Psychology and Behavioral Sciences
Volume 3, Issue 6, December 2014, Pages: 222-232
Received: Nov. 22, 2014;
Accepted: Dec. 5, 2014;
Published: Dec. 16, 2014
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Sarah Noll, Institute of Psychology, Hildesheim, Germany; Dept. Of Neuropsychology, Hamburg, Germany; University of Hildesheim, Hildesheim, Germany; Medical School Hamburg, Hamburg, Germany
Erich Kasten, Institute of Psychology, Hildesheim, Germany; Dept. Of Neuropsychology, Hamburg, Germany; University of Hildesheim, Hildesheim, Germany; Medical School Hamburg, Hamburg, Germany
Background: People suffering from Body Integrity Identity Disorder feel the intensive wish for an amputation of one limb or another kind of handicap. Due to ethic and juristic reasons, the desired surgery is difficult to realize. In spite of these problems several patients were able to achieve the wished amputation, in most cases with a cash-paid surgery in a less developed country. Our study examined whether these patients are sufficient with the amputation in the long run. Methods: We found 21 operated BIID-people (18 men, 3 woman; 27 - 73 years old, average 53.5 years) and interviewed them with a questionnaire. Here, we asked e.g. about quality of life and mental states before and after their surgery, the integration into the social environment, changes of their own dreams, the desire for further surgery and the presence of phantom sensations. Results: Psychological therapy, psychopharmacological medication, and relaxation techniques have had little effect and sometimes increased the desire. None of the patients regretted the surgery and a change for the better was seen in almost all areas of life. There were several problems regarding the quality of life, but they were estimated as bearable in contrast to the happiness to have fulfilled the wish. Many told their closer family members the true reasons of their amputation. Phantom limb feelings were reported, what contradicts the theory of BIID as a limb not embedded in the brain’s body-schema. After the operation most of the participants dreamed of themselves with an amputated body. The majority of the interviewee did not want further restrictions. Conclusions: These results point to the fact that the often assumed negative consequences of an amputation or further surgery do not occur. Thus, a realization of the wish of a person affected by BIID could be a possible form of therapy for patients, when other therapies have shown no effects.
Body Integrity Identity Disorder (BIID): How Satisfied are Successful Wannabes, Psychology and Behavioral Sciences.
Vol. 3, No. 6,
2014, pp. 222-232.
R. Barnes, “The bizarre request for amputation”, The International Journal of Lower Extremity Wounds, 10(4), 2011, pp 186-189.
P. Brugger, “The wish for amputation – bizarre quirk or neurological disorder?“, Transl. J. Ars medici, 2, 2011, pp 1-5. [Der Wunsch nach Amputation – Bizarre Macke oder neurologische Störung?]
M.B. First, “Desire for amputation of a limb: paraphilia, psychosis or a new type of identity disorder”, Psychological medicine, 34, 2005, pp 1-10.
M.B. First, and C.E. Fisher, “Body Integrity Identity Disorder: The persistent desire to acquire a physical disability”, Psychopathology, 45, 2012, pp 3-14.
G. Furth and R. Smith, “Apotemnophilia: Information, Questions, Answers, and Recommendations about self-demand Amputation”. Bloomington, IN: 1st Books Library, 2000.
A.J. Johnson, S.-L- Liew and L. Aziz-Zadeh, “Demographics, learning and imitation, and body schema in Body Integrity Identity Disorder”, Indiana University Undergraduate Journal of Cognitive Science, 6, 2011, pp 8-15.
E. Kasten, “Body Integrity Identity Disorder (BIID): Interrogation of people concerned and explanatory approaches”, Transl. J. Fortschritte der Neurologie und Psychiatrie, 77, 2009, pp 16-24 [Body Integrity Identity Disorder (BIID): Befragung von Betroffenen und Erklärungsansätze.].
E. Kasten and F. Spithaler, “Body Integrity Identity Disorder: personality profiles and investigation of motives,” in Body Integrity Identity Disorder, A. Stirn, A. Thiel and S. Oddo, Eds. Lengerich: Pabst Science Publishers, 2009, pp 20-40.
A. Stirn, A. Thiel and S. Oddo, “Body Integrity Identity Disorder: psychological, neurobiological, ethical and legal aspects”, Lengerich: Pabst, 2009.
A. Stirn, A. Thiel and S. Oddo, “Body Integrity Identity Disorder: clinical picture, diagnosis, therapeutic approaches”, Transl. B. Weinheim: Beltz, 2010. [Body Integrity Identity Disorder: Störungsbild, Diagnostik, Therapieansätze].
I. Martin, „Mancophilia – appearance and interactions“, Transl. B. Maintal: Homo-Mancus, 2010. [Mancophilie – Erscheinungsformen und Interaktionen].
W. Everaerd, “A case of apotemnophilia: a handicap as sexual preference”, American Journal of Psychiatry, 37(2), 1983, pp 285-293.
J. Money and K.W. Simcore, “Acrotomophilia, sex and disability: new concepts and case report”, Sexuality and Disability, 7(12), 1986, pp 43-50.
V.S. Ramachandran, D. Brang, P.D. McGeoch and W. Rosar, “Sexual and food preference in apotemnophilia and anorexia: interactions between 'beliefs' and 'needs' regulated by two-way connections between body image and limbic structures”, Perception, 38(5), 2009, pp 775-777.
P.D. McGeoch, D. Brang, T. Song, R.L. Lee, M. Huang and V.S. Ramachandran, “Xenomelia: a new right parietal lobe syndrome”, JNNP, DOI, 10.1136/jnnp-2011-300224, 2011.
F. Spithaler and E. Kasten, “epidemiological examination of the incidence of changes in body perception“, Transl. J. Zeitschrift für Medizinische Psychologie, 2012. [Epidemiologische Untersuchung der Inzidenz von Veränderungen der Körperwahrnehmung].
D. Neff and E. Kasten, “Body Integrity Identity Disorder (BIID): What do health care professionals know?”, European Journal of Counselling Psychology, 1(2), 2009, pp 16-30.
D. A. Veale, “Compelling Desire for Deafness”, The Journal of Deaf Studies and Deaf Education, 11(3), 2006, pp 369-372.
A.W. Braam, S. Visser, D.C. Cath and W.J.G. Hoogendijk, “Investigation of the syndrome of Apotemnophilia and course of a cognitive-behavioral therapy”, Psychopathology, 39, 2006, pp 32-37.
A.W. Braam and N. de Boer-Kreeft, “Case-Report – The ultimative relief: resolution of the apotemnophilia syndrome” in Body Integrity Identity Disorder, A. Stirn, A. Thiel and S. Oddo, Eds. Lengerich: Pabst Science Publishers, 2009, pp 70-78.
A, Thiel, S. Oddo, S. Skoruppa, J. Thiel, F. Ehni, D. Bennett and A. Stirn, “Psychotherapy- and psychometric research with BIID-sufferers”, in Body Integrity Identity Disorder: psychological, neurobiological, ethical and legal aspects, A. Stirn, A. Thiel, S. Oddo, Eds. Lengerich: Pabst, 2009, pp 58-69.
S. Müller, “BIID, is the wish for amputation an autonomic decision or a manifestation of a neurological disorder?”, Transl. B. in Normal-anders-krank? Akzeptanz, Stigmatisierung und Pathologisierung im Kontext der Medizin, D. Groß, S. Müller & J. Steinmetzer, Eds. Berlin: Medizinisch wissenschaftliche Verlagsgesellschaft, 2008, pp 229-2669. [BIID, ist der Amputationswunsch eine autonome Entscheidung oder Ausdruck einer neurologischen Störung?].
T. Bayne and N. Levy, “Amputees by choice: Body Integrity Identity Disorder and the ethics of amputation”, Journal of Applied Psychology, 22(1), 2005, pp 75-85.
J. Beckford-Ball, “The amputation of healthy limbs is not an option”, British Journal of Nursing, 9(4), 2000, pp 188.
A. Bridy, “Confounding extremities: surgery at the medico-ethical limits of self –modification”, The Journal of Law, Medicine & Ethics, 32(1), 2004, pp 148-158.
N. Levy, “Neuroethics”. Cambridge: University Press, 2007.
S. Müller, “Body Integrity Identity Disorder (BIID) – Is it possible to ethically justify the amputation of limbs?”, Transl. J. Ethik in der Medizin, 20(4), 2008, pp 287-299. [Body Integrity Identity Disorder (BIID) – Lassen sich Amputationen gesunder Gliedmaßen ethisch rechtfertigen?].
A. Manok, “Body Integrity Identity Disorder: the legitimacy of amputations of healthy limbs“, Transl. B. Leipzig: Leipziger Universitätsverlag, 2012. [Body Integrity Identity Disorder: Die Zulässigkeit von Amputationen gesunder Gliedmaßen aus rechtlicher Sicht].
K. Nitschmann, (2007). “Surgery for the soul?”, Transl. J. Zeitschrift für die gesamte Strafrechtswissenschaft, 119, 2007, pp 547-592. [Chirurgie für die Seele?]
D. Brang, P.D. McGeoch and V.S. Ramachandran, „Apotemnophilia: a neurological disorder”, Neuro Report, 19(13), 2008, pp 1305-1306.
A. Sedda, “Body Integrity Identity Disorder: from a psychological to a neurological syndrome”, Neuropsychology Review, 21(4), 2011, pp 334-336.
D. Vitacco, L. Hilti and P. Brugger, “A neurological account of Body Integrity Identity Disorder”, in Body Integrity Identity Disorder: psychological, neurobiological, ethical and legal aspects, A. Stirn, A. Thiel, S. Oddo, Eds. Lengerich: Pabst, 2009, pp 201-210.
V.S. Ramachandran, “Adventures in behavioral neurology—or—what neurology can tell us about human nature”, http://edge.org/ conversation/ adventures_behavioral_neurology, 2012.
P. Brugger, “The phantom limb in dreams”, Consciousness and cognition, (17), 2008, pp 1272-1278.
O. Sacks, “A Leg to Stand On”. London: Gerald Duckworth & Co. Ltd, 1984.
E. Kasten and A. Stirn,. “The wish for an amputation changes from the right to the left site in Body Integrity Identity Disorder”, Transl. J. Zeitschrift für Psychiatrie, Psychotherapie und Psychologie, 57, 2009, pp 55-61. [Wechselnder rechts-links-Amputationswunsch bei Body Integrity Identity Disorder (BIID)].