ANOREXIA NERVOSA AND SOMATOFORM DISSOCIATION: a NEGLECTED BODY-CENTERED PERSPECTIVE

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.

Automated summary

Dissociation is common in patients with anorexia nervosa, especially in those with binge-purging subtype. However, the difference between somatoform and psychoform dissociation has not been well studied. This study aimed to assess the differences in somatoform and psychoform dissociation, psychopathology, and childhood trauma between anorexia nervosa subtypes, and to describe a subgroup of patients with marked somatoform dissociation. The findings suggest the importance of assessing dissociation, especially in individuals with a history of bodily-impacting trauma.