Anorexia Nervosa and Somatoform Dissociation: A Neglected Body-Centered Perspective

• Published in: Journal of trauma & dissociation Vol. 24; no. 1; pp. 141 - 156
• Main Authors: Longo, Paola, Marzola, Enrica, Martini, Matteo, Amodeo, Laura, Abbate-Daga, Giovanni
• Format: Journal Article
• Language: English
• Published: England Routledge 01.01.2023; Taylor & Francis Ltd
• Subjects: Anorexia; Anorexia Nervosa; Anxiety; Anxiety Disorders; Body image; Child; Child abuse & neglect; Childhood; childhood trauma; depression; Disorders; Dissociative Disorders; Eating disorders; Feeding and Eating Disorders; Female; Gender differences; Human body; Humans; Male; Patients; psychoform dissociation; Psychopathology; Somatoform disorders; somatoform dissociation; Trauma; anxiety; childhood trauma; Eating disorders; somatoform dissociation; body image; depression; psychoform dissociation
• ISSN: 1529-9732; 1529-9740
• DOI: 10.1080/15299732.2022.2119631

Dissociation in anorexia nervosa (AN) is common (literature reported 29% of dissociative disorders in eating disorders) and higher in patients with binge-purging AN (BP-AN) than in those with restricter AN (R-AN). However, the distinction between somatoform (SomD) and psychoform dissociation (PsyD) is understudied. We aimed to assess the differences in PsyD and SomD, eating-related, general, and body-related psychopathology, and childhood trauma between subtypes of AN. Then, we attempted to describe a subgroup of patients with AN with marked SomD comparing them to patients without SomD, also controlling the results for PsyD and AN subtypes. Inpatients with AN (n = 111; 109 women and 2 men) completed self-reported questionnaires evaluating dissociation, eating-related, body-related, and general psychopathology, and childhood abuses. Patients with BP-AN reported higher SomD and PsyD and a more severe clinical picture than those with R-AN. The SomD-group (n = 41) showed higher eating concerns, trait-anxiety, body-related variables, and sexual/physical abuse compared to the no-SomD group (n = 70), independently of AN subtype and PsyD symptoms. Results described particular features of patients with AN and SomD. Data, clinically, suggest a careful assessment, for both SomD and PsyD, especially when a history of bodily-impacting trauma is present, potentially fostering dissociation-informed interventions.