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Archives of Assessment Psychology

Abstract

Objective:Body integrity dysphoria (BID; also known as body integrity identity disorder, xenomelia, amputee identity disorder, or apotemnophilia) describes a very rare condition in which non-disabled people feel a desire or need for a physical disability (e.g., amputation, paralysis, or blindness). BID is included in the new version of ICD-11 (6C21: body integrity dysphoria), but, thus far, we are without a standard test of whether a subject suffers from BID and, if so, at what intensity. Accordingly, this study aimed to develop an inventory for the assessment of BID. Methods: We created a questionnaire comprising 80 items covering the desire for amputation alongside possible incongruities between an individual’s mental image of themselves and their actual physical condition and appearance. The questionnaire assesses six dimensions of the respondent’s experience: 1. Influence of BID on day-to-day life, work, and dreams (12 items); 2. Perceived need for a disabled body (13 items); 3. Influence of BID on relationships and sexuality (7 items); 4. Influence of BID on emotions (10 items); 5. Development of BID in childhood and adolescence (4 items); 6. Coming out, interaction with others, official certification (6 items). Results: We collected data from 213 BID sufferers (a comprehensive sample size, considering the rarity of the disorder). The findings show a significant difference (p < .05) in subjectively perceived psychological distress between those expressing a desire for amputation, palsy, or other desires. We further identified significant coherence between the severity of the disorder and the age of manifestation, number of therapeutic options attempted, and presence of an erotic component. The findings enabled us to develop a classification of severity for BID that will prove valuable to the diagnosis of the disorder and selection of therapeutic options.

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