The Role of Specific Experiences in Childhood and Youth in the Development of Body Integrity Identity Disorder (BIID)

Abstract

Task: BIID (Body Integrity Identity Disorder) is an intense feeling of discrepancy between a real intact body and the subjective mental image of a disabled body (e.g. amputation, palsy). The disturbance exists since late childhood or early adolescence and often results in the desire for a surgery. The cause is still unknown but may lie in early developmental phases. Until now, childhood experiences have not been subject of systematic psychological research of BIID. Methods: On the basis of specific hypotheses we investigated differences between a BIID-group (n= 36) and an age and gender parallelized group (n= 36). BIID sufferers vs. control subjects were examined for the following characteristics: quality and quantity of experiences with mental and physical disease, experiences with secondary profit from illness, maladaptive education (emotional neglect, overprotection) and a general admiration for handicapped people in their youth. Results: On the basis of the findings of the present study, it can be assumed, that BIID afflicted persons had experienced no considerable maladaptive education from their parents, neither in the direction of physical abuse nor as overprotective control. On the other hand we found significant differences in specific childhood experiences, particularly with regard to quantity and quality of emotional experience with disability; e.g. participants from our BIID-group reported significantly more disabled people in their former environment than participants from our control group (M BIID = 3.69 ± 0.75, M control = 1.47 ± 0.41, p= 0.004). Moreover we found significant discrepancies according to positive or negative associations towards disability in childhood (M BIID= 5.44 ± 0.31, M control = 3.88 ± 0.29, p< 0.01). We assume those specific experiences with handicapped people in the surrounding of BIID-patients as to be a trigger for early conflicts with the appearance of their own body and an intense feeling that a disabled body fits better to their mental body image. Future investigation should focus on the validation of those cognitions, e.g. through a comparison of BIID-affected people who shared the same social environment in childhood (e.g. siblings).