Wie relevant sind Diagnostik und Behandlung der Körperbildstörung?

Zusammenfassung

In der Behandlung von Anorexia und Bulimia Nervosa gewinnen körperbildbezogene Interventionen zunehmend an Bedeutung. Die verschiedenen Manifestationsebenen der Körperbildstörung – die perzeptive, kognitiv-emotionale und behaviorale Ebene – wurden hinsichtlich ihrer ätiologischen, diagnostischen und klinisch-therapeutischen Relevanz mittels verschiedener wissenschaftlicher Methoden untersucht. Dennoch sind zahlreiche Fragen in Bezug auf die Entstehung und Aufrechterhaltung der Körperbildstörung sowie den effektiveren Einsatz entsprechender psychotherapeutischer Interventionen noch ungeklärt. Wünschenswert wären eine Integration der einzelnen Körperbildkomponenten im Rahmen theoretischer Modelle sowie eine Weiterentwicklung der Behandlungsbausteine unter Berücksichtigung spezifischer Indikationsstellungen.

Abstract

Body image-related interventions become increasingly important in the treatment of anorexia and bulimia nervosa. Previous studies concerning body image disturbance conducted by means of diverse research methods focused on different components of body image – the perceptive, cognitive-emotional and the behavioral component. However, regarding the etiology, maintenance and treatment of body image disturbance in eating disorders, many questions remain unanswered. An integrative perspective on the different body image components within a theoretical framework as well as the development of specific body image-related interventions according to individual indications would be desirable.

Schlüsselwörter

Körperbildstörung - Diagnostik - Behandlung - Anorexia nervosa - Bulimia nervosa

Keywords

body image disorder - diagnostics - treatment - anorexia nervosa - bulimia nervosa

• Literatur

• 1 American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5^th ed. Arlington, VA: American Psychiatric Association; 2013
• 2 Fairburn CG, Cooper Z, Shafran R. Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther 2003; 41: 509-528
• 3 Ahrberg M, Trojca D, Nasrawi N et al. Body image disturbance in Binge Eating Disorder: A review. Eur Eat Disord Rev 2011; 19: 375-381
• 4 Cash TF. Body image: Past, present, and future. Body Image 2004; 1: 1-5
• 5 Thompson JK. The (mis)measurement of body image: Ten strategies to improve assessment for applied and research purposes. Body Image 2004; 1: 7-14
• 6 Tuschen-Caffier B, Florin I. Teufelskreis Bulimie. Ein Manual zur psychologischen Therapie. 2. Aufl Göttingen: Hogrefe; 2012
• 7 Rohde P, Stice E, Marti CN. Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. Int J Eat Disord
• 8 Boone L, Soenens B, Braet C. Perfectionism, body dissatisfaction, and bulimic symptoms: The intervening role of perceived pressure to be thin and thin ideal internalization. J Soc Clin Psychol 2011; 30: 1043-1068
• 9 Hutchinson DM, Rapee RM, Taylor A. Body dissatisfaction and eating disturbances in early adolescence: A structural modeling investigation examining negative affect and peer factors. J Early Adolesc 2010; 30: 489-517
• 10 Ricciardelli LA, Tate D, Williams RJ. Body dissatisfaction as a mediator of the relationship between dietary restraint and bulimic eating patterns. Appetite 1997; 29: 43-54
• 11 Stice E. Risk and maintenance factors for eating pathology: A meta-analytic review. Psychol Bull 2002; 128: 825-848
• 12 Fairburn CG, Peveler RC, Jones R et al. Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. J Consult Clin Psychol 1993; 61: 696-698
• 13 Fairburn CG, Stice E, Cooper Z et al. Understanding persistence in Bulimia nervosa: A 5-year naturalistic study. J Consult Clin Psychol 2003; 71: 103-109
• 14 Keel PK, Dorer DJ, Franko DL et al. Postremission Predictors in Women with Eating Disorders. Am J Psychiatry 2005; 162: 2263-2268
• 15 Thompson MA, Gray JJ. Development and validation of a new body-image assessment scale. J Pers Assess 1995; 64: 258-269
• 16 Farrell C, Lee M, Shafran R. Assessment of body size estimation: A review. Eur Eat Disord Rev 2005; 13: 75-88
• 17 Smith E, Rieger E. The effect of attentional training on body dissatisfaction and dietary restriction. Eur Eat Disord Rev 2009; 17: 169-176
• 18 Smith E, Rieger E. An investigation of the effect of body dissatisfaction on selective attention toward negative shape and weight-related information. Int J Eat Disord 2010; 43: 358-364
• 19 Vossbeck-Elsebusch AN, Waldorf M, Legenbauer T et al. Overestimation of body size in eating disorders and its association to body-related avoidance behavior. Eat Weight Disord
• 20 Shafran R, Lee M, Payne E et al. An experimental analysis of body checking. Behav Res Ther 2007; 45: 113-121
• 21 Latner JD. Body Checking and Avoidance among behavioral weight-loss participants. Body Image 2008; 5: 91-98
• 22 Blechert J, Ansorge U, Tuschen-Caffier B. A Body-Related Dot-Probe Task Reveals Distinct Attentional Patterns for Bulimia nervosa and Anorexia nervosa. J Abnorm Psychol 2010; 119: 575-585
• 23 Rieger E, Schotte DE, Touyz SW et al. Attentional biases in eating disorders: A visual probe detection procedure. Int J Eat Disord 1998; 23: 199-205
• 24 Shafran R, Lee M, Cooper Z et al. Attentional bias in eating disorders. Int J Eat Disord 2007; 35: 93-101
• 25 Jansen A, Nederkoorn C, Mulkens S. Selective visual attention for ugly and beautiful body parts in eating disorders. Behav Res Ther 2005; 43: 183-196
• 26 Roefs A, Jansen A, Moresi S et al. Looking good. BMI, attractiveness bias and visual attention. Appetite 2008; 51: 552-555
• 27 Wietersheim J, Kunzl F, Hoffmann H et al. Selective Attention of Patients With Anorexia nervosa While Looking at Pictures of Their Own Body and the Bodies of Others: An Exploratory Study. Psychosom Med 2012; 74: 107-113
• 28 Suchan B, Vocks S, Waldorf M. Alterations in activity, volume and connectivity of body-processing brain areas in Anorexia nervosa: A review. Eur Psychol [in press]
• 29 Gaudio S, Quattrocchi CC. Neural basis of a multidimensional model of body image distortion in anorexia nervosa. Neurosci Biobehav Rev 2012; 36: 1839-1847
• 30 Williamson DA, White MA, York-Crowe E et al. Cognitive-behavioral theories of eating disorders. Behav Modif 2004; 28: 711-738
• 31 Vocks S, Legenbauer T. Körperbildtherapie bei Anorexia und Bulimia nervosa. Ein kognitiv-verhaltenstherapeutisches Behandlungsprogramm. 2. überarb. Aufl Göttingen: Hogrefe; 2010
• 32 Salbach-Andrae H, Jacobi C, Jaite C. Anorexia und Bulimia nervosa im Jugendalter. Weinheim: Beltz; 2010
• 33 Smolak L, Thompson JK. Body Image, Eating Disorders and Obesity in Youth: Assessment, Prevention, and Treatment. Washington, DC: American Psychological Association; 2009
• 34 Rosen JC. Cognitive-behavioral body-image therapy. In: Garner DM, Garfinkel PE. eds. Handbook of treatment for eating disorders. 2^nd ed New York: Guilford; 1998: 188-201
• 35 Cash TF, Hrabosky JI. Treatment of body image disturbances. In: Thompson JK. ed. Handbook of eating disorders and obesity. New Jersey: John Wiley & Sons; 2004: 515-541
• 36 Legenbauer T, Schütt-Strömel S, Hiller W et al. Predictors of improved eating behaviour following body image therapy: A pilot study. Eur Eat Disord Rev 2011; 19: 129-137
• 37 Vocks S, Legenbauer T, Troje N et al. Körperbildtherapie bei Essstörungen: Beeinflussung der perzeptiven, kognitiv-affektiven und behavioralen Körperbildkomponente. Z Klinische Psychol Psychother 2006; 35: 286-295
• 38 Vocks S, Schulte D, Busch M et al. Changes in neuronal correlates of body image processing by means of cognitive-behavioural body image therapy for eating disorders: A randomised-controlled fMRI study. Psychol Med 2011; 41: 1651-1664
• 39 Key A, George C, Beattie D et al. Body image treatment within an inpatient program for anorexia nervosa: The role of mirror exposure in the desensitization process. Int J Eat Disord 2002; 31: 185-190