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Body Integrity Identity Disorder: Deranged Body Processing, Right Fronto-Parietal Dysfunction, and Phenomenological Experience of Body Incongruity

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Abstract

Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in “non-belonging” of body parts, and the subsequent desire to amputate, paralyse or disable a limb. Little is known about BIID; however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation. The present review systematically investigates which aspects of neurological processing of the body, and sense of self, may be compromised in BIID. We argue that the disorder most likely reflects dysregulation in multiple levels of body processing. That is, the disunity between self and the body could arguably come about through congenital and/or developmental disruption of body representations, which, together with altered multisensory integration, may preclude the experience of self-attribution and embodiment of affected body parts. Ulimately, there is a need for official diagnostic criteria to facilitate epidemiological characterisation of BIID, and for further research to systematically investigate which aspects of body representation and processing are truly compromised in the disorder.

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Acknowledgements

Melita J. Giummarra is supported by a Monash University Postgraduate Publication Award, and Monash Bridging Fellowship. Michael E. R. Nicholls is supported by an ARC Discovery project [#DP0986118]. Peter Brugger was supported by a grant from The Swiss National Science Foundation (# 320030_127480/1).

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Authors and Affiliations

  1. Experimental Neuropsychology Research Unit, School of Psychology and Psychiatry, Monash University, Wellington Road, Clayton, VIC, 3800, Australia

    Melita J. Giummarra & John L. Bradshaw

  2. School of Psychology, Flinders University, Bedford Park, SA, Australia

    Michael E. R. Nicholls

  3. Neuropsychology Unit, Department of Neurology, University Hospital, Zurich, Switzerland

    Leonie M. Hilti & Peter Brugger

  4. Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland

    Peter Brugger

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  1. Melita J. Giummarra
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  2. John L. Bradshaw
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  3. Michael E. R. Nicholls
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  4. Leonie M. Hilti
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  5. Peter Brugger
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Correspondence to Melita J. Giummarra.

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Giummarra, M.J., Bradshaw, J.L., Nicholls, M.E.R. et al. Body Integrity Identity Disorder: Deranged Body Processing, Right Fronto-Parietal Dysfunction, and Phenomenological Experience of Body Incongruity. Neuropsychol Rev 21, 320–333 (2011). https://doi.org/10.1007/s11065-011-9184-8

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