Bodily intolerance of uncertainty: Towards an understanding of how adolescent girls with anorexia nervosa experience their body

In the current thesis, we showed that adolescent girls with AN have disturbances in their body representation that are similar to those observed in adults with AN. We also demonstrated that, in accordance with findings in adults with AN, adolescent girls with AN have higher levels of IU. Moreover, we observed an interplay between body representation disturbances, IU, and bodily experiences. This led to the conceptualization of the construct bodily IU and the development of the BIUQ to assess this construct. Processing body-related information effectively is crucial for developing a healthy body representation. In individuals with AN, body-related information is suggested to be compromised in many ways, with relevant implications for their emotional and social processing (Barca & Pezzulo, 2020). Current findings confirm that adolescents with AN have a distorted mental body representation and highlight the contribution of IU to several domains of body representation. Specifically, bodily IU is an important novel approach to understanding complexity of a distorted body representation, in both AN and other populations. Future research should examine bodily IU and its association with body representation in other psychiatric groups (i.e., binge eating disorder and body dysmorphic disorder), and across life span. Specifically during adolescence the body evolves through many physical changes in a short period of time. These changes are by nature uncertain (e.g., unpredictable changes in shape and weight). Possibly, someone who is intolerant to these specific bodily uncertainties may experience considerable anxiety distress during this developmental trajectory. Additionally, the BIUQ may be useful as a quick and easy-to-administer screening tool for clinicians that may contribute to understanding the nature of specific BID. As such, this information may inform what types of uncertain situations are distressing to an individual, which could subsequently facilitate case conceptualization and treatment planning. In treatment, AN patients will work with uncertainties within the domain of the body. High levels of bodily IU may be problematic as changes to the body are inherently related to the success of the treatment. Therefore, it may be important to find out whether uncertainties within the domain of the body are indeed driven by bodily IU. If so, these higher levels of bodily IU could be targeted during treatment. Further research is undoubtedly needed to explore methods for addressing bodily IU and to determine the most effective ways to incorporate these methods into existing treatment programs. In sum, this thesis makes a significant contribution to understanding how the body is experienced in adolescent girls with AN.