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Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID)

Received: 28 July 2014     Accepted: 18 August 2014     Published: 30 August 2014
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Abstract

People suffering from Body Integrity Identity Disorder (BIID) feel the intense desire for a physical disability (e.g. amputation or palsy of a limb). The suffering is caused by a divergence between their intact real body and their desired mental self-image of a disabled person. Aim of this pilot-study was to answer the question, whether psychotherapy can help to prevent the desire for amputation or palsy. Methods: A questionnaire was developed to investigate experiences with psychotherapy in BIID-patients. These people were asked about the success of different psychological and psychopharmacological types of therapy. Respondents stated whether they experienced an increase or decrease of their desire for amputation or palsy due to the specific kind of therapy and to what extent their psychological strain had been changed after therapy. Results: BIID is a very rare disturbance; still 25 people were investigated in this study. 32% had psychopharmacological treatment, 24% had cognitive behavioral therapy, 20% psychodynamic therapy, 20% had trained a relaxation technique, 8% had counseling therapy and 4% had experiences with art- and body-centered exercise therapies. In contrast to our hypothesis, all therapy-methods tended to cause an increase of the desire for obtaining a disability. A higher number of therapy sessions was positively correlated with an increased desire for an amputation, paralysis or other disability. On the other hand, the psychological strain in relation to BIID was reduced by all types of therapies; the highest reduction could be reached with psychodynamic therapy. Conclusion: Psychotherapy can reduce the psychological strain in BIID affected persons. The fact that the desire to obtain a disability increases during the therapy is explained as a result of an intense exchange about BIID with the therapist.

Published in American Journal of Applied Psychology (Volume 3, Issue 5)
DOI 10.11648/j.ajap.20140305.11
Page(s) 110-115
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Body Integrity Identity Disorder, Amputee Identity Disorder, Xenomelia, Body Incongruence Disorder, Psychotherapy, Amputation, Palsy

References
[1] Bayne T & Lewy L, “Amputees by choice: Body integrity identity disorder and the ethics of amputation” Journal of Applied Philosophy 2005, 22 (1): pp. 75–86.
[2] Braam AJ, Visser S, Cath DC & Hoogendijk WJG, “Investigation oft he syndrome of Apotemnophilia and course of a cognitive-behavioral therapy. Psychopathology. “2006; 39: pp 32-37
[3] Brang D, McGeoch PD, Ramachandran VS, „Apotemnophilia: aneurological disorder”. Cognitive Neuroscience and Neuropsychology. 2008; 19: pp 1305–1306
[4] First MB, “Desire for amputation of a limb: paraphilia, psychosis or a new type of identity disorder”. Psychological medicine. 2005; 34: pp 1-10.
[5] Kasten, E, „Body Integrity Identity Disorder - Körperidentität durch erwünschte Behinderung. Psychiatrie und Psychotherapie up2date“. 2012, 6: pp 1-11
[6] Kasten, E. & Spithaler, F, “Body Integrity Identity Disorder: Personality Profiles and Investigation of Motives.” In: A. Stirn, A. Thiel & S. Oddo (Eds.) Body Integrity Identity Disorder. Pabst Science Publishers, 200: pp. 20–40.
[7] Kasten, E. & Stirn, A, „Wechselnder recht:links-Amputationswunsch bei Body Integrity Identity Disorder (BIID).“ Zeitschrift für Psychiatrie, Psychotherapie und Psychologie. 2009; 57: pp. 55-61.
[8] McGeoch PD, Brand DJ, Song T, Lee RR, Huang M, & Ramachandran VS, “Apotemnophilia: The Neurological Basis of „Psychological Disorder”. Nature Precedings. 2009: pp 1-5.
[9] Moosbrugger H. & Kelava,A, „Testtheorie und Fragebogenkonstruktion“, 2. Aufl., 2012, Springer Verlag.
[10] Müller S, „Dieses Bein will ich nicht.“ Gehirn & Geist. 2007; 7-8: pp 66-70.
[11] Neff D & Kasten E, “Body Integrity Identity Disorder (BIID): What do health care professionals know?” European Journal of Counseling Psychology. 2010, 1(2): pp 16-30.
[12] Noll, S, „Body Integrity Identity Disorder (BIID) – Kann eine Amputation/Operation Betroffenen langfristig helfen?“ Bachelor-Arbeit, Universität Hildesheim, Institut f. Psychologie, 2011.
[13] Oddo S, Thiel A, Skoruppa S, Klinger D, Steis N, Markowitsch HJ, & Stirn A, “Neurobiological and psychological aspects of BIID – an integrative approach”. In: A. Stirn, A. Thiel, S. Oddo (Eds.): Body Integrity Identity Disorder: Psychological, Neurobiological, Ethical and Legal Aspects. 2009: pp 238-246. Lengerich: Pabst.
[14] Ryan CJ, ”Out on a limb: The ethical management of body integrity identity disorder”. Neuroethics, 2009, 2 (1): pp 21-33.
[15] Spithaler F., Kasten E, „Internet-Befragung zur Häufigkeit von Veränderungen der Körperwahrnehmung.“ Zeitschrift für Medizinische Psychologie, 2012, 21(1): pp 39-47.
[16] Stirn, A., Thiel, A., Oddo, S, “Body Integrity Identity Disorder (BIID) - Störungsbild, Diagnostik, Therapieansätze“, 1. Aufl., Beltz Verlag, 2
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Cite This Article
  • APA Style

    Katharina Kröger, Thomas Schnell, Erich Kasten. (2014). Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID). American Journal of Applied Psychology, 3(5), 110-115. https://doi.org/10.11648/j.ajap.20140305.11

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    ACS Style

    Katharina Kröger; Thomas Schnell; Erich Kasten. Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID). Am. J. Appl. Psychol. 2014, 3(5), 110-115. doi: 10.11648/j.ajap.20140305.11

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    AMA Style

    Katharina Kröger, Thomas Schnell, Erich Kasten. Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID). Am J Appl Psychol. 2014;3(5):110-115. doi: 10.11648/j.ajap.20140305.11

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  • @article{10.11648/j.ajap.20140305.11,
      author = {Katharina Kröger and Thomas Schnell and Erich Kasten},
      title = {Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID)},
      journal = {American Journal of Applied Psychology},
      volume = {3},
      number = {5},
      pages = {110-115},
      doi = {10.11648/j.ajap.20140305.11},
      url = {https://doi.org/10.11648/j.ajap.20140305.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajap.20140305.11},
      abstract = {People suffering from Body Integrity Identity Disorder (BIID) feel the intense desire for a physical disability (e.g. amputation or palsy of a limb). The suffering is caused by a divergence between their intact real body and their desired mental self-image of a disabled person. Aim of this pilot-study was to answer the question, whether psychotherapy can help to prevent the desire for amputation or palsy. Methods: A questionnaire was developed to investigate experiences with psychotherapy in BIID-patients. These people were asked about the success of different psychological and psychopharmacological types of therapy. Respondents stated whether they experienced an increase or decrease of their desire for amputation or palsy due to the specific kind of therapy and to what extent their psychological strain had been changed after therapy. Results: BIID is a very rare disturbance; still 25 people were investigated in this study. 32% had psychopharmacological treatment, 24% had cognitive behavioral therapy, 20% psychodynamic therapy, 20% had trained a relaxation technique, 8% had counseling therapy and 4% had experiences with art- and body-centered exercise therapies. In contrast to our hypothesis, all therapy-methods tended to cause an increase of the desire for obtaining a disability. A higher number of therapy sessions was positively correlated with an increased desire for an amputation, paralysis or other disability. On the other hand, the psychological strain in relation to BIID was reduced by all types of therapies; the highest reduction could be reached with psychodynamic therapy. Conclusion: Psychotherapy can reduce the psychological strain in BIID affected persons. The fact that the desire to obtain a disability increases during the therapy is explained as a result of an intense exchange about BIID with the therapist.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID)
    AU  - Katharina Kröger
    AU  - Thomas Schnell
    AU  - Erich Kasten
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    PY  - 2014
    N1  - https://doi.org/10.11648/j.ajap.20140305.11
    DO  - 10.11648/j.ajap.20140305.11
    T2  - American Journal of Applied Psychology
    JF  - American Journal of Applied Psychology
    JO  - American Journal of Applied Psychology
    SP  - 110
    EP  - 115
    PB  - Science Publishing Group
    SN  - 2328-5672
    UR  - https://doi.org/10.11648/j.ajap.20140305.11
    AB  - People suffering from Body Integrity Identity Disorder (BIID) feel the intense desire for a physical disability (e.g. amputation or palsy of a limb). The suffering is caused by a divergence between their intact real body and their desired mental self-image of a disabled person. Aim of this pilot-study was to answer the question, whether psychotherapy can help to prevent the desire for amputation or palsy. Methods: A questionnaire was developed to investigate experiences with psychotherapy in BIID-patients. These people were asked about the success of different psychological and psychopharmacological types of therapy. Respondents stated whether they experienced an increase or decrease of their desire for amputation or palsy due to the specific kind of therapy and to what extent their psychological strain had been changed after therapy. Results: BIID is a very rare disturbance; still 25 people were investigated in this study. 32% had psychopharmacological treatment, 24% had cognitive behavioral therapy, 20% psychodynamic therapy, 20% had trained a relaxation technique, 8% had counseling therapy and 4% had experiences with art- and body-centered exercise therapies. In contrast to our hypothesis, all therapy-methods tended to cause an increase of the desire for obtaining a disability. A higher number of therapy sessions was positively correlated with an increased desire for an amputation, paralysis or other disability. On the other hand, the psychological strain in relation to BIID was reduced by all types of therapies; the highest reduction could be reached with psychodynamic therapy. Conclusion: Psychotherapy can reduce the psychological strain in BIID affected persons. The fact that the desire to obtain a disability increases during the therapy is explained as a result of an intense exchange about BIID with the therapist.
    VL  - 3
    IS  - 5
    ER  - 

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Author Information
  • Medical School Hamburg, University of Applied Sciences, Medical University, Am Kaiserkai 1, D-20457 Hamburg, Germany

  • Medical School Hamburg, University of Applied Sciences, Medical University, Am Kaiserkai 1, D-20457 Hamburg, Germany

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