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DOI: 10.1055/s-0028-1100837
Body Integrity Identity Disorder (BIID): Befragung von Betroffenen und Erklärungsansätze
Body Integrity Identity Disorder (BIID): Interrogation of Patients and Theories for ExplanationPublikationsverlauf
Publikationsdatum:
19. Dezember 2008 (online)

Zusammenfassung
Apotemnophilie, Amputee Identity Disorder oder Body Integrity Identity Disorder (BIID) bezeichnen das intensive Gefühl, der Körper wäre „kompletter” nach der Amputation eines Gliedes. Der Artikel diskutiert die Frage nach übereinstimmenden Persönlichkeitseigenschaften Betroffener und fragt nach Motiven. Anhand von Aussagen von 9 Personen werden Beispiele für auslösende Erfahrungen zitiert. Im Gegensatz zu anderen Kindern waren die Betroffenen oft vom Anblick eines Behinderten fasziniert. Im Artikel wird untersucht, ob das entsprechende Körperteil häufiger Erkrankungen zeigte. Geschildert wird typisches Pretending-Verhalten. Geprüft wird, ob es Parallelen zu körperdysmorphen Erkrankungen (BDD), Fetischismus oder Wahn gibt. Diese fielen gering aus, in der Mehrzahl ist der Wunsch auf ein spezifisches Körperteil fixiert, die Betroffenen sind sich der Absonderlichkeit ihres Begehrens völlig bewusst und hadern mit dem Pro und Kontra. Sexuelle Motive fanden sich bei etwa einem Drittel. Einige der Befragten befanden sich in ärztlicher oder psychologischer Behandlung; dies brachte den Amputationswunsch nicht zum Verschwinden. Bei mehreren der unter BIID-Leidenden wechselte der Amputationswunsch von einer Seite auf die andere. Dieser Befund ist mit der gängigen Theorie einer ZNS-Läsion nicht erklärbar. Diese Menschen haben eher das Ideal eines „perfekten” Körpers, der einen Arm oder ein Bein nicht umfasst. Die meisten bewundern die Schönheit eines Stumpfes und sehen Amputierte als „Helden”, die trotz der Behinderung ihr Leben meistern. BIID ist keine einheitliche Störung, sondern man muss mindestens 3 Achsen trennen: 1. Stärke der neuronalen Dysfunktion, 2. psychische Komponenten (z. B. sekundärer Krankheitsgewinn) und 3. Intensität des sexuellen Interesses.
Abstract
Apotemnophilia, Amputee Identity Disorder or Body Integrity Identity Disorder (BIID) is the intensive feeling that the body will be “more complete” after amputation of a limb. The article disputes the question of matching personality characteristics of these subjects and asks for motives. Based on reports of nine individuals, triggering experiences are referred. In contrast to other children, often these subjects were fascinated by the sight of a handicapped person. In the article is investigated, whether the concerned limb showed more affections. Described is typical pretending behavior. Parallels to body dysmorphic disorder (BDD), fetishism, or delusions are investigated. These were minor, in most cases the wish was fixated on a specific limb, the subjects were aware of the abnormity of their desire and quarreled with the pros and cons. Sexual motives were found in one third. Some of the interviewed persons were in medical or psychological therapy; this did not let the desire disappear. In several BIID sufferers the wish for amputation changed, e. g. from the left to the right leg. This finding is not in accordance with the brain-dysfunction-theory. These people rather have an ideal of a “perfect” body minus one arm or leg. Most admire the beauty of a stump, and see amputees as “heroes” who still master their life in spite of their handicap. BIID is not a homogenous disturbance, one should separate three axes: 1. Strength of neuronal dysfunction, 2. Psychic components (e. g. secondary morbid gain) and 3. Intensity of sexual interests.
Schlüsselwörter
BIID - Body Integrity Identity Disorder - Amputee Identity Disorder - Apotemnophilie - Transabilität - Amputation - Amputierte
Key words
BIID - body integrity identity disorder - amputee identity disorder - apotemnophilia - transability - amputation - amputee
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Prof. Dr. phil. Erich Kasten
Institut für Medizinische Psychologie, Universität zu Lübeck
Ratzeburger Allee 160
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eMail: erikasten@aol.com
