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      La corporalidad funcional como meta terapéutica en el trabajo cognoscitivo-comportamental de los trastornos de la imagen corporal en los TCA: una reconceptualización Translated title: Body Functionality as a Therapeutic Goal for Cognitive Behavioral Work on Body Image Distortion in Eating Disorders

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          Abstract

          Introducción: El artículo propone el concepto de corporalidad funcional como meta terapéutica para las alteraciones de la imagen corporal en los TCA, enfatizando sus implicaciones clínicas y adaptativas. Método: A partir de la revisión sistemática de la literatura disponible y de la experiencia clínica, se planteó una nueva meta terapéutica para los problemas de la imagen corporal en TCA: la utilización funcional del cuerpo. Resultados: Se defi nió la corporalidad funcional como la “utilización del cuerpo acorde con las situaciones a las cuales el individuo se expone -como la mayoría de la gente lo haría en esa situación-, con un patrón coherente de respuestas cognoscitivas, autónomas y motoras”. La concordancia en los tres canales de respuesta se propone como indicador de éxito terapéutico. Conclusiones: La efectividad en las intervenciones para las alteraciones de la imagen corporal en TCA es inconsistente según la evidencia disponible. Se discuten las posibles razones y se propone cambiar el objetivo de la corrección de la insatisfacción o la distorsión de la imagen corporal hacia la funcionalidad en el manejo del cuerpo. Esta propuesta debe ponerse a prueba con estudios empíricos.

          Translated abstract

          Introduction: Body functionality is proposed as a therapeutic goal to treat distorted body image in eating disorders, with an emphasis on its clinical and adaptive implications. Method: Using a systematic review of the available literature and clinical experience, a new therapeutic goal is proposed for body image problems in eating disorders: the functional use of the body. Results: Body functionality is defi ned as “Using the body in a manner that is compatible with the various situations an individual may face, responding as most people would do in the same situation, with a coherent pattern of cognitive, autonomous, and motor responses”. Coherence between the three areas of response is proposed as an indicator of therapeutic success. Conclusions: Based on the available evidence, the effectiveness of interventions for altered body image in eating disorders is inconsistent. Possible reasons for this are discussed and it is proposed that the objective be changed from correction of the dissatisfaction or distortion of the body image to functionality in the way the body is used. This proposal should be tested using empirical studies.

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          Most cited references36

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          The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: a meta-analysis.

          Although body-image disturbance is among the diagnostic criteria for anorexia nervosa and bulimia nervosa, the nature and extent of this disturbance have not been precisely identified. This is the purpose of this first meta-analysis of extant research on body image and eating disorders. Using contemporary techniques, the meta-analysis systematically examined 66 studies (from 1974 to 1993) of perceptual and attitudinal parameters of body image among anorexics and bulimics relative to control groups. Attitudinal body dissatisfaction, both questionnaire and self-ideal discrepancy measures, produced substantially larger effect sizes than did perceptual size-estimation inaccuracy. Body dissatisfaction measures, whether global or weight/shape related, differentiated bulimic and anorexic groups (with bulimics having more dissatisfaction), whereas perceptual distortion indices did not. Somewhat larger effects occurred with whole-body than with body-part size-estimation assessments. Size distortion among patients with eating disorders appears unlikely to reflect a more generalized sensory/perceptual deficit. Scientific, conceptual, and clinical implications of these findings are delineated.
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            Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings.

            Recent findings implicate body dissatisfaction in the development and maintenance of eating pathology. This paper reviews theory and empirical findings regarding the putative origins and consequences of body dissatisfaction because recent findings have not been synthesized or critically evaluated and because these findings have key etiologic and prevention implications. A computer-assisted literature review was conducted to locate relevant prospective and experimental studies. There is evidence that perceived pressure to be thin, thin-ideal internalization and elevated body mass, but not early menarche, increase the risk for subsequent body dissatisfaction. There is also consistent support for the assertion that body dissatisfaction is a risk factor for eating pathology and that this relation is mediated by increases in dieting and negative affect. This review provides support for the claim that sociocultural processes foster body dissatisfaction, which in turn increase the risk for bulimic pathology, and suggests that prevention and treatment interventions might be enhanced by focusing greater attention on body image disturbances. Copyright 2002 Elsevier Science Inc.
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              Body checking and its avoidance in eating disorders.

              One expression of the core psychopathology of eating disorders is the repeated checking and avoidance of shape or weight. Two studies are reported. The primary purpose of the first was to describe the phenomenology of such body checking and avoidance. The aim of the second was to compare body checking and avoidance in women with and without a clinical eating disorder. In Study 1, 64 female patients with clinical eating disorders participated in a semistructured interview assessing the features of body checking and avoidance. In the second study, a self-report questionnaire was used to compare body checking and avoidance in women with and without a clinical eating disorder (n = 110). The majority (92%) of the patients in Study 1 checked their bodies to assess their shape or weight and this was associated significantly with eating disorder symptoms. In Study 2, the clinical group had significantly more body checking and avoidance than the comparison group, and there was a strong association between eating disorder psychopathology and body checking and avoidance. These findings support the view that body checking and avoidance are direct expressions of the overevaluation of shape and weight. Further work is needed to determine whether these expressions contribute to the maintenance of eating disorders. Copyright 2003 by Wiley Periodicals, Inc. Int J Eat Disord 35: 93-101, 2004.
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                Author and article information

                Journal
                rcp
                Revista Colombiana de Psiquiatría
                rev.colomb.psiquiatr.
                Asociacion Colombiana de Psiquiatria. (Bogotá, Distrito Capital, Colombia )
                0034-7450
                September 2007
                : 36
                : 3
                : 451-459
                Affiliations
                [01] Bogotá orgnamePontificia Universidad Javeriana Colombia jgempeler@ 123456cable.net.co
                Article
                S0034-74502007000300006 S0034-7450(07)03600306
                13a27997-bb55-4071-9399-01854b672daa

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 25 May 2007
                : 10 July 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 9
                Product

                SciELO Colombia

                Categories
                Articulo Original

                body image,imagen corporal,cambios en el peso corporal,trastornos de la conducta alimentaria,body weight changes,Eating disorders

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