On Pathogenetic Diagnosis and Treatment Based on Conditioned Emotional Response and Self Body Image in Eating Disorders

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We hypothesized that emotional response conditioned on body image might involve in pathogenesis of anorexia nervosa. The body image estimation and the event-related potentials (ERPs) were obtained from 14 patients with anorexia nervosa (DSM-III) and 18 sex- and age-matched healthy young women.1. The subject estimated real and ideal shapes of self body as well as real shape of a coke bottle imitative of a female body. The patients tended to overestimate the real body shape and to underestimate the ideal body shape. In addition, the patient group overestimated the coke bottle shape as compared with the healthy group.2. Negative slow potential (CNV) of the ERPs increased in amplitude for the patients when the words concerned with eating behaviors were used as a warning stimulus (S1). The patients showed larger components of the S1-related P300 and the late CNV when they responded with unpleasant emotion to these words irrespective of their contents than the healthy group did. The patient group showed the ERPs similar to those with the unpleasant response when the words of S1 were the body shape "fatty" and the parent "mother" .3. The CNV of the patients with overestimation of self body shape increased in amplitude as compared with the healthy group with the overestimation, but there was no significant difference between the patient and healthy groups with the underestimation. These results support our hypothesis that the anorexic patients who overestimate their own body shape may have remarkable conditioned emotional responses to body shape.