Impaired configural body processing in anorexia nervosa: evidence from the body inversion effect

Patients with anorexia nervosa (AN) suffer from severe disturbances of body perception. It is unclear, however, whether such disturbances are linked to specific alterations in the processing of body configurations with respect to the local processing of body part details. Here, we compared a consecutive sample of 12 AN patients with a group of 12 age-, gender- and education-matched controls using an inversion effect paradigm requiring the visual discrimination of upright and inverted pictures of whole bodies, faces and objects. The AN patients presented selective deficits in the discrimination of upright body stimuli, which requires configural processing. Conversely, patients and controls showed comparable abilities in the discrimination of inverted bodies, which involves only detail-based processing, and in the discrimination of both upright and inverted faces and objects. Importantly, the body inversion effect negatively correlated with the persistence scores at the Temperament and Character Inventory, which evaluates increased tendency to convert a signal of punishment into a signal of reinforcement. These results suggest that the deficits of configural processing in AN patients may be associated with their obsessive worries about body appearance and to the excessive attention to details that characterizes their general perceptual style.