#7146 Preliminary fMRI findings investigating a predictive coding model for the implicit psychogenesis of eating disorders and functional motor disorders
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Patients with the most severe and complex personality disorder have trans-diagnostic presentations including Eating Disorders (ED) and Conversion Disorder (CD). The aim of the fMRI study summarised in this poster presentation was to investigate a hypothesis that somatic presentations in this patient group are stimulated by unconscious defences (defined psychoanalytically), which disrupt the Sense of Body Ownership in those with PD and ED and the Sense of Agency in those with PD and CD. Two groups of patients, one group with CD and the other ED, were compared with asymptomatic controls on diagnostic and psychometric measures and a filmed psychoanalytic interview which was independently rated (total n = 88). The analytic interview identified unconscious defences thought to be related to the development of CD or ED symptoms using the Operationalised Psychodynamic Diagnosis (OPD-2) (Task-Force, 2008). A Q-sort task (The Maladaptive Interpersonal Relations Q-Sort) identified maladaptive relational patterns participants were consciously aware of (Zimmermann et al., 2014). Before scanning each participant identified and recorded two neutral memories, two consciously maladaptive memories derived from the Q-sort and two memories related to the participant’s unconscious defences derived from the analytic interview. The Interpersonal Relations Picture Set fMRI paradigm was used to present schematic relational pictures in the scanner each being a cue to recall each specific memory (Fuchs et al., 2018). The findings: The CD group showed reduced activation in the right head of the Caudate nucleus (implicated in initiation of movement) following the unconscious stimulus but not the conscious condition. The ED group showed reduced activation in the right Angular Gyrus (implicated in the Sense of Body Ownership and Self-Other distinction) in the unconscious but not the conscious condition. The hypothesis will be discussed with implications for our understanding of the psychogenesis of somatic symptoms. References Fuchs S, Bohleber LM, Ernst J, Soguel-dit-Piquard J, Boeker H, Richter A. One look is worth a thousand words: new picture stimuli of interpersonal situations. Social Neuroscience 2018;13(3):346–354. Task-Force O. Operationalized psychodynamic diagnostics (OPD). In manual of diagnosis and treatment planning. Hogrefe & Huber Kirkland 2008. Zimmermann J, Stasch M, Grande T, Schauenburg H, Cierpka M. Maladaptive interpersonal patterns q-sort (mipqs): a self-report method for assessing maladaptive interpersonal patterns based on operationalized psychodynamic diagnosis. Zeitschrift Fur Psychiatrie Psychologie Und Psychotherapie 2014;62(1):43–53.
Author: Caroline Susan Mizen
Institution: Devon Partnership NHS Trust
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4407111400