
异常的内脏感觉过程可能代表了 FED 中适应不良过程的第一步，这种过程会损害身体感觉、自我意识和身份。ASEs 的评估可能是识别以身体改变为特征的严重障碍的早期共同脆弱性的有效工具。
