8 However, more recent studies have attempted to identify neural correlates of this condition by means of electrophysiological or neuroimaging techniques. So far, the main explanation for this phenomenon has been in favor of a psychological/psychiatric etiology:a pathological desire driven by a sexual compulsion. 2 Thanks to this survey, which included 52 volunteers, a number of key features of the condition are identified: gender prevalence (most individuals are men), side preference (left-sided amputations are most frequently desired), and finally, a preference toward amputation of the leg versus the arm. 7 Another milestone was a 2005 study by Michael First, an American psychiatrist, who published the first systematic attempt to describe individuals who desire amputation of a healthy limb.
7 However, the first scientific report of this desire only appeared in 1977: Money et al described two cases who had intense desire toward amputation of a healthy limb. These letters were from erotically-obsessed persons who wanted to become amputees themselves.
#BODY INTEGRITY IDENTITY DISORDER SERIES#
6Ī first description of this condition traces back to a series of letters published in 1972 in the magazine Penthouse. 5 Nonetheless, all of these cases share the urgency to permanently damage an apparently intact body. 4 More rare are reports of individuals who seek a sensory deprivation, such as blindness or deafness. Further, some of these individuals seek to be paraplegic. 2 Importantly, in most individuals, the target limb for amputation is not affected by sensory impairments, such as severe pain or sensory defects (McGeoch et al 2011, 3 reporting normal neurological examination). Recent studies show that this preserving behavior is reduced in some individuals who desire the amputation of a healthy limb, instead of actively avoiding body damage. Not surprisingly, most people fear the idea of losing a leg or an arm, or any other violation of the body’s external form. Control over the environment is highly diminished by physical damage to the body: everyday life activities of people with spinal cord injuries or limb amputations, for example, become more challenging. Thanks to these actions, we can drink water when thirsty and leave a room if we see a fire starting. Interacting with the environment to achieve our goals implies mainly motor actions, such as grasping objects or walking to change position.
Keywords: BIID, limb amputation, somatoparaphrenia, body representation, body ownership A proposal is made to adopt a multidisciplinary approach that comprises state-of-the-art technologies and a variety of theoretical models, including both body representation and psychological and sexual components. Finally, future directions and ethical implications are discussed. The paradigms adopted and the clinical features are compared across studies and analyzed in detail. The main etiological hypotheses are presented, from the psychological/psychiatric to the most recent neurologic explanation. Since 1977, case reports and group studies have been produced, trying to understand the cause of this unusual desire. 1Department of Behavioral and Brain Sciences, University of Pavia, Pavia, 2Cognitive Neuropsychology Laboratory, Niguarda Ca’ Granda Hospital, Milan, ItalyĪbstract: This review summarizes the available studies of a rare condition in which individuals seek the amputation of a healthy limb or desire to be paraplegic.
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