In the last decade, neuroscience and psychology alike have paid increasing attention to the study of affective touch, which refers to the emotional and motivational facets of tactile sensation. Some aspects of affective touch have been linked to a neurophysiologically specialised system, namely the C tactile (CT) system. While the role of this system for affiliation, social bonding and communication of emotions have been investigated, less is known about the potential role of affective touch in the awareness of the body as our own, i.e. as belonging to our psychological 'self'. This thesis attempted to contribute to the knowledge on affective touch and its relation to body awareness, by exploring the potential role of this modality to the way we perceive and make sense of our body as our own. Specifically, this work aimed to advance the current state of knowledge by investigating: 1) the effect of affective touch on the sense of body ownership, which is a fundamental aspect of body awareness; 2) the relation between interoceptive modalities, originating both internally (i.e. cardiac awareness) and peripherally (i.e. affective touch), and exteroception in body awareness; 3) the effect of intranasal oxytocin on the perception of affective touch and bodily awareness; 4) the perception and social modulation of affective touch in psychiatric patients who show difficulties in body awareness, namely patients with Anorexia Nervosa, and 5) the modulating role of self-other distinction and of self-other relation in the perception of affective touch and body awareness. In a first experiment (N = 52) the rubber hand illusion paradigm was used to investigate the role played by CT-optimal, affective touch in the sense of body ownership. The results showed that slow, pleasant touch enhanced the experience of embodiment in comparison to faster, neutral touch, suggesting that affective touch might uniquely contribute to the sense of body ownership. The following study (N = 75), used a similar methodology to test whether interoceptive sensitivity as measured by a heartbeat counting task would modulate the extent to which affective touch influences the multisensory process taking place during the rubber hand illusion. The results could not confirm a systematic relation between interoceptive sensitivity and the perception of affective touch, nor its influence on body ownership. The next study (N = 41) included a double-blind, placebo-controlled, randomised, cross-over design testing the effect of intranasal oxytocin on the perception of affective touch and body ownership, as measured by means of the rubber hand illusion. There was no evidence supporting the hypothesis that intranasal oxytocin could influence the CT system as tested in this study. The next study (N = 55) applied some of the above methodologies to investigate the perception of CT-optimal touch in patients with anorexia nervosa and its emotional modulation by top-down factors. The results confirmed the hypothesis that people with anorexia nervosa show a reduced perception of affective touch compared to healthy controls, but its perception was not influenced by top-down affective modulation, in the sense that both patients and healthy controls perceived touch as more pleasant when presented concurrently with positive facial expressions compared to neutral and negative faces. Finally, the last two studies (N = 76 and 35 healthy volunteers, respectively) focused on the relationship between affective touch and body awareness in the context of social cognition. These studies used both online and offline social modulation paradigms to investigate the role of self-other distinction and of self-other relation in the perception of affective touch. The results showed that positive top-down social information can enhance the perceived pleasure of tactile stimulation. Taken together, these studies point to the central role of affective touch in body awareness and social cognition. Finally, they also pave the way for future studies examining the role of disruptions of the CT system in the development of neuropsychiatric impairments of body awareness and social cognition.

Diverses disciplines se sont intéressées à l’anorexie mentale au cours des dernières décennies et ont proposé différents modèles pour l’expliquer. Celui qui domine actuellement, le modèle biopsychosocial, permet de comprendre comment cette problématique se met en place au niveau proximal. Toutefois, une question perdure : existe-t-il une fonction biologique à ce trouble? Il s‘agit de l’énigme que les chercheurs adoptant une perspective évolutionniste ont tenté de résoudre. Plusieurs hypothèses ont été proposées et celles-ci seront revues et critiquées dans le cadre de ce mémoire. Ensuite, une hypothèse alternative, l’hypothèse de la compétition intrasexuelle pour le rang, sera présentée et visera à accroître la valeur explicative des modèles proposés. Il sera argumenté que la restriction alimentaire et les troubles qui en découlent sont des sous-produits de l’intensification de la compétition qui existe entre les femmes dans la culture occidentale moderne. Un projet de recherche mené auprès d’étudiantes universitaires a permis de tester certaines des prédictions faites par le modèle évolutionniste par des analyses corrélationnelles et de régression, en plus de tester l’intégration de la variable compétition au modèle de l’influence tripartite grâce à une analyse des pistes causales (Path analysis). Il a été découvert que la comparaison, la compétition et le rang subjectif en lien avec l’apparence physique sont toutes des variables liées à la recherche de minceur. Étant donné la portée limitée de cette étude, davantage de recherches seront nécessaires afin de bien démontrer la pertinence du modèle. / Various disciplines developed an interest in anorexia nervosa during the last decades and presented different models to explain it. The biopsychosocial model, currently prevailing, allows to understand how this issue takes place on a proximal level. However, one question remains : is there a biological function to this disorder? This is the enigma that researchers adopting an evolutionary perspective tried to solve. Several hypotheses have been formulated and those will be reviewed and criticized in the context of this master’s thesis. Thereafter, an alternative hypothesis, the intrasexual competition for rank hypothesis, will be presented and will aim to increase the explanatory value of the proposed models. It will be argued that self-starvation and disorders resulting from this behavior are by-product of the intensified competition existing between women in modern Western culture. A research project conducted among female university students permitted to test some of the predictions made by this evolutionary model via correlation and regression analysis, and to test the integration of the competition variable to the tripartite influence model with a Path analysis. It was discovered that comparison, competition and subjective rank related to physical appearance are all variables related to drive for thinness. Given the limited scope of this study, more research is needed to fully demonstrate the relevance of this model.

Made available in DSpace on 2017-06-01T18:08:23Z (GMT). No. of bitstreams: 1 dissertacao_camila_neiva_confrontada.pdf: 2127950 bytes, checksum: 3d2d428febf247f77ff42e695df51495 (MD5) Previous issue date: 2008-05-20 / Anorexia, known in the scientific community for many centuries, not only comes to arouse interest of specialists and studious on the subject, but also of the media scene and common sense. As it generates concerns in the social and familiar circle, for the proximity with death where some people put themselves, has become subject of different research. Considering these references and the dissemination of blogs number, in the Internet, that bow to anorexia and the search of a bony body like a life style , under Ana s leadership (Ana/orexia), we do in this work a study of problematical body image in anorexia, starting from analysis of female teenagers statements on Brazilians blogs, having psychoanalytical interpretation as analysis resource. We suppose that such attitudes reflect an obscene and transgressive image, illustrated for the desire that these girls have to reach a bony body, being printed the horror of death and pushing the Other to anguish. Analyzing eight blogs, starting from filed posts, regarding of period between January and December of 2006, we search to understand the identification force among pró-anas , the relation that are established between anorexia ( Ana ) and bulimia ( Mia ) and the way as they are seen themselves, when marking a particular queerness in its bodies and doing the blog a place of lusting and communication among psychical ghosts. With this study, we hope to offer subsidies for the handling in addition clinic and symptoms that take the body in consideration / A anorexia, conhecida na comunidade científica, desde séculos anteriores, vem despertando interesse não só dos especialistas e estudiosos sobre o assunto, mas também da cena midiática e do senso comum. E, na medida em que gera preocupações, no meio social e familiar, pela proximidade com a morte em que certos sujeitos se colocam, ela tem-se tornado tema de diferentes pesquisas. Considerando essas referências e a difusão do número de blogs, na Internet, que reverenciam a anorexia e a busca de um corpo ossudo como um estilo de vida , sob o comando da líder virtual Ana (Ana/orexia), fazemos, neste trabalho e à luz da psicanálise, um estudo sobre as vicissitudes da imagem corporal nessa problemática, por meio da análise de blogs brasileiros, construídos por adolescentes do sexo feminino. Supomos que tais atitudes refletem uma imagem obscena e transgressora, ilustrada pelo desejo que essas garotas possuem de alcançar um corpo com ossos à mostra, estampando o horror da morte e empurrando o Outro à angústia. Analisando oito blogs, a partir de postagens arquivadas e referentes ao período de janeiro a dezembro de 2006, buscamos compreender a força da identificação existente entre as pró-anas , a relação que é estabelecida entre anorexia ( Ana ) e bulimia ( Mia ) e a maneira pela qual elas se vêem, ao marcarem uma estranheza particular em seus corpos e fazerem do blog um lugar de gozo e de comunicação entre fantasmas. Com este estudo, esperamos oferecer subsídios para novos posicionamentos, quanto ao manejo na clínica da adição e de sintomas que levam em consideração o corpo.

Les troubles du comportement alimentaire (TCA) touchent une part importante de la population et constitue un réel problème de santé publique, il est indispensable d’approfondir nos connaissances sur la physiopathologie des TCA afin d’identifier des perspectives thérapeutiques. L’écriture d’une revue systématique a permis d’évaluer la prévalence des TCA selon le sexe, l’origine géographique ou l’âge de la population étudiée et confirme son augmentation au cours des 15 dernières années. L’analyse des données épidémiologiques des patients avec un TCA de la cohorte Eating Disorder and Longitudinal Survey (EDILS) a souligné le stress et le régime alimentaire comme facteurs de survenue et des similarités entre les comorbidités des 3 catégories larges de TCA (Restrictive, boulimique et compulsive). Ces comorbidités étaient fortement associées entre elles et, selon un cercle vicieux pourrait contribuer au maintien de la physiopathologie des TCA. La littérature suggère l’implication d’une dérégulation peptidergique de la prise alimentaire au cours des TCA qui pourrait inclure un mécanisme immunitaire. Les analyses des échantillons plasmatiques de la cohorte ont permis de mieux définir les profils biologiques de peptides et immunoglobulines associés aux 3 catégories larges de TCA et d’évaluer leur utilité pour le phénotypage des patients. La collecte de selles dans la cohorte offre également la possibilité de préciser les profils de microbiote au cours des différents types de TCA. Cette thèse a donc permis de mieux définir les caractéristiques cliniques des TCA et les perturbations de l’axe microbiote-intestin-cerveau associées, en particulier les dérèglements biologiques. / Eating disorders (ED) affect a large population and are a serious public health issue. It is thus essential to deepen our knowledge of ED pathophysiology in order to open new therapeutic perspectives. The prevalence of ED according to sex, geographical origin or age of the study population and its increase over the last 15 years has been highlighted in a systematic review. The analysis of patients with ED from the Eating Disorder and Longitudinal Survey (EDILS) cohort underlined stress and / or diet as triggering factors and noted similarities between the comorbidities of the 3 broad categories of ED (Restrictive, bulimic and compulsive). These comorbidities were strongly associated with each other, and contributed in a vicious circle to the perpetuation of ED. The literature suggests during ED a dysregulation of neuropeptide signaling of food intake that may include some immunological mechanisms. Analyzes of plasma samples from the EDILS cohort allowed a better definition of the peptides and immunoglobulins profiles associated with the 3 broad categories of ED and to evaluate their utility for phenotyping patients. The collection of feces in the cohort offers the possibility of refining the specificity of the microbiota according to different type of ED. This thesis allows to better define the clinical characteristics of 3 broad categories of ED and disturbances of the microbiota-intestine-brain axis, particularly the associated biological dysregulations of neuropeptide signaling.

The aim of the diploma thesis "Maternal Identification in Anorexia Nervosa" is to map the developmental context of the onset of anorexia nervosa in female patients related with the formation of relationships with immediate caregivers and the detailed focus on the daughter's relationship with the mother. The theoretical part offers a cross-section of psychoanalytic theories that specifically deal with such process. These are mainly the object relations theory, the attachment theory as well as the recent theory of mentalization. The initial premise of the whole work is the femininity itself, the age of the patients when the period of adolescence and female gender are amongst the main risk factors for the development of anorexia nervosa and contribute to the disproportion between male and female patients. The concept of identification between daughter and mother within the separation-individuation process is described both in early childhood and during adolescence. The empirical part focuses on a particular examination of the patient's relationships with primary caregivers, the immediate environment from childhood to adulthood and the factors involved in the development of the disease. Through a semi-structured in-depth interview, the study monitors key moments of psychosocial development in four...

Anorexia nervosa (AN) is a mental illnes manifesting itselg, among other signs, with impaired body schema and rejection of food. Principal focus of the thesis was to assess the discrimination treshold, ability to evaluate sensory perception and body self-concept in adolescent female patients hospitalised with anorexia nervosa. Our goal was to clarify and better understand the still not adequately described neurophysiological aspects of anorexia nervosa. The results were compared to control group; both groups comprised 18 girls, the average age of observed group being 14,7 ± 0,71 years and average age of control group being 15,3 ±0,71 years. Two-point discrimination was examined in three areas - arm, between shoulder blades and belly - with modified caliper. The Petrie test was used in sensory perception testing, while body self-concept was measured with BAT questionare. The examinations were performed in standardised conditions during similar day times. We found significant difference in two-point discrimination in the area between the shoulder blades with significance level α = 5 % and p-value p = 0,0001. A statistically significant difference was also observed in body self-concept with significance level α = 5 % and p-value p = 0,017. Thus we conclude that patients suffering from anorexia nervosa...

The diploma thesis is focusing on the topic of eating disorders in young men. The literature review summarizes the current information concerning eating disorders in this population. Eating and feeding disorders included in DSM - 5 are described. The thesis also focuses on orthorexia nervosa and muscle dysmorphia. A separate chapter deals with body image in men and its connection to eating disorders. The final chapter of the literary review section is focused on the possibilities of diagnostics and therapy. The empirical part of the work consists of a quantitative research conducted on a sample of 164 men aged 18-30 years. A questionnaire survey was carried out. Using Spearman's correlation coefficient, a significant correlation was found between the symptomatology of eating disorders and muscle dysmorphia. There was also a significant correlation between Body Mass Index and the symptoms of eating disorders and also between BMI and muscular dysmorphia. Data analysis revealed a positive correlation between the higher symptomatology of eating disorders and dissatisfaction with the amout of body fat. No significant relationship was found between the symptomatology of eating disorders and dissatisfaction with muscle mass. There was a significant correlation between Body Mass Index and dissatisfaction...

(AJ) Adipose tissue produces numerous adipokines, pro- and antiinflammatory cytokines and hormones which may influence the development of insulin resistance, type 2 diabetes mellitus and other comorbidities of the metabolic syndrome. The ability of adipose tissue to store lipids and thus protect other organs and tissues from ectopic lipid accumulation and development of insulin resistance (IR) is largely dependent on the adipogenic potential of preadipocytes. The amount and function of these cells may be the key factor in creating "healthy" adipose tissue or on the contrary "unhealthy" adipose tissue eventually leading to metabolic derangements. The regulation of the amount of body fat by converting preadipocytes into mature adipocytes may be crucial in the prevention and treatment of obesity and its comorbidities. One of the reasons for development of insulin resistance can be the inhibition of the differentiation process of preadipocytes into mature adipocytes with consequent ectopic lipid accumulation caused by the secretion of preadipocyte factor - 1 (Pref - 1). Pref - 1 has been discovered recently as a protein produced by preadipocytes but not by mature adipocytes. Pref - 1 is a member of the protein family sharing similarity with epidermal growth factors which regulate the differentiation of...

Title: Kinesiotherapy in the treatment of patients with eating disorders Summary: The aim of our experiment was evaluate the effect of kineziotherapy (psychomotor therapy) on body image in the treatemnet of the patiens with eating disorders in The Department of Psychiatry on General University Hospital in Prague. The study included 10 women divided into two groups according to the psychiatrist`s diagnosis of anorexia nervosa and bulimia nervosa. The effectiveness of kinesiotherapy was also evaluated about the type of treatment - inpatient of the department for eating disorders and outpatient of the day care institution for eating disorders. We used a validated questionnaire Body Attitude Test (BAT) which is used for negative evaluation of body size, lack of familiarity with one`s own body and general body dissatisfaction. Then we used Test of silhouette according to Stunkard and Test for the evaluation of sensory stimuli according to Petrie. Due to the small sample size, we supplemented the quantitative part with the qualitative interview with open questions. It allowed us to understand the interaction of individuals with their own body. Keywords: anorexia nervosa, bulimia nervosa, kinesiotherapy, psychomotor therapy, body image, Body Attitude Test, Petrie`s test, Stunkard`s test of silhouette, structured...

Despite well-established diagnostic measures and measures of specific dimensions of eating disorder symptomatology, little work has been done to develop a brief, comprehensive, and valid measure for assessing change in eating disorder symptoms. Further, empirically-supported change indices to assess treatment progression and outcome have not yet been developed. The Change in Eating Disorder Symptoms Scale (CHEDS) is a new comprehensive measure designed to assess progress and change during treatment in persons with diagnoses on the eating disorder spectrum. Previous studies have demonstrated the subscale structure, reliability, and validity of the CHEDS. This study determined clinically significant change criteria for the CHEDS to complement the studies that have supported the CHEDS as a reliable and valid measure of eating disorder symptomatology. The CHEDS was also compared to a life functioning scale, the Clinical Impairment Assessment. A reliable change index (RCI) was developed, which generated an inferential statistic that estimates the magnitude of change in a score necessary for a change score to be considered statistically reliable. A cutscore was also developed, which differentiates between functional and dysfunctional populations, between eating disordered clinical subjects and non-clinical subjects. Trajectories were identified using hierarchical linear modeling methods for use in conjunction with clinical significance criteria to aid in the tracking of symptoms during treatment, treatment decision-making, and tailoring treatment according to expected and observed progress. The clinical significance change criteria were then applied to the clinical sample to determine change patterns descriptive of recovered, reliable improvement, deterioration, and no change. Finally, a scoring program with clinical significance change criteria and trajectory analyses for total and subscale scores was developed.